Intraarticular Fractures (eBook)

Minimally Invasive Surgery, Arthroscopy
eBook Download: PDF
2019 | 1st ed. 2019
XX, 432 Seiten
Springer International Publishing (Verlag)
978-3-319-97602-0 (ISBN)

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This superbly illustrated book is a comprehensive and detailed guide to the contemporary arthroscopic management of intraarticular fractures. The opening section addresses a variety of basic aspects and key issues, including the difficulties posed by intraarticular fractures, principles of fixation, cartilage healing, and rehabilitation. The minimally invasive surgical techniques appropriate to individual types of fracture are then fully described and depicted, covering fractures of the shoulder and elbow, wrist, pelvis and hip, knee, and ankle. Guidance is also provided on avoidance and management of complications and rehabilitation. The closing section addresses relevant miscellaneous issues, including arthroscopic management of temporomandibular joint fractures and extended indications for endoscopy-assisted fracture fixation. This volume will be of value for both trainee and experienced surgeons when treating patients with these complex fractures.

Mahmut Nedim Doral, MD, is Professor and Chairman of the Department of Orthopaedics and Traumatology at UFUK University, Dr. Ridvan Ege Hospital, Ankara, Turkey. He took up this position in 2011, having previously been Chairman of the Department of Sports Medicine at the University of Hacettepe, School of Medicine. He was the medical chief of staff of Galatasaray Sportive Club U20 from 2012 to 2014 and director of Hacettepe University Sports Medicine Center from 1995 to 2017.  Professor Doral has held a variety of leadership positions with ISAKOS and ESSKA. He is a Past President of the European Federation of Orthopaedic Sports Traumatology (EFOST), the Asia-Pacific Knee Society, the Turkish Society of Sports Traumatology, Arthroscopy, and Knee Surgery (TUSYAD), and the Turkish Society of Orthopaedics & Traumatology and currently serves on the Executive Council of the Turkish National Olympic Committee. He is also the founder and current President of the Turkish Society of Sports Traumatology and current elected President of the Asia Pacific Orthopaedic Association. He was honored with distinguished visiting professor posts at the University of Pittsburgh School of Engineering in 2006 and Kentucky University in 2009. He has authored more than 150 scientific articles in peer-reviewed journals and his last book, Sports Injuries: Prevention, Diagnosis, Treatment and Rehabilitation, was published by Springer in 2012, with a second edition in 2015 (in four volumes). 

 

Jon Karlsson, MD, PhD, has been Academic Head at the Orthopaedic Department, Sahlgrenska Academy, University of Gothenburg, Sweden, since 2001. Dr. Karlsson graduated from the medical school in Reykjavik, Iceland, in 1978. He defended his PhD thesis at Gothenburg University in 1989 and was appointed Associate Professor in 1990. In 1991 he became a Senior Consultant in the Orthopaedic Department of Sahlgrenska University Hospital, serving as Clinical Head from 1997 to 2001. He was appointed Professor of Orthopaedics and Sports Traumatology in 1998. Dr. Karlsson served as President of the Swedish Association of Sports Medicine, 1999-2001. Since 2008 he has been Editor-in-Chief of KSSTA (Knee Surgery Sports Traumatology Arthroscopy), the official journal of ESSKA. He was program chairman of the biannual ESSKA congress in 2006, 2008, and 2010. Dr. Karlsson has been a member of the ISAKOS Board since 2005 and is currently secretary of the ISAKOS Executive Board of Directors. He is the author of more than 300 peer-reviewed papers and 26 books in Orthopaedics and Sports Traumatology, as well as several book chapters.


Dr. John A. Nyland is a sports certified physical therapist, athletic trainer and strength and conditioning specialist.  He is a member of ESSKA, the Sports and Orthopaedic Sections of the American Physical Therapy Association, the National Athletic Trainers' Association, the American College of Sports Medicine, and the National Strength and Conditioning Association.  He currently serves as Professor and Program Director for the Master of Science in Athletic Training Program at Spalding University in Louisville, Kentucky, USA.

He is an International Editorial Review Board member for Knee Surgery Sports Traumatology Arthroscopy, the Journal of Orthopaedic and Sports Physical Therapy (JOSPT), Arthroscopy:  The Journal of Arthroscopic and Related Surgery, the Journal of Athletic Training, the Turkish Journal of Physiotherapy and Rehabilitation, and Case Reports in Orthopedics.

