The rationale of operative fracture care:
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| Format: | Book |
|---|---|
| Language: | English |
| Published: |
Berlin [u.a.]
Springer
1996
|
| Edition: | 2. ed., completely rev. and enl. |
| Subjects: | |
| Online Access: | Inhaltsverzeichnis |
| Physical Description: | XXIII, 633 S. zahlr. Ill., graph. Darst. |
| ISBN: | 3540593888 |
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| 245 | 1 | 0 | |a The rationale of operative fracture care |c Joseph Schatzker ; Marvin Tile |
| 250 | |a 2. ed., completely rev. and enl. | ||
| 264 | 1 | |a Berlin [u.a.] |b Springer |c 1996 | |
| 300 | |a XXIII, 633 S. |b zahlr. Ill., graph. Darst. | ||
| 336 | |b txt |2 rdacontent | ||
| 337 | |b n |2 rdamedia | ||
| 338 | |b nc |2 rdacarrier | ||
| 650 | 4 | |a Fractures |x Surgery | |
| 650 | 4 | |a Zlomi |x Kirurgija | |
| 650 | 0 | 7 | |a Knochenbruch |0 (DE-588)4031318-9 |2 gnd |9 rswk-swf |
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| 689 | 0 | 1 | |a Chirurgie |0 (DE-588)4009987-8 |D s |
| 689 | 0 | |5 DE-604 | |
| 700 | 1 | |a Schatzker, Joseph |e Sonstige |0 (DE-588)172355664 |4 oth | |
| 700 | 1 | |a Tile, Marvin |e Sonstige |4 oth | |
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| _version_ | 1808046493988290560 |
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| adam_text |
CONTENTS
PART
I
GENERAL
ASPECTS
OF
INTERNAL
FIXATION
CHAPTER
1
PRINCIPLES
OF
STABLE
INTERNAL
FIXATION
J.
SCHATZKER
.
3
1.1
INTRODUCTION
.
3
1.1.1
MECHANICAL
PROPERTIES
OF
BONE
.
3
1.1.2
TYPES
OF
LOAD
AND
FRACTURE
PATTERNS
.
3
1.1.3
CLASSIFICATION
OF
FRACTURES
.
4
1.1.4
EFFECTS
OF
FRACTURE
.
10
1.1.5
SOFT
TISSUE
COMPONENT
AND
CLASSIFICATION
OF
SOFT
TISSUE
INJURIES
.
10
1.2
AIMS
OF
TREATMENT
.
10
1.3
PREVIOUS
EXPERIENCE
WITH
INTERNAL
FIXATION
.
.
11
1.4
RIGIDITY
AND
STABILITY
.
11
1.5
METHODS
OF
STABLE
FIXATION
.
12
1.5.1
LAG
SCREW
.
12
1.5.2
LAG
SCREW,
NEUTRALIZATION,
AND
BUTTRESSING
.
14
1.5.3
TENSION
BAND
PLATE
.
14
1.6
METHODS
OF
RELATIVE
STABILITY
OR
SPLINTING
.
15
1.6.1
EXTERNAL
SKELETAL
FIXATION
.
15
1.6.2
INTRAMEDULLARY
NAILING
.
16
1.6.3
BRIDGE
PLATING
.
17
1.6.4
METHODS
OF
REDUCTION
.
18
1.7
CHANGES
TO
THE
EARLY
CONCEPTS
IN
INTERNAL
FIXATION
.
19
1.7.1
ARTICULAR
FRACTURES
.
22
1.7.2
DIAPHYSEAL
FRACTURES
.
23
1.8
IMPLANT
FAILURE
AND
BONE
GRAFTING
.
25
1.9
IMPLANT
REMOVAL
.
26
REFERENCES
.
26
CHAPTER
2
INTRA-ARTICULAR
FRACTURES
J.
SCHATZKER
.
29
2.1
INTRODUCTION
.
29
2.2
CLINICAL
ASPECTS
.
31
2.2.1
PHYSICAL
EXAMINATION
.
31
2.2.2
RADIOLOGICAL
EVALUATION
.
31
2.3
SURGERY
.
32
2.3.1
TIMING
.
32
2.3.2
APPROACH
AND
TECHNIQUE
.
33
2.4
POSTOPERATIVE
CARE
.
37
2.5
LATE
INTRA-ARTICULAR
RECONSTRUCTIONS
.
37
REFERENCES
.
37
CHAPTER
3
OPEN
FRACTURES
J.
SCHATZKER
AND
M.
TILE
.
39
3.1
INTRODUCTION
.
39
3.2
ASSESSMENT
OF
THE
SOFT
TISSUE
WOUND
.
39
3.3
CLASSIFICATION
.
39
3.4
MANAGEMENT
.
40
3.4.1
DECISION
MAKING
.
40
3.4.2
IMMEDIATE
TREATMENT
.
40
3.4.3
OPERATIVE
TREATMENT
.
40
3.4.3.1
LIMB
SALVAGE
.
40
3.4.3.2
CLEANSING
.
41
3.4.3.3
DEBRIDEMENT
.
41
3.4.3.4
CHOICE
OF
FIXATION
.
41
3.4.3.5
IMPLANT
SELECTION
.
42
3.4.3.6
CARE
OF
THE
SOFT
TISSUE
WOUND
.
43
3.4.3.7
SECONDARY
FRACTURE
CARE
.
44
3.4.3.8
OPEN
JOINT
INJURIES
.
45
3.5
SUMMARY
.
46
REFERENCES
.
46
PART
II
FRACTURES
OF
THE
UPPER
EXTREMITY
CHAPTER
4
FRACTURES
OF
THE
PROXIMAL
HUMERUS
M.
TILE
.
51
4.1
INTRODUCTION
.
51
4.1.1
GENERAL
CONSIDERATIONS
.
51
4.1.2
ANATOMY
.
51
4.1.3
VASCULAR
ANATOMY
.
51
4.1.4
FOUR-SEGMENT
CLASSIFICATION
.
52
4.1.5
STABILITY
.
53
4.1.6
SURGICAL
DIFFICULTIES
.
53
4.2
CLASSIFICATION
.
53
4.3
NATURAL
HISTORY
AND
SURGICAL
INDICATIONS
.
55
4.3.1
STABLE
FRACTURES
.
55
4.3.2
UNSTABLE
FRACTURES
.
55
4.3.2.1
MINIMAL DISPLACEMENT
.
56
4.3.2.2
MAJOR
DISPLACEMENT
.
56
4.3.3
ARTICULAR
FRACTURES
.
65
4.3.3.1
IMPACTED
(HILL-SACHS)
.
65
4.3.3.2
HUMERALHEAD
.
67
4.3.3.3
GLENOID
LABRUM
.
67
4.4
MANAGEMENT
.
69
4.4.1
ASSESSMENT
.
69
4.4.1.1
CLINICAL
.
69
XVI
CONTENTS
4.4.1.2
RADIOLOGICAL
.
69
4.4.1.3
EXAMINATION
UNDER
ANESTHESIA
.
69
4.4.2
DECISION
MAKING
.
69
4.4.2.1
STAHLE
FRACTURES
.
69
4.4.2.2
UNSTABLE
FRACTURES
.
70
4.4.3
SURGICAL
TECHNIQUE
.
