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Tips & Tricks in Orthopedic Surgery

Tips & Tricks in Orthopedic Surgery

          
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About the Book

• A simple and well-illustrated book.
• Designed to fulfil the need of a practical concise manual for fracture management.
• With special focus on emergency room care.
• All the illustrations are developed from a self-made photographic gallery by the author.
• Case assessment on arrival, step-by-step management of fractures and pre-operative planning are described.
• All the procedures are described in a manner that will help the reader to visualise it.
• All the methods described by the author are gathered from his own experience, and the experiences of teachers, masters and young colleagues.
• Explains the importance of instruments and implant options in preoperative preparation and equipment layout in the OR.
• Easy source of revision for both new and experienced surgeons

About the Author

Ajit N Damle MS(Ortho) MS(GS) D Ortho



Table of Contents:
Section I Upper Extremity 1. Clavicle Fracture 3 Treatment Methods Available 4 2. Fracture of Lateral End of Clavicle 12 Clinical Diagnosis 12; Clinical Assessment of Reducibility 12; Treatment: Non-operative 13; Indications for Internal Fixation 15; Incision 16; Associated Injuries 18 3. Acromioclavicular Dislocation 20 Patient Position and Surgical Technique 20; Follow up and Implant Removal 21 4. Posterior Dislocation of the Shoulder 23 Case Study 23 5. Fracture Dislocation of the Shoulder 27 Cases 1 and 2 27; Few Observations 29; Message 35 6. Humerus Neck Fracture 36 Few Common Observations 36; Two-Part Fracture of Neck of Humerus 38; Three or More Parts Impacted/Minimally Displaced Fractures 38; Locking Plate 41; Three or More Parts Fracture of Neck of Humerus: Displaced 42; Comment on Bone Grafting 45; Steps of Bone Grafting and Plate Fixation 46; Postoperative Care 47; Nonunion of Fracture of Neck of Humerus 48 7. Humerus Shaft Interlock Nailing 50 Interlocking Nailing in Humerus 50; Case 1: Palliative Surgery to Alleviate Pain 50; Case 2: Long Oblique Fracture of Upper/3 Area 50; Case 3: Segmental Long Oblique Fracture 50; Case 4: Repeat Surgeries 52; Case 5: Fracture in Lower/4 Area 54; Case 6: Fracture of Lower/3 Area 56; Case 7: Fracture of Lower/4 Area 56; Case 8: 3-Part Fracture of Mid/3 57; Conclusions from the Above Cases 58 8. Humerus Holstein and Lower Shaft Fracture 59 Holstein Fracture and Fractures in Lower/4 Humerus 59; Decades Ago 62; Future 63 9. Humerus Lower-End Exposure 64 Posterior Exposure for Fracture of Lower/4 Humerus 64 10. Elbow Fracture Dislocation 67 Elbow Lateral Dislocation with Sectoral Fracture of Head of Radius 67 Prelims.indd 13 08-11-2014 11:13:16xiv Tips and Tricks in Orthopedic Surgery 11. Fracture of Medial Epicondyle of Humerus 69 Clinical Presentation 69; Treatment 69; Technique 70; Missed Fracture of Medial Condyle of Humerus 70 12. Capitellum Fracture 72 Current Trends 72; Recommendation 74; Technique 74; Clinical Example 75; Message 75 13. Radius Neck Fracture 76 Fracture Epiphyseal Injury to the Neck/Head of the Radius in Adolescence 76 14. Forearm Fractures 81 Fracture of Radius and Ulna 81; General Comments on Plate and IM Nail as an Implant 81; Plate as an Implant 82; Ununited Fracture of Radius and Ulna after Plate Fixation for Both the Bones 84; Biomechanical Differences in a Plate and a Nail 86; Nail as an Implant 89; Instruments Required 89; Technique of Radius Nail Insertion 90; Open Reduction 91; Technique of Ulna Nail Insertion 92; Importance of Achieving a Good Union in the Ulna 95; After a Bone Union, Whether the Plate and the Nail Need to be Removed? 