Orthopaedic Trauma Surgery: Volume 2: Lower Extremity Fractures and Dislocation

Description

This book adopts the principle of guiding surgery by anatomy, fixation by biomechanics, and clinical procedures by functional recovery. In each chapter, the applied anatomy of the fracture site is first introduced, which confers prominence to the relationship between the anatomical structure and surgery and emphasizes the structure that must be protected and repaired during surgery. In addition, the biomechanical characteristics of the fracture site are described, so that the appropriate fixation method can be selected according to the characteristics of the mechanical environment. In most chapters on periarticular fractures, the book also describes in detail how the joints fulfil their function, which is often the core of clinical decision-making, with the hope that the reader can understand the how and the why. This book adopts the outline-style format instead of the traditional paragraph-by-paragraph discussion to supply readers with the "extracted essence" in a more succinct manner, which improves the logical flow and concision and thereby improves the readability of the book. In addition, using more than 3,000 illustrations and photos in 3 volumes, many of which were obtained from our clinical practice, the book discusses injury mechanisms and the classification and assessment of extremity and axial skeleton fractures, with a focus on typical and new surgical methods developed in recent years. These illustrations and photos provide the reader with a good reference for learning surgical techniques and skills. This second volume is focusing on lower extremity fractures in 12 chapters. Foreword Preface Contents Contributors 1: Hip Dislocations and Femoral Head Fractures 1.1 Basic Theory and Concepts 1.1.1 Overview 1.1.2 Applied Anatomy 1.1.3 Mechanism of Injury 1.1.4 Classification of Femoral Head Fractures and Hip Dislocations 1.1.5 Assessment of Hip Dislocations and Femoral Head Fractures 1.1.5.1 Clinical Assessment 1.1.5.2 Imaging Assessment 1.2 Surgical Treatment 1.2.1 Closed Reduction Technique for Hip Dislocations 1.2.2 Indications and Purposes of Surgical Treatment 1.2.2.1 Indications 1.2.2.2 Purposes of Surgery 1.2.3 Surgical Techniques 1.2.3.1 Open Reduction and Internal Fixation for Femoral Head Fractures (The Smith-Petersen Approach) 1.2.3.2 Open Reduction and Internal Fixation for Femoral Head Fracture (The Kocher–Langenbeck Approach) 1.2.4 Surgical Complications and Preventive Measures References 2: Fractures of the Femoral Neck 2.1 Basic Theory and Concepts 2.1.1 Overview 2.1.2 Applied Anatomy 2.1.3 Mechanism of Injury 2.1.4 Classification of Femoral Neck Fractures 2.1.5 Assessment of Femoral Neck Fractures 2.1.5.1 Clinical Assessment 2.1.5.2 Imaging Assessment 2.2 Surgical Treatment 2.2.1 Surgical Indications and Purpose 2.2.1.1 Surgical Indications 2.2.1.2 Timing for Surgery 2.2.1.3 Purposes of Surgery 2.2.2 Surgical Techniques 2.2.2.1 Closed/Open Reduction and Internal Fixation for Femoral Neck Fractures 2.2.2.2 Hip Arthroplasty (The Posterolateral Approach) 2.2.3 Prevention and Treatment of Postoperative Complications of Fractures References 3: Intertrochanteric Fractures of the Femur 3.1 Basic Theory and Concepts 3.1.1 Overview 3.1.2 Applied Anatomy 3.1.3 Mechanism of Injury 3.1.4 Classification of Intertrochanteric Femoral Fractures 3.1.5 Assessment of Intertrochanteric Femoral Fractures 3.1.5.1 Clinical Assessment 3.1.5.2 Imaging Assessment 3.1.5.3 Evaluation of the Intertrochanteric