74
4.4.3.1
TIMING
.
74
4.4.3.2
APPROACHES
.
74
4.4.3.3
REDUCTION
.
77
4.4.3.4
METHODS
OF
INTERNAL
FIXATION
.
77
4.4.3.5
WOUND
CLOSURE
.
81
4.4.3.6
POSTOPERATIVE
CARE
.
81
REFERENCES
.
82
CHAPTER
5
FRACTURES
OF
THE
HUMERUS
(12-A,
B,AND
C)
J.
SCHATZKER
.
83
5.1
INTRODUCTION
.
83
5.2
INDICATIONS
FOR
SURGERY
.
83
5.2.1
FAILURE
TO
OBTAIN
A
SATISFACTORY
REDUCTION
.
83
5.2.2
FAILURE
TO
MAINTAIN
REDUCTION
.
84
5.2.3
INJURIES
TO
THE
CHEST
WALL
.
85
5.2.4
BILATERAL
HUMERAL
FRACTURES
.
85
5.2.5
MULTIPLE
INJURIES
.
85
5.2.6
VASCULAR
LESIONS
.
85
5.2.7
NEUROLOGICAL
LESIONS
.
86
5.2.8
FRACTURES
OF
THE
SHAFT
ASSOCIATED
WITH
INTRA-ARTICULAR
FRACTURES
OR
ARTICULAR
EXTENSIONS
OF
THE
FRACTURE
.
86
5.2.9
OPEN
FRACTURES
OF
THE
HUMERUS
.
87
5.2.10
PATHOLOGICAL
FRACTURES
OF
THE
HUMERUS
.
87
5.3
SURGICAL
APPROACHES
.
87
5.4
SURGICAL
METHODS
OF
STAHLE
FIXATION
.
88
5.4.1
BIOMECHANICAL
CONSIDERATIONS
.
88
5.5
POSTOPERATIVE
REGIMEN
.
91
5.6
REMOVAL
OF
INTERNAL
FIXATION
.
93
REFERENCES
.
94
CHAPTER
6
FRACTURES
OF
THE
DISTAL
END
OF
THE
HUMERUS
(13-A,B,AND
C)
J.
SCHATZKER
.
95
6.1
INTRODUCTION
.
95
6.2
FRACTURES
WITH
A
GOOD
PROGNOSIS
.
95
6.2.1
FRACTURES
OF
THE
EPICONDYLES
.
95
6.2.1.1
FRACTURES
OF
THE
LATERAL
EPICONDYLE
(13-A1.1)
.
95
6.2.1.2
FRACTURES
OF
THE
MEDIAL
EPICONDYLE
(13-A1.
2)
.
95
6.2.1.3
FRACTURES
OF
THE
LATERAL
CONDYLE
(BL)
.
97
6.2.1.4
FRACTURES
OF
THE
CAPITELLUM
(13-B3.1)
.
97
6.3
FRACTURES
WITH
A
POOR
PROGNOSIS:
THE
EXTRA-ARTICULAR
GROUP
A2
AND
A3
AND
COMPLETE
ARTICULAR
TYPE
C
.
98
6.3.1
SUPRACONDYLAR
FRACTURES
.
98
6.3.1.1
NATURAL
HISTORY
.
98
6.3.1.2
FACTORS
INFLUENCING
DECISIONS
IN
TREATMENT
.
99
6.3.1.3
INDICATIONS
FOR SURGERY
.
101
6.3.1.4
SURGICAL
TREATMENT
.
102
REFERENCES
.
111
CHAPTER
7
FRACTURES
OF
THE
OLECRANON
(12-B1)
J.
SCHATZKER
.
113
7.1
INTRODUCTION
.
113
7.2
METHODS
OF
EVALUATION
AND
GUIDES
TO
TREATMENT
.
114
7.3
CLASSIFICATION
.
115
7.3.1
INTRA-ARTICULAR
FRACTURES
.
115
7.3.1.1
TRANSVERSE
(21-B1.1)
.
115
7.3.1.2
OBLIQUE
(21-B1.1)
.
115
7.3.1.3
COMMINUTED
FRACTURES
AND
ASSOCIATED
INJURIES
.
115
7.3.2
EXTRA-ARTICULAR
FRACTURES
.
116
7.4
SURGICAL
TREATMENT
.
116
7.4.1
POSITIONING
THE
PATIENT
.
116
7.4.2
DRAPING
.
116
7.4.3
TOURNIQUET
.
116
7.4.4
SURGICAL
EXPOSURE
.
116
7.4.5
TECHNIQUES
OF
REDUCTION
AND
INTERNAL
FIXATION
.
117
7.4.5.1
TRANSVERSE
FRACTURES
.
117
7.4.5.2
TRANSVERSE
FRACTURES
WITH
JOINT
DEPRESSION
.
118
7.4.5.3
OBLIQUE
FRACTURES
.
118
7.4.5.4
COMMINUTED
FRACTURES
.
118
7.5
POSTOPERATIVE
CARE
.
119
REFERENCES
.
119
CHAPTER8
FRACTURES
OF
THE
RADIAL
HEAD
(21-A2.2,
21-B2.1,21-B2.2,AND
21-B2.3)
J.
SCHATZKER
.
121
8.1
INTRODUCTION
.
121
8.2
MECHANISM
OF
INJURY
.
121
8.3
GUIDES
TO
TREATMENT
.
121
8.4
SURGICAL
TREATMENT
.
122
8.4.1
CLASSIFICATION
.
122
8.4.2
POSITIONING
AND
DRAPING
THE
PATIENT
.
123
8.4.3
SURGICAL
EXPOSURE
.
123
8.4.4
TECHNIQUES
OF
REDUCTION
AND
INTERNAL
FIXATION
.
123
8.4.4.1
COMMINUTED
FRACTURES
.
123
8.4.4.2
SPLIT-WEDGE
FRACTURES
.
123
8.4.4.3
IMPACTION
FRACTURES
.
123
8.4.5
POSTOPERATIVE
CARE
.
125
REFERENCES
.
125
CONTENTS
XVII
CHAPTER
9
FRACTURES
OF
THE
RADIUS
AND
ULNA
M.
TILE
.
127
9.1
INTRODUCTION
.
127
9.2
NATURAL
HISTORY
.
127
9.2.1
CLOSED
TREATMENT
.
127
9.2.2
OPEN
TREATMENT
.
127
9.2.3
AO/ASIF
TECHNIQUES
.
127
9.3
MANAGEMENT
.
128
9.3.1
PRINCIPLES
.
128
9.3.2
INDICATIONS
FOR SURGERY
.
128
9.3.2.1
FRACTURES
OF
BOTH
BONES
.
128
9.3.2.2
FRACTURE
OF
ONE
BONE
.
128
9.3.2.3
OPEN
FRACTURE
OF
THE
FOREARM
.
.
.
129
9.3.3
TIMING
OF
SURGERY
.
129
9.3.4
SURGICAL
TECHNIQUE
.
132
9.3.4.1
PRELIMINARY
CONSIDERATIONS
.
132
9.3.4.2
SURGICAL
APPROACHES
.
132
9.3.4.3
REDUCTION
TECHNIQUES
.
135
9.3.4.4
TECHNIQUE
OF
FRACTURE
FIXATION
.