Dr. Nyland is President of the JOSPT - Movement Science Media Board of Directors and serves as a rehabilitation consultant with the International Grande Hospital in Kathmandu, Nepal. He is a past recipient of the Excellence in Education Award from the Sports Section of the American Physical Therapy Association and the John Joyce Award from the International Society of Arthroscopy, Knee Surgery, and Orthopaedic Sports Medicine. 

He has authored or co-authored 180 peer reviewed papers and 35 book chapters, developed the books 'Clinical Decisions in Therapeutic Exercise: Planning and Implementation' and 'Innovations in Knee Rehabilitation' and authored a home study course entitled 'Therapeutic Strategies for Developing Neuromuscular Control in the Kinetic Chain'. 

Nyland served on the 1996 and 2008 USA Paralympic games sports medicine staff as an athletic trainer and physical therapist, and as an International Para-Archery Classifier in 2012 and 2016.

Karl Peter Benedetto, MD, PhD, was Chief of Trauma at Landeskrankenhaus (State Hospital) Feldkirch in Austria from 2000 until 2016, when he retired to work in private practice in Innsbruck. Prior to moving to Feldkirch, he was first Vice Chairman (1988-1998) and then Interim Chairman of the Trauma University Innsbruck. He was appointed a Professor at the University of Innsbruck in 1990. Dr. Benedetto has served as President of the Austrian Society of Sports Medicine (2011-2015), President of the German-speaking Arthoscopy Association (1994-1996), President of ESSKA (2002-2004), and President of the Austrian Society for Trauma Surgery (2008-2010). He was President of the Magellan Society from 2004 to 2006. He has been a board member and also a corresponding and honorary member of multiple national and international societies. Dr. Benedetto has published 92 articles in peer-reviewed journals and written numerous book chapters. He has served as team doctor for various soccer teams, volleyball teams, and the Austrian ski team.