Femoral Fracture Stability 3.1.5.4 Evaluation of Special Types of Fractures and Potentially Unstable Fractures (Fig. 3.8) 3.2 Treatment of Intertrochanteric Femoral Fractures 3.2.1 Conservative Treatments 3.2.2 Surgical Treatment 3.2.2.1 Basic Principles of Surgical Treatment 3.2.2.2 Selection of Surgical Treatment Methods 3.2.2.3 Surgical Techniques 3.2.2.4 Prevention and Treatment of Surgical Complications References 4: Subtrochanteric Femoral Fractures 4.1 Basic Theory and Concepts 4.1.1 Overview 4.1.2 Functional Anatomy 4.1.3 Mechanism of Injury and Fracture Classification 4.1.4 Assessment of Subtrochanteric Femoral Fractures 4.1.4.1 Clinical Assessment 4.1.4.2 Imaging Assessment 4.2 Surgical Treatment of Subtrochanteric Femoral Fractures 4.2.1 Surgical Indications 4.2.2 Surgical Options and Principles of Surgical Treatment 4.2.3 Surgical Techniques 4.2.3.1 Closed Reduction and Intramedullary Nail Fixation for Subtrochanteric Femoral Fractures 4.2.3.2 Open Reduction and Plate-Screw Fixation for Subtrochanteric Femoral Fractures 4.2.3.3 Experiences and Lessons 4.2.4 Surgical Complications and Their Prevention and Treatment References 5: Femoral Shaft Fractures 5.1 Basic Theory and Concepts 5.1.1 Overview 5.1.2 Applied Anatomy 5.1.3 Mechanism of Injury 5.1.4 Classification of Femoral Shaft Fractures 5.1.5 Assessment of Femoral Shaft Fractures 5.1.5.1 Clinical Assessment and Surgical Treatment 5.1.5.2 Imaging Assessment 5.2 Surgical Treatment 5.2.1 Surgical Indications 5.2.2 Femoral Shaft Fractures and Surgical Treatment (Roberts et al. 2005) 5.2.3 Selection of Final Internal Fixation Approaches 5.2.4 Surgical Techniques 5.2.4.1 Internal Fixation with Antegrade Intramedullary Nailing 5.2.4.2 Retrograde Intramedullary Nailing for Internal Fixation 5.2.4.3 Open Reduction and Internal Fixation of Femoral Shaft Fractures (The Lateral Approach) 5.2.5 Postoperative Complications and Their Prevention and Treatment Strategies References 6: Distal Femoral Fractures 6.1 Basic Theory and Concepts 6.1.1 Overview 6.1.2 Applied Anatomy 6.1.3 Mechanism of Injury (Collinge 2010) 6.1.4 Classification of Distal Femoral Fractures 6.1.5 Assessment of Distal Femoral Fractures 6.1.5.1 Clinical Assessment 6.1.5.2 Imaging Assessment 6.2 Surgical Treatment 6.2.1 Surgical Indications and Purposes 6.2.2 Surgical Techniques 6.2.2.1 Open Reduction and Internal Fixation of Distal Femoral Fractures Experience and Lessons 6.2.2.2 Retrograde Intramedullary Nailing for Proximal Femoral Fractures 6.2.3 Surgical Complications and Their Prevention and Treatment References 7: Patellar Fractures 7.1 Basic Theory and Concepts 7.1.1 Overview 7.1.2 Applied Anatomy 7.1.3 Mechanism of Injury (Bedi and Karunakar 2010) 7.1.4 Classification 7.1.5 Assessment of Patellar Fractures 7.1.5.1 Clinical Assessment (Bedi and Karunakar 2010) 7.1.5.2 Imaging Assessment 7.2 Surgical Treatment 7.2.1 Surgical Indications 7.2.2 Surgical Techniques 7.2.2.1 Open Reduction and Tension Band Internal Fixation for Patellar Fractures Body Position and Preoperative Preparation Operative Incision According to the Preoperative Incision Marks by Surface Projection Surgical Procedures Postoperative Management Experience and Lessons 7.2.2.2 Partial Patellectomy Surgical Techniques Experience and Lessons 7.2.2.3 Total Patellectomy Surgical Techniques Experience and Lessons 7.2.3 Prevention of and Treatment Measures for Surgical Complications References 8: Tibial Plateau Fractures 8.1 Basic Theory and Concepts 8.1.1 Overview 8.1.2 Applied Anatomy 8.1.3 Mechanism of