137
9.4
SPECIAL
CONSIDERATIONS
.
144
9.4.1
FRACTURES
OF
BOTH
BONES
OF
THE
FOREARM
.
144
9.4.2
FRACTURES
OF
ONE
BONE
.
144
9.4.2.1
FRACTURES
OF
THE
RADIUS
WITH
DISTAL
RADIOULNAR
SUBLUXATION
(GALEAZZI)
.
144
9.4.2.2
FRACTURES
OF
THE
ULNA
.
145
9.4.3
FRACTURES
OF
THE
FOREARM
IN
ADOLESCENTS
.
149
9.4.4
OPEN
FRACTURES
OF
THE
FOREARM
.
.
.
149
9.5
COMPLICATIONS
.
155
9.5.1
RADIOULNAR
SYNOSTOSIS
.
155
9.5.2
STRESS
FRACTURE
.
157
9.5.3
REFRACTURE
AND
PLATE
REMOVAL
.
157
REFERENCES
.
157
CHAPTER
10
FRACTURES
OF
THE
DISTAL
RADIUS
T.S.AXELROD
.
159
10.1
DISTAL
RADIUS
FRACTURES
.
159
10.1.1
CLASSIFICATION
.
159
10.1.2
IMAGING
.
160
10.1.3
CLOSED
TREATMENT
.
160
10.1.4
MANAGEMENT
AND
DECISION
MAKING
.
162
10.1.4.1
PERCUTANEOUS
PINNING
.
163
10.1.4.2
PINS
AND
PIASTER
.
163
10.1.4.3
EXTERNAL
SKELETAL
FIXATION
.
163
10.1.4.4
LIMITED
OPEN
REDUCTION
.
166
10.1.4.5
OPEN
REDUCTION
AND
INTERNAL
FIXATION
.
166
10.1.4.6
ALGORITHM
FOR
TREATMENT
.
166
10.1.5
SURGICAL
TECHNIQUE
.
166
10.1.5.1
EXTERNAL
FIXATION
APPLICATION
.
167
10.1.5.2
LIMITED OPEN
REDUCTION
.
167
10.1.5.3
OPEN
REDUCTION
AND
INTERNAL
FIXATION
.
170
10.2
THE
DISTAL
RADIOULNAR
JOINT
.
173
10.3
POSTOPERATIVE
CARE
.
173
10.4
COMPLICATIONS
.
175
10.4.1
PIN
SITE
INFECTION
.
175
10.4.2
MEDIAN
NERVE
COMPRESSION
.
175
10.4.3
REFLEX
SYMPATHETIC DYSTROPHY
.
.
.
175
10.5
CONCLUSIONS
.
175
REFERENCES
.
175
PART
III
FRACTURES
OF
THE
SPINE,
PELVIS,
AND
ACETABULUM
CHAPTER
11
FRACTURES
OF
THE
SPINE
R.
HU
.
179
11.1
INTRODUCTION
.
179
11.2
HISTORY
.
179
11.2.1
INTERNAL
FIXATION
AND
FUSION
.
179
11.2.2
DISTRACTION
ROD
FIXATION
.
180
11.2.3
SEGMENTAL
SUBLAMINAR
WIRES
.
180
11.2.4
SHORT-SEGMENT
FIXATION
.
180
11.3
INITIAL
ASSESSMENT
AND
MANAGEMENT
.
180
11.3.1
PHYSICAL
EXAMINATION
.
181
11.3.1.1
NEUROLOGICAL
EXAMINATION
.
181
11.3.1.2
SACRAL
REFLEXES
.
182
11.3.1.3
CORTICOSTEROIDS
.
182
11.3.2
INITIAL
RADIOLOGICAL
ASSESSMENT
.
.
.
182
11.3.2.1
PLAIN
FILMS
AND
TOMOGRAPHY
.
182
11.3.2.2
COMPUTED
TOMOGRAPHY
SCAN
.
185
11.3.2.3
MYELOGRAPHY
.
185
11.3.2.4
MAGNETIC
RESONANCE
IMAGING
.
185
11.4
CLASSIFICATION
.
187
11.5
OPERATIVE
DECISION-MAKING
WITH
NEUROLOGICAL
AND
BIOMECHANICAL
GOALS
.
190
11.5.1
INDICATIONS
.
190
11.5.1.1
DOES
THE
PATIENT
HAVE
A
NEUROLOGICAL
DEFICIT?
IF
SO,
TO
WHAT
DEGREE?
.
190
11.5.1.2
ARE
THE
ANTERIOR
ELEMENTS
INTACT?
.
.
190
11.5.1.3
ARE
THE
POSTERIOR
ELEMENTS
INTACT?
.
190
11.5.1.4
WHAT
INFORMATION
TO
ASSESS
WITH
IMAGING?
.
191
11.5.1.5
WILL
THE
PATIENT
TOLERATE
OPERATIVE
OR
NONOPERATIVE
TREATMENT?
.
191
11.6
PREPARATION
FOR
SURGERY
.
191
11.6.1
TIMING
OF
SURGERY
.
191
11.6.2
PATIENT
POSITIONING
.
192
11.6.3
INTRAOPERATIVE
BLOOD
LOESS
.
192
11.7
ANATOMY
AS
RELATED
TO
SURGICAL
APPROACHES
.
192
11.7.1
POSTERIOR
APPROACH
.
192
11.7.1.1
CERVICAL
SPINE
POSTERIOR
APPROACH
.
193
11.7.1.2
CERVICAL
SPINE
DECOMPRESSION
.
193
11.7.1.3
THORACIC
SPINE
POSTERIOR
APPROACH
.
193
11.7.1.4
LUMBOSACRAL
JUNCTION
POSTERIOR
APPROACH
.
193
11.7.2
THORACOLUMBAR
AND
LUMBAR
SPINE
DECOMPRESSION
.
193
11.7.3
ANTERIOR
APPROACH
.
194
CONTENTS
11.7.3.1
CERVICAL
SPINE
.
195
11.7.3.2
CERVICOTHORACIC
JUNCTION
.
195
11.7.3.3
THORACIC
SPINE
.
195
11.7.3.4
THORACOLUMBAR
JUNCTION
.
196
11.7.3.5
LUMBAR
SPINE
.
196
11.7.3.6
LUMBOSACRAL
JUNCTION
.
197
11.7.4
DECOMPRESSION
ANTERIOR
APPROACH
197
11.8
FRACTURES
AND
SPECIFIC
MANAGEMENT
.
198
11.8.1
UPPER
CERVICAL
.
198
11.8.1.1
ATLAS
INJURY
.
198
11.8.1.2
ATLAS
AND
ODONTOID
INJURY
.
198
11.8.1.3
ODONTOID
INJURY
.
199
11.8.1.4
C2
INJURY
.
202
11.8.2
LOWER
CERVICAL
SPINE
.
202
11.8.3
THORACIC
SPINE
.
203
11.8.4
THORACOLUMBAR
JUNCTION
.
205
11.8.4.1
INTERNAL
FIXATION
.
210
11.8.5
LUMBAR
SPINE
.
212
11.8.6
SACRAL
FRACTURES
.
214
11.9
POSTOPERATIVE
CARE
.
215
11.9.1
BRACE
WEAR
.
