Treatment of complex fractures:
Saved in:
| Format: | Book |
|---|---|
| Language: | English |
| Published: |
Philadelphia [u.a.]
Saunders
2002
|
| Series: | The orthopedic clinics of North America
33,1 |
| Subjects: | |
| Online Access: | Inhaltsverzeichnis |
| Physical Description: | XIII, 290 S. zahlr. Ill., graph. Darst. |
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| 245 | 1 | 0 | |a Treatment of complex fractures |c Philip J. Kregor ... guest ed. |
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| adam_text | TREATMENT OF COMPLEX FRACTURES
CONTENTS
Preface xiii
Philip J. Kregor and Marc F. Swiontkowski
Scapula Fractures 1
Peter Alexander Cole
Scapula fractures are relatively rare fractures which are typically a result of
high energy trauma. Associated multisystemic injuries, therefore, occur with
a high frequency. The management of scapula fractures has historically been
nonoperative, perhaps in part due to the paucity of information regarding
outcomes, combined with a relative unfamiliarity with treating these injuries.
It is likely, however, that intraarticular fractures, and certain other highly
displaced variants, have a better outcome when treated operatively. A well
conceived diagnostic work up and a properly executed plan of rehabilitation
are requisite.
Management of the Smashed Distal Humerus 19
Shawn W. O Driscoll, Joaquin Sanchez Sotelo,
and Michael E. Torchia
The purpose of this article is to present a principle based approach to treating
the smashed distal humerus. These injuries are challenging to even the most
experienced surgeons. The four goals, in order of priority, are soft tissue heal¬
ing without infection, restoration of diaphyseal bone stock, union between
the distal fragments and the shaft, and a stable and mobile articulation.
Wrist Fractures 35
Douglas P. Hanel, Marci D. Jones, and Thomas E. Trumble
The benefits of a well reduced and well healed wrist fracture are predictable.
This knowledge has prompted the development of myriad treatment meth¬
ods and fixation devices. The choice of open versus closed reduction and
the devices used to maintain that reduction could most often be determined
with a well defined and reproducible closed reduction maneuver. With this
maneuver, the integrity of the critical volar ulnar corner of the radius is
determined as is articular stepoff, metaphyseal comminution, and distal ra
dionular joint (DRUJ) stability. Reconstruction of the subluxed or dislocated
DRU] starts with the reduction of the radius, frequently obviating the need
to address fractures involving the ulnar head and styloid. Most importantly,
the results of treatment reflect surgical decision over the fixation method.
ORTHOPEDIC CLINICS OF NORTH AMERICA
VOLUME 33 • NUMBER 1 • JANUARY 2002 vii
High Energy Pelvic Ring Disruptions 59
M. L. Chip Routt, Jr, Sean E. Nork, and William J. Mills
High energy pelvic ring disruptions are associated with numerous primary
organ system injuries. Early, accurate pelvic reduction and stable fixation
optimize patient outcome. A variety of fixation techniques have been ad¬
vocated. A multispecialty team approach is advantageous when managing
these patients and their pelvic injuries.
Associated Injuries Complicating the Management of Acetabular
Fractures: Review and Case Studies 73
Philip J. Kregor and David Templeman
The treatment of acetabular fractures has evolved considerably in the past
three decades. Associated injuries to the femoral head, proximal femur, or
femoral shaft can complicate the initial management of the acetabular frac¬
ture, and mandate a careful treatment strategy for optimal treatment of both
the acetabular fracture and associated injury. These injuries may have a
large impact on the clinical outcome. The surgeon must consider surgical
approaches, timing, and alternative modes of fixation. A discussion with
case illustrations is provided.
Femoral Neck Fractures 97
Andrew H. Schmidt and Mark F. Swiontkowski
Femoral neck fractures in the geriatric patient continue to represent a thera¬
peutic challenge. Despite advances in surgical techniques and medical care,
the risk of nonunion and osteonecrosis after fixation have not changed ap¬
preciably in the last 50 years. Considerable debate continues to occur with
respect to the relative merits of internal fixation versus arthroplasty. The rel¬
ative benefits and complications of unipolar and bipolar hemiarthroplasty,
as well as total hip replacement, continue to be poorly understood. The next
decade will bring advances in the prevention and treatment of osteoporosis
that may finally decrease the incidence of these fractures. Advances in the
use of bone graft substitutes may finally improve the outcome of internal
fixation.
Subtrochanteric Femur Fractures 113
Stephen H. Sims
Fractures in the subtrochanteric zone of the proximal femur present com¬
plex treatment challenges. These treatment difficulties are related to the
anatomic and biomechanic features that are unique to this area. These frac¬
tures occur in older patients from low energy trauma and in younger patients
with high energy trauma, with separate diagnostic and treatment signifi¬
cance. Intramedullary fixation with standard centromedullary nails, as well
as cephalomedullary nails, are commonly employed as fixation methods to
treat this fracture. The techniques and results of this will be reviewed.
Complicated Femoral Shaft Fractures 127
George V. Russell, Jr, Philip J. Kregor, Christopher A. Jarrett,
and Michael Zlowodzki
The treatment of femoral shaft fractures has become safe and reproducible
since the advent of popularization of intramedullary nailing, however, many
femora] shaft fractures are complicated by associated fractures, extensive
comminution, extensive contamination, and arterial injury compartmen
tal syndrome. Other conditions associated with the use of femoral nailing
Vlii CONTENTS
include femora nonunions, broken hardware, acute fractures with prior im¬
plants, and infections. The management of these complex femoral shaft frac¬
tures demands special techniques for successful outcome.