Foreword 6
Preface 8
Preface 10
Preface 11
Acknowledgments 12
Contents 13
Part I: General Knowledge 17
1: Natural History of Bone Bruise 18
1.1 Introduction 18
1.2 Bone Bruise Classification 19
1.3 Bone Bruise Location and Mechanism 19
1.4 Clinical and Histological Findings 21
1.5 The Natural Course 22
1.6 Treatment 23
1.7 Conclusion 23
References 24
2: Arthroscopic Treatment Vs. Open Surgery in Intra-articular Fractures 26
2.1 Background 26
2.2 Articular Fracture Reduction 27
2.3 Associated Soft Tissue Injuries 27
2.4 Loose Bodies 28
2.5 Articular Degenerative Changes 28
2.6 Conclusion 29
References 29
3: Intra-articular Fractures: Principles of Fixation 30
3.1 Introduction 30
3.2 Classification 30
3.3 Unique Features of Intra-articular Fractures 33
3.4 Imaging of Intra-Articular Fractures 33
3.5 Basic Principles of Management of  Intra-articular Fractures 33
3.6 Importance of Step-Offs/Gaps 35
3.7 Healing of Articular Cartilage 36
3.8 Conclusion 37
References 37
4: Intra-articular Fractures: Philosophy of Minimally Invasive Fixation 39
4.1 Minimally Invasive Fixation 39
4.2 Intra-articular Fractures 40
4.2.1 Description 40
4.2.2 Problems Related to the Treatment 41
4.2.3 Treatment Planning 41
4.3 Conclusion 42
References 42
5: Biologic Solutions for Articular Cartilage Healing 44
5.1 Introduction 44
5.2 Articular Cartilage Surgical Treatment 45
5.2.1 Reconstructive Procedures 45
5.2.2 Tissue Engineering and Scaffold-Based Procedures 46
5.3 Nonsurgical Articular Cartilage Treatment 49
5.3.1 Injections 49
5.3.2 New Injective Biological Approaches 50
5.4 Conclusion 50
References 50
6: Rehabilitation Principles Following Minimally Invasive Fracture Fixation 54
6.1 Introduction 54
6.2 Postsurgical Malalignment, Segment Length, or Joint Surface Inclination Changes 54
6.3 Healing Potential 55
6.4 Articular Surface Congruency 56
6.5 Potential Stress Shielding or Stress Riser from Fixation Hardware 57
6.6 Patient Expectations “Realistic or Not” 57
6.7 Optimizing Full Kinematic/Kinetic Chain Function 57
6.8 Patient/Client Understanding, the Importance of Therapeutic Lessons 58
6.9 Optimizing Metabolic Energy System Function 59
6.10 Repetitive Microtraumatic, Acute Isolated, or Polytraumatic Intra-articular Fractures 59
6.11 Pain 59
6.12 Gender, Genetics, Lifestyle, and Age 60
6.13 Therapeutic Exercise to Improve Function and Cognitive Appraisal: Psychobehaviors 61
6.14 Therapeutic Exercise and Patient Education 64
6.15 Objective and Subjective Function Assessments 66
6.16 Sufficient Follow-up 67
6.17 Conclusion 67
References 68
7: Arthroscopic Treatment Vs. Open Surgery in Intra-articular Fractures 71
7.1 Calcaneus and Talus Fractures 73
7.2 Ankle Fractures 73
7.3 Knee Fractures 74
7.4 Hip Fractures 77
7.5 Bennett Fractures 77
7.6 Wrist Fractures 77
7.7 Elbow Fractures 78
7.8 Shoulder Fractures 78
7.9 Conclusion 79
References 79
Part II: Arthroscopic Management of Shoulder and Elbow Fractures 83
8: Arthroscopic Treatment of Acromioclavicular Dislocations 84
8.1 Introduction 84
8.2 Anatomy and Biomechanics 84
8.3 Mechanism of Injury 85
8.4 Classification 85
8.5 Clinical Evaluation 86
8.6 Radiographic Evaluation 86
8.7 Treatment 87
8.7.1 Arthroscopy-Assisted Techniques 88
8.7.2 Arthroscopic Technique 91
8.8 Complications 93
8.9 Conclusion 94
References 94
9: The Arthroscopy-Assisted Anatomical Reconstruction of Acromioclavicular and Coracoclavicular Ligament in Chronic Acromioclavicular Joint Dislocation 98
9.1 Introduction 98
9.2 Surgical Technique 99
9.2.1 Imaging and Diagnosis 99
9.2.2 Preoperative Set-Up 100
9.2.3 Graft Harvesting: Preparation 100
9.2.4 Portal Placement: Arthroscopy Diagnostic 100
9.2.5 Acromioclavicular Joint Preparation 101
9.2.6 Reduction: Temporary Fixation 102
9.2.7 Coracoid Process Preparation: Graft Sling Passage 102
9.2.8 Acromion-Clavicle Bone Tunnel Preparation 102
9.2.9 Graft Passage: Fixation 103
9.2.10 Closure 105
9.3 Post-Operative Care 105
9.4 The Procedure Rationale 105
9.5 Conclusion 106
References 107
10: Distal Clavicle Fractures 108
10.1 Introduction 108
10.2 Diagnosis 110
10.2.1 Clinical Examination 110
10.2.2 Radiological Imaging 111
10.3 Treatment Modalities 111
10.3.1 Nonsurgical Treatment 111
10.3.2 Surgical Treatment 111
10.4 Author’s Preferred Surgical Management 112
10.5 Postoperative Treatment 113
10.6 Conclusion 114
References 114
11: Glenoid Fractures 116