215
11.9.2
MOBILIZATION
.
216
11.9.3
COMPLICATIONS
AND
THEIR
PREVENTION
.
216
11.9.4
PEDICLE
SCREW
INSERTION
.
216
11.9.5
THROMBOEMBOLIE
DISEASE
.
216
11.9.6
URINARYCARE
.
217
11.10
OUTCOMES
OF
TREATMENT
OF
SPINAL
INJURY
.
.
217
11.11
CONCLUSION
.
217
REFERENCES
.
218
CHAPTER12
FRACTURES
OFTHEPELVIS
M.TILE
.
221
12.1
INTRODUCTION
.
221
12.2
UNDERSTANDING
THE
INJURY
.
221
12.2.1
RING
STRUCTURE
OF
THE
PELVIS
.
221
12.2.2
ANATOMICAL
LESIONS
.
221
12.2.3
STABILITY
OF
THE
PELVIS
.
224
12.2.3.1
SACROILIAC
COMPLEX
.
225
12.2.3.2
PELVIC
FLOOR
.
226
12.2.4
TYPES
OF
INJURIOUS
FORCES
ACTING
ON
THE
PELVIS
.
227
12.2.5
EFFECT
OF
FORCES
ON
SOFT
TISSUE
.
.
.
228
12.3
CLASSIFICATION
.
228
12.3.1
TYPE
A
STABLE
FRACTURES
.
229
12.3.2
TYPE
B
-
PARTIALLY
STABLE
FRACTURES
229
12.3.2.1
OPEN
BOOK
(ANTEROPOSTERIOR
COMPRESSION)
FRACTURES
(BL,
B3.1)
229
12.3.2
PARTIALLY
STABLE
FRACTURES
(TYPE
B2)
231
12.3.2.1
LATERAL
COMPRESSION
FRACTURES
.
.
231
12.3.3
TYPE
C
-
UNSTABLE
FRACTURES
-
COMPLETE
DISRUPTION
OF
THE
POSTERIOR
ARCH
.
235
12.3.4
UNUSUAL
TYPES
OF
FRACTURE
.
236
12.4
NATURAL
HISTORY
.
236
12.5
MANAGEMENT
OF
THE
PELVIC
DISRUPTION
.
238
12.5.1
ASSESSMENT
.
238
12.5.1.1
GENERAL
ASSESSMENT
.
238
12.5.1.2
SPECIFIC
MUSCULOSKELETAL
ASSESSMENT
238
12.5.1.3
DIAGNOSIS
OF
PELVIC
INSTABILITY
.
.
.
239
12.5.2
RESUSCITATION
.
240
12.5.3
PROVISIONAL
STABILIZATION
.
241
12.5.3.1
EXTERNAL
FIXATION
OR
PELVIC
CLAMP
.
242
12.5.3.2
SKELETAL
TRACTION
.
243
12.5.3.3
EARLY
INTERNAL
FIXATION
.
244
12.5.4
DEFINITIVE
STABILIZATION
.
244
12.5.4.1
STABLE
FRACTURES
(TYPE
A)
.
245
12.5.4.3
UNSTABLE
FRACTURES
(TYPE
C)
.
246
12.5.4.4
SURGICAL
TECHNIQUES
.
256
12.5.4.5
POSTOPERATIVE
CARE
.
265
12.5.4.6
COMPLICATIONS
.
265
12.6
CONCLUSIONS
.
269
REFERENCES
.
269
CHAPTER
13
FRACTURES
OF
THE
ACETABULUM
M.TILE
.
271
13.1
INTRODUCTION
.
271
13.1.1
NATURAL
HISTORY
.
271
13.1.2
SURGICAL
ANATOMY
.
274
13.1.3
MECHANISM
OF
INJURY
.
276
13.2
ASSESSMENT
.
276
13.2.1
CLINICAL
ASSESSMENT
.
276
13.2.2
RADIOLOGICAL
ASSESSMENT
.
276
13.2.2.1
SPECIAL
RADIOGRAPHS
OF
THE
PELVIS
.
.
276
13.2.2.2
SPECIFIC
ACETABULAR
VIEWS
.
276
13.2.2.3
TOMOGRAPHY
.
280
13.2.2.4
COMPUTED
TOMOGRAPHY
.
280
13.3
CLASSIFICATION
.
283
13.4
MANAGEMENT
.
284
13.4.1
INDICATIONS
.
284
13.4.1.1
FRACTURE
FACTORS
.
284
13.4.2
PATIENT
FACTORS
.
298
13.4.3
DECISION
MAKING
ALGORITHM
.
298
13.4.3.1
GENERAL
RESUSCITATION
.
298
13.4.3.2
FRACTURE
PERSONALITY
ASSESSMENT
.
.
300
13.4.3.3
SIGNIFICANT
DISPLACEMENT
OR
DISLOCATION
.
300
13.4.3.4
URGENT
OPEN
REDUCTION
AND
INTERNAL
FIXATION
.
300
13.4.3.5
ASSESSMENT
OF
CONGRUITY
.
300
13.4.3.6
ASSESSMENT
OF
OPERABILIT
.
302
13.4.4
SURGICAL
CONSIDERATIONS
.
304
13.4.4.1
GENERAL
CONSIDERATIONS
.
304
13.4.4.2
APPROACHES
.
306
13.4.4.3
REDUCTION
.
313
13.4.4.4
INTERNAL
FIXATION
.
317
13.4.4
POSTOPERATIVE
CARE
.
319
13.5
COMPLICATIONS
.
321
13.6
CONCLUSIONS
.
321
REFERENCES
.
324
CONTENTS
XIX
PART
IV
FRACTURES
OF
THE
LOWER
EXTREMITY
CHAPTER
14
SUBCAPITAL
AND
INTERTROCHANTERIC
FRACTURES
J.
SCHATZKER
.
327
14.1
ANATOMY
AND
BLOOD
SUPPLY
.
327
14.1.1
CROSS-SECTIONAL
ANATOMY
OF
THE
HEAD
.
327
14.1.1.1
NECK
SHAFT
ANGLE
.
327
14.1.1.2
GREATER
TROCHANTER
.
327
14.1.2
BLOOD
SUPPLY
.
328
14.2
CLASSIFICATION
.
328
14.3
SUBCAPITAL
FRACTURES
.
328
14.3.1
CLASSIFICATION
.
328
14.3.2
HISTORY
AND
PHYSICAL
EXAMINATION
.
330
14.3.3
IMAGING
TECHNIQUES
.
330
14.3.3.1
X-RAYS
.
330
14.3.3.2
BONE
SCAN
.
330
14.3.3.3
TOMOGRAPHY
.
330
14.3.3.4
MAGNETIC
RESONANCE
IMAGING
.
330
14.3.4
SURGICAL
TREATMENT
.
330
14.3.4.1
METHOD
OF
REDUCTION
.
332
14.3.4.2
METHODS
OF
INTERNAL
FIXATION
.
334
14.3.4.3
METHODS
OF
JOINT REPLACEMENT
.
.
.
336
14.3.5
DECISION
MAKING
.
336
14.3.5.1
UNDISPLACED
FRACTURES
.
336
14.3.5.2
DISPLACED
FRACTURES
.
337
14.3.5.3
SPECIAL
FRACTURE
SITUATIONS
.