97; The Technique of Nail Removal 99; Ulna Nail Removal 99; Radius Nail Removal 99; Nail Removal by a Vertical Osteotomy 100; The Technique of Vertical Osteotomy 100; Radius 105; Ulna 107 15. Bow Fracture of Forearm 108 Bow (Greenstick) Fracture of Radius and/or Ulna 108; Untreated/Missed Bow Fracture 108; Treatment in a Fresh Case 110; Steps in Reduction of a Bow Fracture 111 16. Refracture of Forearm 113 Fracture Healing and Refracture in Forearm Bones in Adolescence 113; Observations 114 17. Monteggia Fracture Dislocation 116 Transverse Fracture of Olecranon with Fracture of Head of Radius and Associated Posterior Dislocation of Elbow 116 18. Lower/3 Radius and Ulna Fracture in a Child 122 Fracture of Lower/3 Radius and Ulna in a Child 122; Which Material for the Cast? 122 19. Lower/4 Radius and Ulna Fracture in a Child 124 Case 1: Transverse Displaced Fracture of the Radius and Ulna 124; Case 2: An Oblique Fracture of the Radius with a Serrated Fracture of the Ulna 125; Case 3: Late Presentation of Case 1 126; Case 4: Late Presentation of Case 2 127; Case 5: Greenstick Fracture of Radius Only 129; Case 6: Greenstick Fracture of Both Radius and Ulna 129; Case 7: Redisplacement in an Oblique Fracture I 129; Case 8: Re-Displacement in an Oblique Fracture II 130; Message 130 20. Malunited Fracture of Lower/4 Radius in a Child 133 Malunited Fracture of Lower/4 Radius 133 21. Inferior RU Dislocation in a Child 136 Inferior Radioulnar (RU) Joint Dislocation 136 Prelims.indd 14 08-11-2014 11:13:16Contens xv 22. Colles’ Fracture 137 Undisplaced Colles’ Fracture 137; Typical Cases 141 23. Comminuted Fracture of Lower Radius 153 Comminuted Fracture of Lower-End of Radius 153 24. Fracture of Neck of 5th Metacarpal 155 The Technique 156; Postoperative Immobilization 157 25. Emergency Room Technique 158 Emergency Room Care 158 Section II Lower Extremity and Pelvis 26. Pelvis and Acetabulum Fractures 175 27. Fracture of Neck of Femur 190 Intracapsular Fracture of Neck of Femur 190; Impacted Fracture of Neck of Femur 191; Impacted Fracture in the 3rd Decade of Life 195; Fracture of Neck of Femur in the Middle Age 195; Basi-Trochanteric Fracture 198; Ipsilateral Fracture of Neck and Shaft of Femur 200; Fracture of Neck of Femur in Adolescence 206; Osteotomy in Fracture of Neck of Femur 209; Stress Fracture 215; Types of Partial Hip Replacement 215; First Aid on Arrival and Diagnosis 217; Important Steps in a Bipolar Replacement 218; Few Technical Things 221 28. Fracture of Trochanter 226 Problems of Internal Fixation 227; Fracture Morphology 227; Assessment of a Fracture 228; Method of Internal Fixation 228; Timing and Factors for Surgery 228; Choice of Implant 228; Patient Position 229; Fracture Reduction 229; Fracture Reduction and Implant Position 229; Technique of DHS 229; Tricks in Fracture Reduction and Plate Fixation 231; Lesser Trochanter Fixation 242; Primary Bone Grafting 244; Fracture Collapse and Medialization 244; Medialization after a Lateral Wall Osteotomy/ Fracture 246; Trochanteric Stabilization Plate 248; Special Situation in Inter-Trochanteric Fractures 250; Long Medial Beak 253; When Further Medialization and Telescoping is Expected 255; Mechanical Complications 259; 95 Degree DCS in Trochanteric Fracture 264; Intracapsular and Extracapsular Fracture 264; Few Unfortunate Situations 265; Technique and Observations in a Bipolar Replacement in a Failed DHS 265; Re-Attachment of Greater Trochanter 268 29. Fracture of Subtrochanteric Area 270 Subtrochanteric Fracture and Jewett Nail Plate 270; Limb Length 271; Few Case Studies 271; Subtrochanteric Fracture: DHS Fixation 274; Observations and Suggestions 277; Subtrochanteric Fracture: DCS 279; Technique of the Screw Insertion in the Calcar 280; Intramedullary Device in Subtrochanteric Fracture 286 30. Fracture of Femur Shaft 290 The Operation Room at Any Time 291; Non-operative Methods 292; Fracture of Femur Shaft in Infants and Adolescence 293; Prelims.indd 15 08-11-2014 11:13:16xvi Tips and Tricks in Orthopedic Surgery Technique to Assess Rotary Alignment in a Shaft Fracture 294; Typical Cases 301; Periprosthetic Fracture 317; Special Situations in Removal of Femur Nail and/or a Plate 322 31. Ipsilateral Femur and Tibia Fractures 324 On Arrival 324 32. Fracture of Patella 326 Incision and Exposure 326; Timing of Surgery 326; Anesthesia 326; Instrumentation 327; Implants 327; Principles 328; Technique 329; Late Presentation of Fracture of Patella 330; Fracture of Patella of Different