11.1 Introduction 116
11.2 Glenoid Anatomy 116
11.3 Pathomechanics and Fracture Types 117
11.4 Epidemiology 118
11.5 Treatment Indications 119
11.6 Surgical Treatment 120
11.6.1 Arthroscopic Surgical Technique 120
11.7 Results of Treatment, Complications, and Unanswered Questions 122
11.8 Conclusion 125
References 125
12: Arthroscopic Treatment of Greater Tuberosity Fractures of the Proximal Humerus 127
12.1 Background 127
12.2 Surgical Technique 127
12.3 Rehabilitation 130
12.4 Outcomes 130
12.5 Conclusion 130
References 130
13: Arthroscopy-Assisted Reduction-Internal Fixation in Greater and Lesser Humeral Tuberosity Fracture 132
13.1 Clinical and Imaging Evaluation 133
13.2 Indication for Surgical Intervention 134
13.3 Surgical Technique: Arthroscopy-Assisted Humeral Tuberosity Fracture Fixation 136
13.3.1 Position: Portal Placement 136
13.3.2 Diagnostic Arthroscopy: Subacromial Decompression 136
13.3.3 Greater Tuberosity Fracture Exposure: Fragment Identification—Reduction and Fixation 136
13.3.4 Lesser Tuberosity Fracture Exposure: Fragment Identification—Reduction and Fixation 139
13.4 Postoperative Rehabilitation 142
13.5 Discussion 143
References 143
14: Arthroscopic-Assisted Surgery of the Distal Humeral Fractures 145
14.1 Introduction 145
14.2 Classifications 145
14.3 Diagnosis 147
14.3.1 Mechanism of Injury 147
14.3.2 Clinical Diagnosis 148
14.3.3 Imaging 148
14.4 Treatment 149
14.5 Operative Setup and Patient Positioning 150
14.6 Portal Placement and Surgical Approach 150
14.7 Surgery 151
14.8 Conclusion 153
References 154
15: Radial Head and Olecranon Process Fractures 156
15.1 Epidemiology 156
15.2 Diagnosis 156
15.3 Imaging 157
15.4 Classification 157
15.5 Treatment 158
15.5.1 Radial Head Fractures 158
15.6 Complex Elbow and Forearm Injuries 158
15.7 Olecranon Process Fractures 158
15.8 Tension Band Wire/Cannulated Screw 159
15.9 Plating 159
15.10 Arthroscopic Radial Head Fixation 159
15.11 Conclusion 159
References 160
16: Shoulder Rehabilitation After Minimal Invasive Surgery Around Shoulder Joint 162
16.1 Rehabilitation After Proximal Humerus Fracture Surgery 162
16.2 Rehabilitation After Acromioclavicular Joint Dislocation Surgery 163
16.2.1 Phase I: 0–3 Weeks Post-surgery 163
16.2.2 Phase II: 4–6 Weeks Post-surgery 166
16.2.3 Phase III: 6–8 Weeks Post-surgery 167
References 170
17: Rehabilitation After Minimally Invasive Fixation of Elbow Fractures 172
17.1 General Rehabilitation Guidelines 172
17.2 Phases of the Rehabilitation Program 172
17.2.1 Phase I (Weeks 0–3) 173
17.2.2 Phase II (Weeks 4–7) 175
17.2.3 Phase III (Weeks 8–14) 176
17.2.4 Phase IV (Weeks 15–30) 176
17.3 Conclusion 176
References 177
Part III: Arthroscopic Management of Wrist Fractures 178
18: Distal Radius Fractures 179
18.1 Introduction 179
18.2 Intra-articular Distal Radius Fracture 179
18.3 Role of Wrist Arthroscopy for Treating Intra-articular Distal Radius Fractures 180
18.4 Technique 180
18.5 Radial Styloid Process Fractures 182
18.6 Three-Part Fractures 183
18.7 Four-Part Fractures 183
18.8 Conclusion 184
References 184
19: Distal Radius Fractures with Metaphyseal Involvement: “Minimally Invasive Volar Plate Osteosynthesis” 185
19.1 Introduction 185
19.2 Anatomical and Biomechanical Concepts 186
19.3 Surgical Technique 186
19.4 Rehabilitation Protocols 189
19.5 Discussion 191
References 192
20: Arthroscopic Treatment of Scaphoid Fractures 194
20.1 Diagnosis and Mechanism of Injury 194
20.2 Anatomy 194
20.3 Fracture Types 195
20.4 Fracture Treatment 195
20.5 Open Versus Arthroscopic Surgical Treatment 196
20.6 Grafting 198
20.7 Conclusion 198
References 199
21: Carpal Fractures Other Than the Scaphoid 200
21.1 Introduction 200
21.2 Anatomy 200
21.3 Triquetral Fractures 201
21.4 Hamate Fractures 202
21.5 Lunate Fractures 202
21.6 Trapezium Fractures 203
21.7 Capitate Fractures 204
21.8 Trapezoid Fractures 204
21.9 Pisiform Fractures 205
21.10 Conclusion 205
References 206
22: Rehabilitation After Minimally Invasive Fixation of Hand Fractures 207
22.1 Introduction 207
22.2 Advantages of Minimally Invasive Procedures 207
22.3 Assessment 208
22.3.1 Inspection and Palpation 208
22.3.2 Pain 208
22.3.3 Range of Motion 208
22.3.4 Edema 208
22.3.5 Muscle Testing 208
22.3.6 Grip and Pinch Strength 208
22.3.7 Functional Tests and Scales 208
22.4 Rehabilitation 209
22.4.1 Edema Management 209