338
14.3.6
POSTOPERATIVE
MANAGEMENT
.
339
14.3.7
COMPLICATIONS
.
339
14.3.7.1
NONUNION
.
339
14.3.7.2
AVASCULAR
NECROSIS
AND
LOESS
OF
FIXATION
.
340
14.4
INTERTROCHANTERIC
FRACTURES
.
340
14.4.1
SURGICAL
ANATOMY
AND
CLASSIFICATION
340
14.4.2
HISTORY
AND
PHYSICAL
EXAMINATION
.
341
14.4.3
SURGICAL
TREATMENT
.
342
14.4.3.1
REDUCTION
.
343
14.4.3.2
INTERNAL
FIXATION
.
343
14.4.4
POSTOPERATIVE
MANAGEMENT
.
345
14.4.5
COMMON
EARLY
AND
LATE
POSTOPERATIVE
COMPLICATIONS
.
345
REFERENCES
.
348
CHAPTER
15
SUBTROCHANTERIC
FRACTURES
OF
THE
FEMUR
J.
SCHATZKER
.
349
15.1
BIOMECHANICAL
CONSIDERATIONS
.
349
15.1.1
MECHANICAL
FORCES
.
349
15.1.2
DEGREE
OF
COMMINUTION
.
349
15.1.3
LEVEL
OF
THE
FRACTURE
.
350
15.1.4
PATTERN
OF
THE
FRACTURE
.
350
15.1.5
DEFORMITY
.
350
15.2
NATURAL
HISTORY
.
350
15.3
INDICATIONS
FOR
OPEN
REDUCTION
AND
.
INTERNAL
FIXATION
.
351
15.4
SURGICAL
TECHNIQUES
.
351
15.4.1
DIAGNOSIS
.
351
15.4.2
CLASSIFICATION
.
353
15.4.3
PLANNING
THE
SURGICAL
PROCEDURE
.
.
353
15.4.3.1
IMPLANTS
.
353
15.4.3.2
PREOPERATIVE
PLANNING
.
357
15.4.4
SURGERY
.
359
15.4.4.1
THE
OPERATING
TABLE
.
359
15.4.4.2
POSITIONING
THE
PATIENT
.
361
15.4.4.3
SURGICAL
APPROACH
FOR
PLATING
.
362
15.4.4.4
TECHNIQUE
OF
OPEN REDUCTION
AND
INTERNAL
FIXATION
.
363
15.4.4.5
BONE-GRAFTING
.
365
15.4.5
POSTOPERATIVE
CARE
.
365
15.4.5.1
SIGNS
OF
INSTABILITY
.
365
15.4.5.2
INFECTION
.
366
REFERENCES
.
366
CHAPTER
16
FRACTURES
OF
THE
FEMUR
J.
SCHATZKER
.
367
16.1
INTRODUCTION
.
367
16.2
FACTORS
IMPORTANT
IN
EVALUATING
THE
MODE
OF
TREATMENT
.
367
16.3
SURGICAL
TREATMENT
.
368
16.3.1
TIMING
OF
SURGERY
.
368
16.3.1.1
MULTIPLE
SYSTEM
INJURIES
.
368
16.3.1.2
HEAD
INJURY
.
369
16.3.1.3
OPEN
FRACTURES
.
369
16.3.1.4
VASCULAR
INJURY
.
369
16.3.1.5
IPSILATERAL
NECK
FRACTURE
OR
DISLOCATION
OF
THE
HIP
.
369
16.3.1.6
IPSILATERAL
FRACTURE
OF
THE
FEMORAL
SHAFT
AND
LIGAMENTOUS
DISRUPTION
OF
THE
KNEE
.
370
16.3.1.7
FLOATING
KNEE
SYNDROME
.
370
16.3.1.8
ISOLATED
FRACTURES
OF
THE
FEMORAL
SHAFT
.
370
16.3.2
SURGICAL
TECHNIQUE
.
370
16.3.2.1
POSITIONING
THE
PATIENT,
SKIN
PREPARATION,
AND
DRAPING
.
370
16.3.2.2
SURGICAL
APPROACH
.
371
16.3.2.3
TECHNIQUE
OF
OPEN REDUCTION
.
.
.
372
16.3.2.4
TECHNIQUE
OF
FRACTURE
FIXATION
.
.
.
373
16.3.2.5
BONE
GRAFTING
.
383
16.3.2.6
WOUND
CLOSURE
.
383
16.3.3
POSTOPERATIVE
CARE
.
383
16.4
SPECIAL
CONSIDERATIONS:
OPEN
FRACTURES
OF
THE
FEMUR
.
385
REFERENCES
.
385
XX
CONTENTS
CHAPTER
17
SUPRACONDYLAR
FRACTURES
OF
THE
FEMUR
(33-A,B,AND
C)
J.
SCHATZKER
.
17.1
INTRODUCTION
.
17.2
GUIDES
TO
TREATMENT
AND
INDICATIONS
FOR
SURGERY
.
17.2.1
ABSOLUTE
INDICATIONS
.
17.2.1.1
INTRA-ARTICULAR
FRACTURES
IN
WHICH
ADEQUATE
JOINT
CONGRUITY
CANNOT
BE
RESTORED
BY
MANIPULATION
.
17.2.1.2
OPEN
INTRA-ARTICULAR
FRACTURES
.
.
.
17.2.1.3
ASSOCIATED
NEUROVASCULAR
INJURIES
.
17.2.1.4
IPSILATERAL
FRACTURE
OF
THE
TIBIAL
PLATEAU
.
17.2.1.5
IPSILATERAL
FRACTURE
OF
THE
TIBIA
(THE
FLOATING
KNEE)
.
17.2.1.6
MULTIPLE
INJURIES
.
17.2.1.7
PATHOLOGICAL
FRACTURES
.
17.2.2
RELATIVE
INDICATIONS
.
17.3
SURGICAL
TREATMENT
.
17.3.1
TIMING
OF
SURGERY
.
17.3.2
HISTORY
AND
PHYSICAL
EXAMINATION
.
17.3.3
RADIOLOGICAL
EXAMINATION
.
17.3.4
CLASSIFICATION
.
17.3.5
PLANNING
THE
SURGICAL
PROCEDURE
.
.
17.3.6
SURGICAL
ANATOMY
OF
THE
DISTAL
FEMUR
.
17.3.7
POSITIONING
AND
DRAPING
THE
PATIENT
17.3.8
SURGICAL
EXPOSURE
.
17.3.8.1
LATERAL
EXPOSURE
.
17.3.8.2
ANTERIOR
EXPOSURE
.
17.3.9
TECHNIQUES
OF
REDUCTION
AND
INTERNAL
FIXATION
.
17.3.9.1
TYPE
A
FRACTURES
.
17.3.9.2
TYPE
B
FRACTURES
.
17.3.9.3
TYPE
C
FRACTURES
.
17.3.9.4
SUPRACONDYLAR FRACTURES
ABOVE
A
TOTAL
KNEE
REPLACEMENT
.
17.3.9.5
THE
OPEN SUPRACONDYLAR
FRACTURE
.
17.3.10
BONEGRAFTING
.
17.3.11
METHYL
METHACRYLATE
.