Injury 8.1.4 Classification of Tibial Plateau Fractures 8.1.5 Assessment of Tibial Plateau Fractures (Chan et al. 1997) 8.1.5.1 Clinical Assessment 8.1.5.2 Imaging Assessment (Dias et al. 1987; Liow et al. 1999; Macarini et al. 2004) 8.2 Surgical Treatment 8.2.1 Surgical Indications 8.2.2 Surgical Timing and Treatment Principles 8.2.3 Selection of Surgical Strategies 8.2.4 Surgical Technique 8.2.4.1 Temporary Fixation with an External Fixator Across the Knee for Tibial Plateau Fractures (Cole et al. 2009) 8.2.4.2 Closed Reduction and External Fixation with a Hybrid Fixator for Tibial Plateau Fractures (Babis et al. 2011; Kumar and Whittle 2000) 8.2.4.3 Open Reduction and Internal Fixation for Tibial Plateau Fractures (Endayan et al. 1996) Body Position and Preoperative Preparation Operative Incision According to the Preoperative Incision Marks by Surface Projection Fracture Reduction and Fixation Incision Closure Postoperative Management Experience and Lessons 8.2.5 Postoperative Complications and Their Prevention and Treatment Strategies References 9: Tibial Shaft Fractures 9.1 Basic Theory and Concepts 9.1.1 Overview 9.1.2 Applied Anatomy 9.1.3 Mechanism of Injury 9.1.4 Assessment of Tibial Shaft Fractures 9.1.4.1 Clinical Assessment 9.1.4.2 Imaging Assessment 9.1.5 Classification of Tibial Shaft Fractures 9.2 Surgical Treatment 9.2.1 Surgical Indications 9.2.2 Timing of Surgery 9.2.3 Selection of Surgical Strategies 9.2.3.1 Initial Soft Tissue Treatment Technique for Tibial Shaft Open Fractures Application of Antibiotics Debridement and Wound Irrigation Wound Treatment (Fig. 9.7) 9.2.3.2 Lower-Leg Fasciotomy for Compartment Decompression Body Position and Preoperative Preparation Operative Incision According to the Preoperative Incision Marks by Surface Projection Surgical Techniques Postoperative Management 9.2.3.3 Unilateral External Fixation of Tibial Shaft Fractures with a Fixator Frame Body Position and Preoperative Preparation Surgical Technique Experience and Techniques 9.2.3.4 Intramedullary Nail Fixation Body Position and Preoperative Preparation Operative Incision According to the Preoperative Incision Marks by Surface Projection, Surgical Approach, and Intramedullary Nail Entry Point Surgical Techniques Experience and Lessons 9.2.3.5 Plate-Screw Fixation Body Position and Preoperative Preparation Operative Incision According to the Preoperative Incision Marks by Surface Projection (Fig. 9.28) Surgical Technique Postoperative Management Experience and Lessons 9.2.4 Surgical Complications and Their Prevention and Treatment References 10: Ankle Fractures 10.1 Basic Theory and Concepts 10.1.1 Overview 10.1.2 Applied Anatomy 10.1.3 Mechanisms of Injury 10.1.4 Classification of Ankle Fractures 10.1.5 Assessment of Ankle Fractures 10.1.5.1 Clinical Assessment 10.1.5.2 Imaging Assessment 10.2 Surgical Treatment 10.2.1 Surgical Indications and Purposes 10.2.2 Surgical Techniques 10.2.2.1 Choices of Surgical Approaches 10.2.2.2 Body Position and Preoperative Preparation 10.2.2.3 Operative Incision According to the Preoperative Incision Marks by Surface Projection and Surgical Approaches 10.2.2.4 Reduction and Fixation of Ankle Fractures 10.2.2.5 Postoperative Management 10.2.2.6 Experiences and Lessons 10.2.3 Surgical Complications and Their Prevention and Treatment References 11: Pilon Fractures 11.1 Basic Theory and Concepts 11.1.1 Overview 11.1.2 Applied Anatomy 11.1.3 Mechanism of Injury in Pilon Fractures 11.1.4 Classification of Pilon Fractures 11.1.5 Preoperative Assessment 11.1.5.1 Clinical