22.4.2 Proprioceptive Input 209
22.4.3 Scar Tissue Management 211
22.4.4 Pain Management 211
22.4.5 Manual Therapy 212
22.4.6 Orthotics 213
22.5 Therapeutic Exercise Regimes 213
22.5.1 Tendon-Gliding Exercises 213
22.5.2 Grip and Pinch Exercises 213
22.5.3 Muscle Reeducation 215
22.6 Conclusion 216
References 216
Part IV: Arthroscopic Management of Pelvis and Hip Fractures 218
23: Arthroscopic Management of Acetabular Fractures 219
23.1 Introduction 219
23.2 Acetabular Fractures 219
23.3 Current Role of Hip Arthroscopy in the Treatment of Acetabular Fractures 220
23.3.1 Removal of Fragments 220
23.3.2 Fracture Fixation 221
23.3.3 Diagnosis 222
23.3.4 Direct Acetabular Visualization to Prevent Screw Penetration 224
23.4 Limitations of Hip Arthroscopy in the Treatment of Acetabular Fracture 224
23.4.1 Postoperative Care 225
23.4.2 Complications 225
23.5 Conclusion 225
References 226
24: Arthroscopic Reduction and Internal Fixation of Femoral Head Fractures 228
24.1 Introduction 228
24.2 Femoral Head Fractures 228
24.2.1 Preoperative Planning 229
24.2.1.1 Experience 229
24.2.1.2 Game Plan/Contingencies 229
24.2.1.3 Femoroacetabular Impingement (FAI) Considerations 229
24.2.2 Consent 230
24.2.3 Equipment 231
24.2.4 Setup 231
24.2.5 Traction 231
24.2.6 Portals 231
24.2.7 Fluid Pressure 231
24.2.8 Arthroscopic Reduction 232
24.2.9 Arthroscopic Internal Fixation 232
24.2.10 Dynamic Arthroscopic and Fluoroscopic Testing 232
24.2.11 Postoperative Considerations 232
24.3 Femoral Head Malunions 233
24.4 Conclusion 234
References 234
25: The Role of Hip Arthroscopy in Posttraumatic Hip Dislocation 236
25.1 Imaging Limitations and the Value of Diagnostic Hip Arthroscopy 236
25.2 Indications for Hip Arthroscopy After Dislocation 237
25.2.1 Loose Bodies 237
25.2.2 Labral Tears 238
25.2.3 Osteochondral Lesions 238
25.2.4 The Femoroacetabular Impingement (FAI) Implication 239
25.2.5 Ligamentum Teres Rupture 239
25.3 Interpretation of the Available Literature 240
25.4 Complications 240
25.5 Cautionary Note 241
25.6 Conclusion 241
References 241
26: Posterior Acetabular Rim Fractures 243
26.1 Introduct?on 243
26.2 Case 244
26.3 Discussion 246
26.4 Conclusion 248
References 248
Part V: Arthroscopic Management of Knee Fractures 250
27: Arthroscopy-Assisted Retrograde Nailing of Femoral Shaft Fractures 251
27.1 Arthroscopy-Assisted Retrograde Femoral Nailing of Femoral Shaft Fractures 251
27.1.1 Advantages 251
27.1.2 Surgical Technique 252
27.2 Arthroscopy-Assisted Removal of Retrograde Femoral Nail 256
27.3 Limitations 256
27.4 Conclusion 256
References 257
28: The Distal Femur Fractures 258
28.1 Introduction 258
28.2 Classification 258
28.3 Treatment 258
28.4 Preferred Intramedullary Nailing Surgical Technique 264
28.5 Arthroscopy-Assisted Reduction and Internal Fixation: Femoral Condylar Fracture (Type B3 Hoffa Fracture) 265
28.6 Conclusion 265
References 265
29: Eminentia Fractures 267
29.1 Introduction 267
29.2 Indications 267
29.3 Surgical Technique 267
29.3.1 Setup 267
29.3.2 Fracture Reduction 269
29.3.3 Screw Fixation 270
29.4 Rehabilitation 271
29.5 Conclusion 272
References 272
30: Eminentia Fractures: Transquadricipital Approach 273
30.1 Introduction 273
30.2 Clinical Evaluation and Classification 273
30.3 Management 274
30.3.1 Nonsurgical Treatment 274
30.3.2 Surgical Treatment 274
30.4 Transquadricipital Tendinous Arthroscopic Approach 275
30.4.1 Surgical Preparation 275
30.4.2 Arthroscopic Evaluation of the Joint and Reduction of the Fracture 275
30.5 Conclusion 277
References 277
31: Knee Soft Tissue Injuries Combined with Tibial Plateau Fractures 280
31.1 Introduction 280
31.2 Imaging 281
31.3 Management 281
31.3.1 Meniscal Injuries 281
31.3.2 Cruciate Ligament Injuries 281
31.3.3 Collateral Ligament Injuries 282
31.4 Outcome 282
31.5 Conclusion 282
References 283
32: Arthroscope-Assisted Surgical Treatment of Patellar Fractures 285
32.1 Surgical Technique 286
32.2 Discussion 289
32.3 Conclusion 290
References 290
33: Patella Fractures by Different Techniques 292
33.1 Introduction 292
33.2 Analysis of the Literature 294
33.3 Screw Fixation 294
33.4 Cerclage and Tension Band Wiring Technique 295
33.5 Screws and Tension Band 296
33.6 Conclusion 298
References 298
34: Articular Cartilage Injuries Associated with Patellar Dislocation 300
34.1 Introduction/Epidemiology 300
34.2 Imaging 301
34.3 Management 301