Periprosthetic Fractures of the Femur 143
Andrew H. Schmidt and Richard F. Kyle
Periprosthetic fractures of the femur represent a heterogeneous and chal¬
lenging problem for the orthopedic surgeon. The incidence of these fractures
is dramatically increasing, as there are more and more patients with aging
total joint replacements. The fractures may occur as the result of a traumatic
event, but more often are the result of minor trauma spontaneous fracture,
and they are frequently associated with preexisting, sometimes neglected,
problems with the associated joint replacement.
Distal Femur Fractures with Complex Articular Involvement:
Management by Articular Exposure and Submuscular Fixation 153
Philip J. Kregor
The A.O./O.T.A. C3 distal femur fracture is characterized by complex ar¬
ticular involvement and is often accompanied by a very short distal femur
segment, small osteochondral fragments, and high energy soft tissue dis¬
ruption. Current fixation strategies do not provide for optimal visualiza¬
tion/reduction of the articular surface in conjunction with stable fixation of
the distal femoral block. Malunion, loss of fixation, need for supplemental
fixation, and need for bone grafting is common in the treatment of the €3
distal femur fracture. The transarticular percutaneous osteosynthesis tech¬
nique, popularized by Krettek, et al, utilizes a lateral peripatellar approach for
optimal articular visualization and submuscular fixation for minimal devi
talization. In this article, its use is described, as well as reduction and fixation
strategies for the articular surface.
Open Reduction and Internal Fixation of High Energy
Tibial Plateau Fractures 177
William J. Mills and Sean E. Nork
Proximal tibial articular fractures are caused by a variety of mechanisms
and are characterized by numerous distinct fracture patterns. Surgical treat¬
ment for other than minimally displaced or nondisplaced fractures is recom¬
mended to restore joint congruity and limb alignment, and to allow early,
stable, knee motion.
Hybrid External Fixation for Tibial Plateau Fractures: Clinical
and Biomechanical Correlation 199
J. Tracy Watson, Steve Ripple, Susan J Hoshaw, and David Fhyrie
The biomechanical data support the use of tensioned wire fixation to stabi¬
lize complex fractures of the proximal tibia. The authors will show that the
stability of a four wire construct is comparable to the gold standard of dual
plating internal fixation techniques. Using these techniques, many recent in¬
vestigators have demonstrated improved clinical results, with average knee
scores for most patients ranging from 85 to 90.
High Energy Tibial Shaft Fractures 211
Bruce French and Paul Tornetta, III
High energy tibial fractures are common injuries that are managed by most
practicing orthopaedic surgeons. Many methods of treatment are available.
This article reviews the options for skeletal stabilization, the risks and benefits
of each, and the necessary concepts that effect outcome.
CONTENTS TX
Pilon Fractures: Assessment and Treatment 231
Joseph Borrelli, Jr and Erik Ellis
The treatment of high energy intra articular fractures of the tibial plafond
involves many potential complications. A protocol has been developed. This
protocol recognizes the importance of the surrounding soft tissues and is
based on sound principles and thorough clinical experience. This article dis¬
cusses this protocol and its use and explains why it is now more widely
accepted.
Fractures of the Talar Neck 247
Michael Archdeacon and Roger Wilber
Fractures of the talus have been described for 400 years. This article reviews
the history of this injury and its treatment. It also discusses the modern results
and complications involved with the injury and treatment.
Fractures of the Calcaneus 263
David P. Barei, Carlo Bellabarba, Bruce J. Sangeorzan,
and Stephen K. Benirschke
Displaced fractures of the calcaneous are relatively common injuries that re¬
main a treatment enigma. Virtually all aspects of the management of calcaneal
fractures are a source of debate. Contemporary imaging, reduction, and fix¬
ation techniques attempt to improve the long term results of these injuries.
The complex fracture fragments displace in predictable patterns. Meticulous
surgical technique, restoration of extra and intra articular anatomy, and ob¬
taining rigid fracture fixation are critical to obtaining satisfactory operative
results. This article extensively reviews the controversies and summarizes
the current opinions in the management of displaced calcaneal fractures.
Index 287
Subscription Information Inside back cover
X CONTENTS
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| spelling | Treatment of complex fractures Philip J. Kregor ... guest ed. Philadelphia [u.a.] Saunders 2002 XIII, 290 S. zahlr. Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier The orthopedic clinics of North America 33,1 Fracturen gtt Fractures Treatment Fractures therapy Therapie (DE-588)4059798-2 gnd rswk-swf Knochenbruch (DE-588)4031318-9 gnd rswk-swf Knochenbruch (DE-588)4031318-9 s Therapie (DE-588)4059798-2 s DE-604 Kregor, Philip J. Sonstige (DE-588)133083330 oth The orthopedic clinics of North America 33,1 (DE-604)BV000001089 33,1 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=009627871&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Treatment of complex fractures The orthopedic clinics of North America Fracturen gtt Fractures Treatment Fractures therapy Therapie (DE-588)4059798-2 gnd Knochenbruch (DE-588)4031318-9 gnd |
| subject_GND | (DE-588)4059798-2 (DE-588)4031318-9 |
| title | Treatment of complex fractures |
| title_auth | Treatment of complex fractures |
| title_exact_search | Treatment of complex fractures |
| title_full | Treatment of complex fractures Philip J. Kregor ... guest ed. |
| title_fullStr | Treatment of complex fractures Philip J. Kregor ... guest ed. |
| title_full_unstemmed | Treatment of complex fractures Philip J. Kregor ... guest ed. |
| title_short | Treatment of complex fractures |
| title_sort | treatment of complex fractures |
| topic | Fracturen gtt Fractures Treatment Fractures therapy Therapie (DE-588)4059798-2 gnd Knochenbruch (DE-588)4031318-9 gnd |
| topic_facet | Fracturen Fractures Treatment Fractures therapy Therapie Knochenbruch |
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