17.4
POSTOPERATIVE
CARE
.
17.5
COMPLICATIONS
.
17.6
CONCLUSIONS
.
REFERENCES
.
CHAPTER
18
FRACTURES
OF
THE
PATELLA
J.
SCHATZKER
.
18.1
INTRODUCTION
.
18.2
METHODS
OF
EVALUATION
AND
GUIDES
TO
TREATMENT
.
18.3
CLASSIFICATION
.
18.3.1
OSTEOCHONDRAL
FRACTURES
.
18.3.2
STELLATE
FRACTURES
.
18.3.3
TRANSVERSE
FRACTURES
.
387
387
389
390
390
391
391
391
392
392
392
392
392
392
393
393
393
393
395
396
396
396
396
398
398
404
404
406
408
410
410
411
411
412
413
415
415
415
415
415
415
416
18.4
SURGICAL
TREATMENT
.
416
18.4.1
UNDISPLACED
FRACTURES
.
416
18.4.2
DISPLACED
FRACTURES
.
416
18.4.2.1
SURGICAL
APPROACHES
.
416
18.4.2.2
BIOMECHANICAL
CONSIDERATIONS
.
.
.
416
18.4.2.3
TECHNIQUES
OF
INTERNAL
FIXATION
.
.
.
417
18.5
POSTOPERATIVE
CARE
.
418
REFERENCE
.
418
CHAPTER
19
FRACTURES
OF
THE
TIBIAL
PLATEAU
J.
SCHATZKER
.
419
19.1
INTRODUCTION
.
419
19.2
CLASSIFICATION
AND
GUIDES
TO
TREATMENT
.
.
.
420
19.2.1
TYPEL(41-BL)
.
420
19.2.2
TYPE
II
(41-B3.1)
.
420
19.2.3
TYPE
III
(41-B.2)
.
422
19.2.4
TYPE
IV
(41-BL,41-B2,AND41-B3)
.
423
19.2.5
TYPEV
(41-C1)
.
424
19.2.6
TYPE
VI
.
425
19.2.7
RELATIONSHIP
OF
THE
COMPREHENSIVE
CLASSIFICATION
TO
THE
SIX
FRACTURE
TYPES
.
426
19.2.8
ABSOLUTE
INDICATIONS
FOR SURGERY
.
.
428
19.2.8.1
OPEN
FRACTURES
.
428
19.2.8.2
ACUTE
COMPARTMENT
SYNDROME
.
.
.
428
19.2.8.3
ASSOCIATED
VASCULAR
OR
NEUROLOGICAL
INJURY
.
428
19.3
METHODS
OF
ASSESSMENT
.
428
19.3.1
HISTORY
.
428
19.3.2
PHYSICAL
EXAMINATION
.
428
19.3.3
RADIOLOGICAL
EXAMINATION
.
428
19.4
SURGICAL
TREATMENT
.
430
19.4.1
PLANNING
THE
SURGICAL
PROCEDURE
.
.
430
19.4.2
APPROACHES
.
430
19.4.3
POSITIONING
THE
PATIENT
.
432
19.4.4
TIMING
THE
SURGICAL
PROCEDURE
.
.
.
432
19.4.5
METHODS
OF
OPEN
REDUCTION
AND
INTERNAL
FIXATION
.
432
19.4.6
INTERNAL
FIXATION
OF
DIFFERENT
FRACTURE
TYPES
.
435
19.4.6.1
TYPEI
.
435
19.4.6.2
TYPELL
.
435
19.4.6.3
TYPE
III
.
435
19.4.6.4
TYPE
IV
.
435
19.4.6.5
TYPEV
.
435
19.4.6.6
TYPE
VI
.
435
19.4.7
LIGAMENT
AND
MENISCAL
REPAIR
.
.
.
436
19.4.8
POSTOPERATIVE
CARE
.
436
19.5
SUMMARY
AND
CONCLUSIONS
.
437
REFERENCES
.
438
CONTENTS
XXI
CHAPTER
20
FRACTURES
OF
THE
TIBIA
M.
TILE
.
439
20.1
INTRODUCTION
.
439
20.2
NATURAL
HISTORY
.
439
20.2.1
NONOPERATIVE
SCHOOL
.
440
20.2.2
OPERATIVE
SCHOOL
.
441
20.2.3
PIASTER
DISEASE
.
442
20.2.3.1
COMPARTMENT
SYNDROMES
.
442
20.2.3.2
REFLEX
SYMPATHETIC DYSTROPHY
.
.
.
442
20.2.3.3
THROMBOEMBOLIE
DISEASE
.
442
20.2.3.4
SEVERE
SOFT
TISSUE
INJURY
.
444
20.2.4
FACTORS
INFLUENCING
THE
NATURAL
HISTORY
.
444
20.2.4.1
PATHOANATOMY
OF
THE
FRACTURE
.
.
.
444
'
20.2.4.2
SOFT
TISSUE
INJURY
.
446
20.2.4.3
OTHER
INJURIES
TO
THE
LIMB
.
446
20.2.4.4
PATIENT
FACTORS
.
446
20.2.4.5
THE
HEALTH
CARE
TEAM
.
446
20.2.5
SUMMARY
.
447
20.3
ASSESSMENT
.
447
20.3.1
CLINICAL
ASSESSMENT
.
447
20.3.1.1
HISTORY
.
447
20.3.1.2
PHYSICAL
ASSESSMENT
.
447
20.3.2
RADIOLOGICAL
ASSESSMENT
.
449
20.4
MANAGEMENT
.
449
20.4.1
DECISION
MAKING
.
449
20.4.2
NONOPERATIVE
TREATMENT
.
449
20.4.3
INDICATIONS
FOR
SURGERY
.
451
20.4.3.1
PRIMARY
INDICATIONS
.
452
20.4.3.2
DELAYED
PRIMARY
INDICATIONS
.
459
20.4.3.3
SECONDARY
INDICATIONS
.
459
20.4.4
ROLE
OF
AMPUTATION
IN
SEVERE
TIBIAL
FRACTURES
.
459
20.4.5
TIMING
OF
SURGERY
.
461
20.4.6
SURGICAL
METHODS
.
461
20.4.6.1
APPROACHES
.
461
20.4.6.2
REDUCTION
TECHNIQUES
.
464
20.4.6.3
FIXATION
.
464
20.4.6.4
WOUND
CLOSURE
.
485
20.4.6.5
POSTOPERATIVE
COURSE
.
486
20.5
CONCLUSIONS
.
488
REFERENCES
.
488
21.2.5
THE
DILEMMA
.
495
21.2.6
SUMMARY
.
496
21.3
CLASSIFICATION
.
496
21.3.1
COMPREHENSIVE
CLASSIFICATION
.
498
21.3.2
USE
OF
CLASSIFICATION
IN
DECISION
MAKING
.
498
21.3.2.1
FIBULA
.
498
21.3.2.2
ARTICULAR
SURFACE
OF
THE
TIBIA
.
499
21.3.2.3
DISTAL
TIBIAL
METAPHYSIS
.
499
21.3.3
PERSONALITY
OF
THE
FRACTURE
.
499
21.4
ASSESSMENT
.
501
21.4.1
CLINICAL
.
501
21.4.2
RADIOLOGICAL
.