34.4 Outcomes 304
34.4.1 Clinical Outcomes 304
34.4.2 Chondral Lesion Progression 304
34.4.3 Osteoarthritis 305
34.5 Conclusion 305
References 305
Part VI: Arthroscopic Management of Ankle Fractures 308
35: Arthroscopy-Assisted Syndesmotic Reduction in Ankle Fractures 309
35.1 Introduction 309
35.2 Preoperative Assessment 310
35.3 Clinical Assessment 310
35.4 Radiographic Assessment 310
35.5 Intraoperative Assessment 311
35.6 Arthroscopic Assessment 311
35.7 Treatment 312
35.8 The Authors’ Preferred Method 313
35.9 Conclusion 315
References 315
36: Minimally Invasive Fixation of Complex Intra-articular Fractures of the Distal Tibial Plafond 317
36.1 Conclusion 323
References 323
37: Arthroscopic-Assisted External Fixation of Pilon Fractures 325
37.1 Introduction 325
37.2 Classification 325
37.3 Imaging 327
37.4 Treatment 327
37.4.1 Initial Evaluation 327
37.4.2 Treatment Principles 327
37.4.3 Surgical Technique 328
37.5 Conclusion 330
References 331
38: Treatment of Tibia Pilon Fractures with the Ilizarov Method 332
38.1 Introduction 332
38.2 Surgical Technique 333
38.3 Results 334
38.4 Discussion 334
38.5 Conclusion 336
References 336
39: Malleolar Fractures: Guidelines and Tips for Surgical Fixation 338
39.1 Introduction 338
39.2 Malleolar Fractures 340
39.2.1 Lateral Malleolar Fractures 340
39.2.2 Medial Malleolar Fractures 342
39.2.3 Posterior Malleolar Fractures 345
39.3 The Use of Arthroscopy in Malleolar Fractures 346
References 347
40: The Role of Arthroscopy in the Management of Fractures Around the Ankle 353
40.1 Introduction 353
40.1.1 Anterior Portals (Most Commonly Used Portal) 355
40.1.2 Posterior Portals 355
40.1.3 Preoperative Planning 355
40.1.4 Arthroscopic Examination of the Ankle Joint 356
40.1.5 Technique 356
40.1.6 Arthroscopic-Assisted Reduction of the Fracture and Fixation (Bonasia et al. 2011 Gumann and Hamilton 2011
40.1.6.1 Medial Malleolar Fracture 357
40.1.6.2 Lateral Malleolar Fixation 357
40.1.6.3 Bimalleolar Fractures 358
40.1.7 Maisonneuve Fracture (Imade et al. 2004 Jones et al. 2003
40.1.8 Juvenile Intra-articular Epiphyseal Fractures (Imade et al. 2004 Jennings et al. 2007
40.2 Figures 40.7 and 40.8: Talar Lesions (Gholam et al. 2000 Subairy et al. 2004
40.3 Tibial Plafond Fractures 361
40.3.1 Postoperative Management 361
40.4 Discussion 361
40.5 Conclusion 362
40.5.1 Tips and Pearls for Effective Arthroscopy for Ankle Fracture (Hepple and Guha 2013 Thordarson et al. 2001b)
References 363
41: Minimally Invasive Management of Osteochondral Defects to the Talus 365
41.1 Introduction 365
41.2 Historical Perspective 366
41.3 Non-surgical Management 366
41.4 Surgical Management 367
41.4.1 Arthroscopic Bone Marrow Stimulation (BMS) 367
41.5 Retrograde Drilling 368
41.6 Osteochondral Fragment Fixation 368
41.6.1 Surgical Technique: Arthrotomy 368
41.7 Surgical Technique: Arthroscopic Lift, Drill, Fill and Fix (LDFF) Procedure 369
41.8 Osteochondral Fragment Fixation: Postoperative Management 370
41.9 Osteochondral Fragment Fixation: Results 371
41.10 Minimally Invasive Replacement Surgery for Talar OCDs after Failed Primary Surgery 371
41.11 Arthroscopic Cartilage Transplantation: Technique and Results 372
41.12 Minimally Invasive Osteochondral Transplantation Procedures 372
41.13 Conclusion 373
References 373
42: Talar Neck Fractures 376
42.1 Anatomy 376
42.2 Mechanism of Injury 378
42.3 Clinical Assessment 379
42.4 Imaging 379
42.5 Classification 380
42.6 Indications and Contraindications 381
42.7 Preoperative Planning 382
42.8 Treatment 382
42.9 Surgical Technique 383
42.10 Arthroscopic Treatment of Talar Neck Fracture 385
42.11 Operative Technique 385
42.12 Pearls and Pitfalls 385
42.13 Postoperative Management 386
42.14 Results and Complications 386
42.15 Functional Outcome 387
42.16 Conclusion 388
References 388
Part VII: Miscellaneous 390
43: Simulation Training and Assessment in Fracture Treatment 391
43.1 Introduction 391
43.2 The Evolution of Virtual and Augmented Reality for Educating Surgeons 392
43.3 Surgical Training 393
43.4 Conclusion 395
References 395
44: Return to Play After Intra-articular Knee Fractures 397
44.1 Introduction 397
44.2 Distal Femur Fractures 397
44.2.1 Tibial Eminentia Fracture 398
44.2.2 Patella Fractures 399
44.2.3 Tibial Plateau Fractures 400
44.3 Tibial Tuberosity Avulsion Fractures 401
44.4 Conclusion 401
References 402
Index 404

