Orthopedic urgencies and emergencies:
Gespeichert in:
| Weitere Verfasser: | |
|---|---|
| Format: | Buch |
| Sprache: | English |
| Veröffentlicht: |
Philadelphia, Pennsylvania
Elsevier
[2016]
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| Schriftenreihe: | Orthopedic clinics of North America
volume 47, number 3 (July 2016) |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | xvii Seiten, Seite 485-643 Illustrationen |
| ISBN: | 9780323448505 |
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| 245 | 1 | 0 | |a Orthopedic urgencies and emergencies |c editors James H. Calandruccio, Benjamin J. Grear, Benjamin M. Mauck, Jeffrey R. Sawyer, Patrick C. Toy, John C. Weinlein |
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| adam_text | Titel: Orthopedic urgencies and emergencies
Autor: Calandruccio, James H
Jahr: 2016
Orthopedic Urgencies and Emergencies ix
CONTENTS
Erratum xv
Preface: Orthopedic Urgencies and Emergencies xvii
Jennifer Flynn-Briggs
Adult Reconstruction
Patrick C. Toy
Management of Hip Pain in Young Adults
Derek Ward and Javad Parvizi
485
The diagnosis and treatment of hip pain in the young adult remain a challenge.
Recently, understanding of a few specific hip conditions has improved, most
notably femoroacetabular impingement. The differential diagnosis of hip
pain has also expanded significantly, offering new challenges and opportu-
nities. Along with the diagnostic dilemma, optimal treatment strategies for
many conditions have yet to be proven and are current areas of important in-
quiry. This article reviews the current research on hip pain in the young adult
and presents an overview of diagnostic and management strategies.
Total Hip Arthroplasty Performed Through Direct Anterior Approach Provides 497
Superior Early Outcome: Results of a Randomized, Prospective Study
Javad Parvizi, Camilo Restrepo, and Mitchell G. Maltenfort
Studies suggest that total hip arthroplasty (THA) performed through direct
anterior (DA) approach has better functional outcomes than other surgical ap-
proaches. The immediate to very early outcomes of DA THA are not known. A
prospective, randomized study examined the very early outcome of THA per-
formed through DA versus direct lateral approach. The functional outcomes
on day 1, day 2, week 6, week 12, 6 months, and 1 year were measured. Patients
receiving DA THA had significantly higher functional scores during the early
period following surgery. The difference in functional scores leveled out at 6
months.
Diagnosis of Periprosthetic Joint Infection Following Hip and Knee 505
Arthroplasty
Javad Parvizi, Safa Cyrus Fassihi, and Mohammad A. Enayatollahi
The diagnosis of periprosthetic joint infection (PJI) following total hip arthro-
plasty and total knee arthroplasty has been one of the major challenges ir ortho-
pedic surgery. As there is no single absolute test for diagnosis of PJI, diagnostic
criteria for PJI have been proposed that include using several diagnostic modal-
ities. Focused history, physical examination, plain radiographs, and initial sero-
logic tests should be followed by joint aspiration and synovial analysis. Newer
diagnostic techniques, such as alpha-defensin and !nter!eukin-6, hold great
promise in the future diagnosis of equivocal infections.
x Contents
Trauma
John C. Weinlein
Acute Compartment Syndrome 517
Andrew H. Schmidt
Acute compartment syndrome (ACS) is a well-known pathophysiologic
complication of trauma or tissue ischemia. ACS affects the appearance, func-
tion, and even the viability of the involved limb, and demands immediate
diagnosis and treatment. However, ACS is difficult to diagnose and the only
effective treatment is decompressive surgical fasciotomy. The clinical signs
and symptoms may easily be attributed to other aspects of the injury,
which further complicates the diagnosis. This article highlights the latest infor-
mation regarding the diagnosis of ACS, how to perform fasciotomies, and
how to manage fasciotomy wounds, and also reviews complications and out-
comes of ACS.
Treatment of Hip Dislocations and Associated Injuries: Current State of Care 527
Michael J. Beebe, Jennifer M. Bauer, and Hassan R. Mir
Hip dislocations, most often caused by motor vehicle accidents or similar high-
energy trauma, comprise a large subset of distinct injury patterns. Understand-
ing these patterns and their associated injuries allows surgeons to provide
optimal care for these patients both in the early and late postinjury periods.
Nonoperative care requires surgeons to understand the indications. Surgical
care requires the surgeon to understand the benefits and limitations of several
surgical approaches. This article presents the current understanding of hip
dislocation treatment, focusing on anatomy, injury classifications, nonoperative
and operative management, and postinjury care.
Management of Pelvic Ring Injuries in Unstable Patients 551
Matthew I. Rudloff and Kostas M. Triantafillou
High-energy pelvic ring injuries can represent life-threatening injuries in the
polytraumatized patient, particularly when presenting with hemodynamic insta-
bility. These injuries mandate a systematic multidisciplinary approach to evalu-
ation and timely intervention to address hemorrhage while concomitantly
addressing mechanical instability. These pelvic injuries are associated with
potentially lethal hemorrhage originating from venous, arterial, and osseous
sources. A thorough understanding of anatomy, radiographic findings, and
initial physical examination can alert one to the presence of pelvic instability
necessitating emergent treatment. The focus is on hemorrhage control, using
techniques for skeletal stabilization, angiography, and open procedures to
decrease mortality in this high-risk patient population.