Assessment 11.1.5.2 Imaging and Other Auxiliary Examinations 11.2 Surgical Treatment for Pilon Fractures 11.2.1 Surgical Indications 11.2.2 Strategies for Staged Surgical Treatment 11.2.3 Surgical Techniques 11.2.3.1 Limited Open Reduction and Trans-ankle External Fixation Frame for Pilon Fractures 11.2.3.2 Open Reduction and Internal Fixation for Pilon Fractures 11.2.4 Surgical Complications and Their Prevention and Treatment References 12: Calcaneus Fractures 12.1 Basic Theory and Concepts 12.1.1 Overview 12.1.2 Applied Anatomy 12.1.3 Mechanisms of Injury 12.1.4 Fracture Classification 12.1.4.1 Extra-articular Fractures 12.1.4.2 Intra-articular Fractures 12.1.5 Assessment of Calcaneus Fractures 12.1.5.1 Clinical Assessment 12.1.5.2 Radiographic Evaluation 12.2 Surgical Treatment 12.2.1 Surgical Indications (Dhillon et al. 2011) 12.2.2 Surgical Procedures 12.2.2.1 The Lateral Approach for Open Reduction and Internal Fixation for Intra-articular Fractures of the Calcaneus Body Position and Preoperative Preparation Operative Incision According to the Projection on the Body Surface The Surgical Approach (Fig. 12.18) Fracture Reduction and Fixation Incision Closure Postoperative Management Experience and Lessons 12.2.2.2 Closed Reduction and Internal Fixation Technique for Tongue-Type Calcaneus Fractures via the Minimally Invasive Approach Fracture Reduction and Fixation 12.2.3 Surgical Complications and Their Prevention and Treatment Strategies References 13: Talus Fractures 13.1 Basic Theory and Concepts 13.1.1 Overview 13.1.2 Applied Anatomy 13.1.3 Mechanism of Injury in Talus Fractures 13.1.4 Classification of Talus Fractures 13.1.5 Preoperative Assessment 13.1.5.1 Clinical Assessment 13.1.5.2 Imaging and Other Auxiliary Examinations 13.2 Surgical Treatment for Talus Fractures 13.2.1 Surgical Indications 13.2.2 Timing for Surgery 13.2.3 Surgical Techniques 13.2.3.1 Open Reduction and Internal Fixation for Talus Fractures Body Position and Preoperative Preparation Surgical Incision and Approaches Sequence and Techniques for Fracture and Dislocation Reduction 13.2.3.2 Closed Reduction and Percutaneous Internal Fixation (Abdelgaid and Ezzat 2012) Indications Body Position and Preoperative Preparation Reduction of Talus Fractures Fixation of the Talus Fracture Postoperative Management 13.2.3.3 Advantages and Disadvantages of Various Fixation Methods 13.2.4 Surgical Complications and Their Prevention and Treatment 13.2.4.1 Soft Tissue Complications 13.2.4.2 Nonhealing of Fractures 13.2.4.3 Malhealing of Fractures 13.2.4.4 Osteonecrosis 13.2.4.5 Post-traumatic Arthritis References 14: Achilles Tendon Rupture 14.1 Basic Theory and Concepts 14.1.1 Overview 14.1.2 Applied Anatomy 14.1.3 Mechanism of Injury of Achilles Tendon Rupture 14.1.4 Classification of Achilles Tendon Injuries 14.1.5 Assessments of Achilles Tendon Rupture 14.1.5.1 Clinical Assessment 14.1.5.2 Radiographic Evaluation 14.2 Surgical Treatment 14.2.1 Principles of Treatment 14.2.2 Open Suture Repair for Acute Achilles Tendon Rupture Using the Krackow Locking Stitch Technique 14.2.3 Percutaneous Minimally Invasive Suture for Repairing Acute Achilles Tendon Rupture 14.2.3.1 Development and Design of the Channel-Assisted Minimally Invasive Achilles Tendon Suture Repair Technique 14.2.3.2 The CAMIR Procedures for Acute Achilles Tendon Rupture 14.2.4 Abraham’s V-Y Lengthening Repair of Subacute Achilles Tendon Rupture 14.2.5 The Lindholm Repair Method for an Old Achilles Tendon Rupture (Fig. 14.11) 14.2.6 Experience and Lessons References