Erscheint lt. Verlag 15.5.2019
Zusatzinfo XX, 432 p. 248 illus., 185 illus. in color.
Sprache englisch
Themenwelt Medizin / Pharmazie Medizinische Fachgebiete Chirurgie
Medizin / Pharmazie Physiotherapie / Ergotherapie
Schlagworte Cartilage • Fixation • Joint fractures • minimally invasive techniques • Rehabilitation • trauma surgery
ISBN-10 3-319-97602-8 / 3319976028
ISBN-13 978-3-319-97602-0 / 9783319976020
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PDFPDF (Wasserzeichen)
Größe: 21,5 MB

DRM: Digitales Wasserzeichen
Dieses eBook enthält ein digitales Wasser­zeichen und ist damit für Sie persona­lisiert. Bei einer missbräuch­lichen Weiter­gabe des eBooks an Dritte ist eine Rück­ver­folgung an die Quelle möglich.

Dateiformat: PDF (Portable Document Format)
Mit einem festen Seiten­layout eignet sich die PDF besonders für Fach­bücher mit Spalten, Tabellen und Abbild­ungen. Eine PDF kann auf fast allen Geräten ange­zeigt werden, ist aber für kleine Displays (Smart­phone, eReader) nur einge­schränkt geeignet.

Systemvoraussetzungen:
PC/Mac: Mit einem PC oder Mac können Sie dieses eBook lesen. Sie benötigen dafür einen PDF-Viewer - z.B. den Adobe Reader oder Adobe Digital Editions.
eReader: Dieses eBook kann mit (fast) allen eBook-Readern gelesen werden. Mit dem amazon-Kindle ist es aber nicht kompatibel.
Smartphone/Tablet: Egal ob Apple oder Android, dieses eBook können Sie lesen. Sie benötigen dafür einen PDF-Viewer - z.B. die kostenlose Adobe Digital Editions-App.

Zusätzliches Feature: Online Lesen
Dieses eBook können Sie zusätzlich zum Download auch online im Webbrowser lesen.

Buying eBooks from abroad
For tax law reasons we can sell eBooks just within Germany and Switzerland. Regrettably we cannot fulfill eBook-orders from other countries.

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