503
21.5
INDICATIONS
FOR
SURGERY
.
503
21.5.1
MINIMAL DISPLACEMENT
.
503
21.5.2
SIGNIFICANT
DISPLACEMENT
.
503
21.5.2.1
OPERABLE
.
503
21.5.2.2
INOPERABLE
.
505
21.6
SURGICAL
TECHNIQUE
.
509
21.6.1
TIMING
.
509
21.6.2
APPROACH
.
509
21.6.2.1
SOFT
TISSUE
.
509
21.6.2.2
SKELETAL
TISSUE
.
510
21.6.3
TECHNIQUE
OF
INTERNAL
FIXATION
.
.
.
510
21.6.3.1
WITHOUT
FIBULAR
FRACTURE
.
510
21.6.3.2
WITH
FIBULAR
FRACTURE
.
510
21.6.4
FIXATION
TECHNIQUES
WITH
POOR
SKIN
AND
SOFT
TISSUE
(GRADE
3)
.
516
21.6.5
WOUND
CLOSURE
.
516
21.6.6
POSTOPERATIVE
CARE
.
516
21.6.6.1
EARLY
.
516
21.6.6.2
LATE
.
519
21.7
COMMON
PITFALLS
OF
TREATMENT
.
519
21.7.1
POOR
DECISION
MAKING
.
520
21.7.2
OPERATING
THROUGH
POOR
SKIN
.
.
.
520
21.7.3
TECHNICAL
DIFFICULTIES
WITH
THE
FIBULA
520
21.7.4
TECHNICAL
DIFFICULTIES
WITH
THE
TIBIAL
FRACTURE
.
520
21.7.5
POOR POSTOPERATIVE
CARE
.
520
21.8
LATE
RECONSTRUCTION:
SUPRAMALLEOLAR
OSTEOTOMY
.
520
REFERENCES
.
521
CHAPTER
21
FRACTURES
OF
THE
DISTAL
TIBIAL
METAPHYSIS
INVOLVING
THE
ANKIE
JOINT:
THE
PILON
FRACTURE
M.
TILE
.
491
21.1
INTRODUCTION
.
491
21.2
NATURAL
HISTORY
.
491
21.2.1
NATURE
OF
THE
INJURY
.
491
21.2.1.1
AXIAL
COMPRESSION
.
491
21.2.1.2
SHEAR
(TENSION)
.
493
21.2.1.3
COMBINED
.
494
21.2.2
STATE
OF
THE
BONE
.
494
21.2.3
STATE
OF
THE
SOFT
TISSUES
.
495
21.2.4
TECHNICAL
DIFFICULTIES
.
495
CHAPTER
22
FRACTURES
OF
THE
ANKIE
M.
TILE
.
523
22.1
INTRODUCTION
.
523
22.1.1
BASIC
PRINCIPLES
.
523
22.1.2
ANATOMICAL
CONSIDERATIONS
.
523
22.1.2.1
STABILITY
.
523
22.1.2.2
CONGRUITY
.
523
22.1.2.3
PHYSIOLOGY
.
524
22.1.2.4
PATHOANATOMY
.
524
22.1.3
NATURAL
HISTORY
.
526
22.1.4
MECHANISM
OF
INJURY
.
528
22.1.4.1
SUPINATION
-
ADDUCTION
.
529
XXII
CONTENTS
22.1.4.2
EVERSION
-
ABDUCTION
.
22.2
CLASSIFICATION
.
22.2.1
INTRODUCTION
.
22.2.2
COMPREHENSIVE
CLASSIFICATION
.
.
.
.
22.2.2.1
TYPEA
.
22.2.2.2
TYPEB
.
22.2.2.3
TYPEC
.
22.2.2.4
ISOLATED
MEDIAL
MALLEOLUS
FRACTURE
.
22.3
ASSESSMENT
OF
STABILITY
.
22.3.1
CLINICAL
ASSESSMENT
.
22.3.1.1
HISTORY
.
22.3.1.2
PHYSICAL
EXAMINATION
.
22.3.2
RADIOLOGICAL
ASSESSMENT
.
22.3.2.1
LATERAL
COMPLEX:
FIBULA
AND
TIBIOFIBULAR
SYNDESMOSIS
.
22.3.2.2
TALUS
.
22.3.2.3
POSTERIOR
TIBIAL
PROCESS
.
22.3.2.4
MEDIAL
COMPLEX
.
22.4
MANAGEMENT
.
22.4.1
DECISION
MAKING
.
22.4.1.1
TYPEA
.
22.4.1.2
TYPES
BANDC
.
22.4.1.3
ISOLATED
MEDIAL
MALLEOLAR
FRACTURE
.
22.4.2
SURGICAL
TECHNIQUE
.
22.4.2.1
TOURNIQUET
.
22.4.2.2
TIMING
.
22.4.2.3
INCISIONS
.
22.4.2.4
OPEN
REDUCTION
AND
INTERNAL
FIXATION
.
22.4.3
WOUND
CLOSURE
.
22.4.4
POSTOPERATIVE
PROGRAM
.
22.4.4.1
IMMEDIATE
MANAGEMENT
.
22.4.4.2
EARLY
MOTION
.
22.5
SPECIAL
PROBLEMS
IN
ANKIE
FRACTURES
.
22.5.1
OPEN
ANKIE
FRACTURES
.
22.5.2
ANKIE
FRACTURES
IN
THE
ELDERLY
.
.
.
22.5.3
PRIMARY
ANKIE
ARTHRODESIS
.
22.5.4
FIBULAR LENGTHENING
FOR
MALUNION
.
22.5.5
SUPRAMALLEOLAR OSTEOTOMY
.
22.5.6
ANKIE
FRACTURES
IN
ADOLESCENTS
.
.
.
REFERENCES
.
CHAPTER23
FRACTURES
OF
THE
TALUS
M.TILE
.
23.1
INTRODUCTION
.
23.2
ANATOMICAL
CONSIDERATIONS
.
23.2.1
VASCULAR
ANATOMY
.
23.2.1.1
EXTRAOSSEOUS
ARTERIAL
SUPPLY
.
.
.
.
23.2.1.2
INTRAOSSEOUS
.
23.2.1.3
SUMMARY
.
23.2.2
MECHANISM
OF
INJURY
.
23.2.2.1
COMMON
PATTERN
.
23.2.2.2
ATYPICAL
PATTERNS
.
23.2.2.3
TOTAL
DISLOCATION
OF
THE
TALUS
.
23.3
CLASSIFICATION
AND
NATURAL
HISTORY
.
530
531
531
534
534
535
535
536
536
537
537
537
537
538
540
540
540
541
541
542
542
545
545
545
545
545
548
556
556
556
556
557
557
558
559
559
560
560
561
563
563
563
563
564
565
565
565
565
567
567
568
23.3.1
FRACTURES
OF
THE
BODY
OF
THE
TALUS
.
568
23.3.2
FRACTURES
OF
THE
TALAR
NECK
.
569
23.3.2.1
TYPE
A:
UNDISPLACED
FRACTURES
OF
THE
TALAR
NECK
.
569
23.3.2.2
TYPE
B:
DISPLACED
FRACTURES
OF
THE
TALAR
NECK
WITH
SUBLUXATION
OF
SUBTALAR
JOINT
.