Patterns 331 33. Post-Stiffness Fractures 340 34. Fracture of Anterior Tibial Eminence 345 Fixation with a Circlage Wire 345; Fracture of the Anterior Tibial Eminence with Associated Fracture of Tibial Condyle 346; Clinical Examples 346 35. Fracture of Posterior Tibial Eminence 351 An Isolated Injury 351 36. Fractures of Tibial Condyle 356 Introduction to the Fracture of Tibial Condyle 356; Fracture Morphology and Site of Fracture 357; The Incision for a Good Exposure 360; Fracture of Tibial Condyle in a Neuropathic Joint 361; Bicondylar Fracture of Tibia 361; Options Possible 365; Choice of a Plate for Fracture of Tibial Condyle 373; Technique of Fracture Fixation 375; How Can One Achieve This? 377; Diagnosis and Missed Fracture of Tibial Condyle 377; Treatment 380; Contusion Fracture of Lateral Tibial Condyle 382; Fracture of Lateral Tibial Condyle in the Elderly 382; Widening of the Lateral Tibial Condyle 383; Fracture of Anterior Tibial Eminence and Undisplaced Fracture of Lateral Condyle 383; Incorrect History and Fasciotomy 384; Fracture of Lateral Tibial Condyle 384; A Split Fracture of Lateral Condyle with Minimum Displacement 384; Lateral Condyle Elevation from Medial Side 389; Implant Removal 393; Learning from Cases 393; Medial Tibial Condyle Fracture 404; Nonunion in Fracture of Tibial Condyle 410; Post-Stiffness Fracture of Tibial Condyle 412; Posteromedial and Posterolateral Condyle Fracture of Tibial Plateau 413; Clinical Examples 414 37. Fractures of Tibial Shaft 424 Non-operative Method 429 38. External Fixator 436 Review of the Principles and Technique of Application of External Fixation 436; The Components of Assembly 437; Uniplaner, Unilateral Fixator 440; Prestressing and Final Fixation 441; Triangularization 443; Case Examples: Use of an External Fixator 444; Lessons Learnt from the Above Cases 447 39. External Fixator in Open Fracture of Tibia 450 Fixation of Fibula 450; Refracture after External Fixator Removal 457 40. Tibia Interlock Nailing 459 Few Preferences 459; Few Practical Observations in Tibia Interlock Nailing 460; Segmental Fracture of Tibia 466 41. Stress Fracture of Tibia 469 42. Tibia Plate Fixation 475 Width of a Tibia Plate 475; Which Surface of Tibia? 475; Message 480 43. Tibia Lower MIPO Plate 481 How would I Plan? 483; MIPO Technique: Must Obtain a Good Reduction! 485; Long Segment of Tibia with Comminution 487 44. Ankle Injuries 491 Introduction 491; Management in General 491; Could This have been Avoided? 493; The Outcome 495; Medial Malleolus Fixation 495; Reduction Technique and Which Implant? 495; Ankle Lateral Malleolus 500; Level of Fracture of the Fibula 502; X-ray Views and Positioning 502; Timing of Surgery 503; Patient Positioning 504; Implants for the Lateral Malleolus 505; Non-operative Method: Protocol 507; Complications after a Fracture of Lateral Malleolus 509; Late Presentation 510; Tibio-Fibular Diastasis 512; Adduction Fracture of Ankle 513; Trimalleolar Fracture of Ankle 518; Ankle: What to Avoid? 522; Ankle: Medial and Posterior Malleolus Large Fragments 529; Lateral Column Segmental Fracture 529; Ankle Open Fracture 530; Suggested Steps 531; Ankle External Fixation 531; Ankle Fractures and Diabetes 533; Ankle Fracture in Treated Case of Clubfoot 538; Ankle Refracture 538; Childress Procedure 539; Ankle Injuries in Children 540; Tillaux Injury 542; Ankle Fusion after Bimalleolar Fracture 542; Bone Cuts 543 Follow-up Care 545; Cast Removal 545; Case Examples 545 45. Foot Injuries 547 Stress Fracture of Metatarsals 547; Not to Do 548; Fracture of Distal Part of 5th Metatarsal 548 46. Tips for Better Care 551 Index 553


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Product Details
  • ISBN-13: 9789351524847
  • Publisher: Jaypee Brothers Medical Publishers
  • Binding: PAPERBACK
  • Edition: 1
  • Language: English
  • Returnable: Y
  • Spine Width: 24 mm
  • Width: 174 mm
  • ISBN-10: 9351524841
  • Publisher Date: 20 Mar 2015
  • Depth: 25
  • Height: 244 mm
  • No of Pages: 576
  • Series Title: Tips and Tricks
  • Weight: 700 gr


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