Pediatrics
Jeffrey R. Sawyer
Pediatric Open Fractures 565
Arianna Trionfo, Priscilla K. Cavanaugh, and Martin J. Herman
Open fractures in children are rare and are typically associated with better
prognoses compared with their adult equivalents. Regardless, open fractures
pose a challenge because of the risk of healing complications and infection,
leading to significant morbidity even in the pediatric population. Therefore,
the management of pediatric open fractures requires special consideration.
Contents xi
This article comprehensively reviews the initial evaluation, classification, treat-
ment, outcomes, and controversies of open fractures in children.
Compartment Syndrome in Children 579
Pooya Hosseinzadeh and Christopher B. Hayes
Compartment syndrome in children can present differently than in adults.
Increased analgesic need should be considered the first sign of evolving
compartment syndrome in children. Children with supracondylar humeral frac-
tures, floating elbow injuries, operatively treated forearm fractures, and tibial
fractures are at high risk for developing compartment syndrome. Elbow flexion
beyond 90 in supracondylar humeral fractures and closed treatment of fore-
arm fractures in floating elbow injuries are associated with increased risk of
compartment syndrome. Prompt diagnosis and treatment with fasciotomy in
children result in excellent long-term outcomes.
Upper Extremity
Benjamin M. Mauck and James H. Calandruccio
Acute Ischemia of the Upper Extremity 589
William C. Pederson
Ischemia of the upper extremity is uncommon but can occur with open or
closed trauma. Those dealing with traumatic injury of the upper extremity
should be conversant with techniques of vascular surgery and microsurgery
to address these injuries when they occur. Closed injury can occu^ as well,
and at times these are best managed nonoperatively. This article discusses
the management of both in the acute setting.
Acute Carpal Tunnel Syndrome: A Review of Current Literature 599
Jonathan D. Gillig, Stephen D. White, and James Nicholas Rachel
Acute carpal tunnel syndrome is a progressive median nerve compression lead-
ing to loss of two-point discrimination. Most cases are encountered in the
emergency department following wrist trauma and distal radial fractures.
Although rare, atraumatic etiologies have been reported, and diligent evalua-
tion of these patients should be performed. If missed or neglected, irreversible
damage to the median nerve may result. Once diagnosed, emergent carpal
tunnel release should be performed. If performed in a timely manner, out-
comes are excellent, often with complete recovery.
Compartment Syndrome of the Hand 609
Nikhil R. Oak and Reid A. Abrams
Hand compartment syndrome has many etiologies; untreated, it has dire func-
tional consequences. Intracompartmental pressure exceeding capillary filling
pressure causes decreased tissue perfusion resulting in progressive ischemic
death of compartment contents. Clinical findings can evolve. Serial physical ex-
aminations are recommended and, if equivocal, interstitial pressure monitoring
is indicated. Definitive management is emergent fasciotomies with incisions
designed to decompress the involved hand compartments, which could include
the thenar, hypothenar, and interosseous compartments, and the carpal tunnel.
Careful wound care, edema management, splinting, and hard therapy are crit-
ical. Therapy should start early postoperatively, possibly before wound closure.
xii Contents
High-pressure Injection Injuries of the Hand 617
Tyler A. Cannon
High-pressure injection hand injuries are often overlooked, with severe compli-
cations owing to the acute inflammatory response. Prognosis depends on the
type of material injected, location of injection, involved pressure, and timing to
surgical decompression and debridement. Acute management involves broad-
spectrum antibiotics, tetanus prophylaxis, emergent decompression within 6
hours, and complete removal of the injected material. Most patients have re-
sidual sequelae of stiffness, pain, sensation loss, and difficulties in returning
to work. The hand surgeon s role is prompt surgical intervention, early postop-
erative motion, and education of patient and staff regarding short- and long-
term expectations.
Foot and Ankle
Benjamin J. Grear
Review of Talus Fractures and Surgical Timing 625
Benjamin J. Grear
This review article provides an overview of talus fractures. Special attention is
given to the clinical literature that evaluates the timing of surgical management
for displaced talus fractures. Several series support delayed definitive fixation
for talus fractures, suggesting displaced fractures do not necessitate emergent
surgical fixation.
Index
639
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| title_full | Orthopedic urgencies and emergencies editors James H. Calandruccio, Benjamin J. Grear, Benjamin M. Mauck, Jeffrey R. Sawyer, Patrick C. Toy, John C. Weinlein |
| title_fullStr | Orthopedic urgencies and emergencies editors James H. Calandruccio, Benjamin J. Grear, Benjamin M. Mauck, Jeffrey R. Sawyer, Patrick C. Toy, John C. Weinlein |
| title_full_unstemmed | Orthopedic urgencies and emergencies editors James H. Calandruccio, Benjamin J. Grear, Benjamin M. Mauck, Jeffrey R. Sawyer, Patrick C. Toy, John C. Weinlein |
| title_short | Orthopedic urgencies and emergencies |
| title_sort | orthopedic urgencies and emergencies |
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