569
23.3.2.3
TYPE
C:
DISPLACED
FRACTURES
OF
THE
TALAR
NECK
WITH
POSTERIOR
DISLOCATION
OF
THE
BODY
.
571
23.3.3
SUBTALAR
DISLOCATION
.
573
23.3.4
TOTAL
DISLOCATION
OF
THE
TALUS
.
573
23.4
MANAGEMENT
.
573
23.4.1
ASSESSMENT
.
574
23.4.1.1
CLINICAL
ASSESSMENT
.
573
23.4.1.2
RADIOLOGICAL
ASSESSMENT
.
574
23.4.2
DECISION
MAKING
.
574
23.4.2.1
FRACTURES
OF
THE
BODY
.
575
23.4.2.2
FRACTURES
OF
THE
TALAR
NECK
.
576
23.4.3
SURGICAL
TECHNIQUE
.
580
23.4.3.1
TIMING
.
580
23.4.3.2
ANTIBIOTICS
.
580
23.4.3.3
TOURNIQUET
.
581
23.4.3.4
SKIN
APPROACHES
.
581
23.4.3.5
STABLE
INTERNAL
FIXATION
.
583
23.4.3.6
POSTOPERATIVE
CARE
.
583
23.4.4
SPECIAL
PROBLEMS
.
586
23.4.4.1
OPEN
FRACTURES
AND
FRACTURE
DISLOCATIONS
.
586
23.4.4.2
COMMINUTED
FRACTURES
OF
THE
TALAR
BODY
.
587
REFERENCES
.
588
CHAPTER
24
FRACTURES
OF
THE
CALCANEUS
M.TILE
.
589
24.1
INTRODUCTION
.
589
24.2
ANATOMY
.
590
24.3
PATHOANATOMY
(MECHANISM
OF
INJURY)
.
592
24.4
CLASSIFICATION
.
593
24.5
ASSESSMENT
.
595
24.5.1
RADIOGRAPHIE
ASSESSMENT
.
595
24.6
DECISION
MAKING
.
595
24.6.1
FRACTURE
FACTORS
.
595
24.6.2
PATIENT
FACTORS
.
596
24.7
TREATMENT
.
596
24.7.1
NONOPERATIVE
TREATMENT
.
596
24.7.2
OPERATIVE
TREATMENT
.
597
24.7.2.1
GENERAL
ASPECTS
.
597
24.7.2.2
SPECIFIC
ASPECTS
.
598
24.8
POSTOPERATIVE
CARE
.
602
24.9
PROGNOSIS
AND
RESULTS
.
602
24.10
CONCLUSIONS
.
603
REFERENCES
.
603
CONTENTS
25
INJURIES
OF
THE
MIDFOOT
AND
FOREFOOT
D.J.G.
STEPHEN
.
605
25.1
FRACTURES
OF
THE
NAVICULAR
.
605
25.1.1
ANATOMY
.
605
25.1.2
TREATMENT
.
605
25.2
FRACTURES
OF
THE
CUBOID
.
607
25.3
FRACTURES
OF
THE
METATARSAIS
.
608
25.3.1
ANATOMY
.
608
25.3.2
TREATMENT
.
609
25.3.3
FRACTURES
OF
THE
PROXIMAL
FIFTH
METATARSAL
.
614
25.4
FRACTURES
OF
THE
PHALANGES
.
616
25.5
TARSOMETATARSAL
(LISFRANC)
FRACTURE-DISLOCATIONS
.
617
25.5.1
ANATOMY
.
617
25.5.2
MECHANISM
AND
CLASSIFICATION
.
617
25.5.3
CLINICAL
AND
RADIOLOGICAL
DIAGNOSIS
.
617
25.5.4
TREATMENT
.
618
25.6
COMPARTMENT
SYNDROMES
OF
THE
FOOT
.
619
REFERENCES
.
620
SUBJECT
INDEX
.
623 |
| any_adam_object | 1 |
| author_GND | (DE-588)172355664 |
| building | Verbundindex |
| bvnumber | BV010467197 |
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| ctrlnum | (OCoLC)455914377 (DE-599)BVBBV010467197 |
| discipline | Medizin |
| edition | 2. ed., completely rev. and enl. |
| format | Book |
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| genre | 1\p (DE-588)4143413-4 Aufsatzsammlung gnd-content |
| genre_facet | Aufsatzsammlung |
| id | DE-604.BV010467197 |
| illustrated | Illustrated |
| indexdate | 2024-08-22T00:45:03Z |
| institution | BVB |
| isbn | 3540593888 |
| language | English |
| oai_aleph_id | oai:aleph.bib-bvb.de:BVB01-006975044 |
| oclc_num | 455914377 |
| open_access_boolean | |
| owner | DE-355 DE-BY-UBR DE-19 DE-BY-UBM |
| owner_facet | DE-355 DE-BY-UBR DE-19 DE-BY-UBM |
| physical | XXIII, 633 S. zahlr. Ill., graph. Darst. |
| publishDate | 1996 |
| publishDateSearch | 1996 |
| publishDateSort | 1996 |
| publisher | Springer |
| record_format | marc |
| spelling | The rationale of operative fracture care Joseph Schatzker ; Marvin Tile 2. ed., completely rev. and enl. Berlin [u.a.] Springer 1996 XXIII, 633 S. zahlr. Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Fractures Surgery Zlomi Kirurgija Knochenbruch (DE-588)4031318-9 gnd rswk-swf Chirurgie (DE-588)4009987-8 gnd rswk-swf 1\p (DE-588)4143413-4 Aufsatzsammlung gnd-content Knochenbruch (DE-588)4031318-9 s Chirurgie (DE-588)4009987-8 s DE-604 Schatzker, Joseph Sonstige (DE-588)172355664 oth Tile, Marvin Sonstige oth DNB Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=006975044&sequence=000001&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis 1\p cgwrk 20201028 DE-101 https://d-nb.info/provenance/plan#cgwrk |
| spellingShingle | The rationale of operative fracture care Fractures Surgery Zlomi Kirurgija Knochenbruch (DE-588)4031318-9 gnd Chirurgie (DE-588)4009987-8 gnd |
| subject_GND | (DE-588)4031318-9 (DE-588)4009987-8 (DE-588)4143413-4 |
| title | The rationale of operative fracture care |
| title_auth | The rationale of operative fracture care |
| title_exact_search | The rationale of operative fracture care |
| title_full | The rationale of operative fracture care Joseph Schatzker ; Marvin Tile |
| title_fullStr | The rationale of operative fracture care Joseph Schatzker ; Marvin Tile |
| title_full_unstemmed | The rationale of operative fracture care Joseph Schatzker ; Marvin Tile |
| title_short | The rationale of operative fracture care |
| title_sort | the rationale of operative fracture care |
| topic | Fractures Surgery Zlomi Kirurgija Knochenbruch (DE-588)4031318-9 gnd Chirurgie (DE-588)4009987-8 gnd |
| topic_facet | Fractures Surgery Zlomi Kirurgija Knochenbruch Chirurgie Aufsatzsammlung |
| url | http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=006975044&sequence=000001&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA |
| work_keys_str_mv | AT schatzkerjoseph therationaleofoperativefracturecare AT tilemarvin therationaleofoperativefracturecare |