Orthopaedics
Trauma resources from the Orthopaedics Hyperguide.
Plain radiographs may reveal posterior spurs and calcification in the distal extent of the tendon and bony overgrowth or cystic changes in the calcaneus consistent with chronic inflammation. Although we do not use MRI…
Achilles tendon rupture can be a debilitating injury that results in significant loss of function if left untreated. Ruptures are generally associated with a gradual degeneration of the tendon precipitated by a…
Traditional medicine teaches that infants and children with a diaphyseal femur fracture do well when treated with "basic principles" of conservative care. Postfracture joint stiffness does not occur. Delayed union is…
The ball and socket configuration of the hip joint is inherently stable and allows excellent range of motion in all directions. The acetabulum lies between the anterior and posterior columns of the pelvis, and is…
The radial nerve and profunda brachii artery follow the winding course marked by the radial groove. The medial border is defined by the lesser tuberosity to the medial supracondylar ridge while the lateral border…
segments also define the proximal path of the biceps tendon through the intertubercular or bicipital groove, a common site of shoulder pathology. Finally, the proximal humeral shaft provides insertions for deltoid,…
The bony anatomy of the ankle consists of articulations between the tibia and talus and between the fibula and talus. Although motion exists between the tibia and fibula at the ankle, no articular cartilage is present…
Treatment options for fractures of the os calcis include ice and elevation, followed by early range of motion. Non-weightbearing is maintained until the fracture is healed. This treatment is recommended for nondisplaced…
A fracture of the odontoid process is the most common injury to the second cervical vertebrae. It constitutes 10% to 15% of all cervical spine fractures. It is usually precipitated by a blow to the vertex of the skull.1…
Tibia fractures are the most common long bone fractures that result in nonunions and malunions. The tibia is subcutaneous, its blood supply is precarious, and complications of operative treatment are common. No other…
Stress fractures can occur if normal bone is exposed to repeated abnormal stress (fatigue fractures) or if normal stress is placed on bones with compromised elastic resistance (insufficiency fractures). This article…
External fixation has been used to treat fractures for more than 130 years. External fixation was first reported in 1853 by Malgaigne, who described using an external claw device to treat patellar fractures. In the 21st…
Understanding the anatomy of the femur is important for successful management of femoral shaft fractures and related injuries of the thigh. The anatomy of the femoral diaphysis can be defined by the shape of the…
Most fractures of the tibial diaphysis can be managed with functional bracing. Many fractures, however, require operative stabilization. Grade III open fractures are unstable and require fixation. Closed fractures and…
The bony anatomy of the foot can be divided into the hindfoot, midfoot, and forefoot. The hindfoot consists of the talus and calcaneus, which articulate at three facets, the posterior being the largest. The…
The majority of injuries involving the scapula are due to high-energy trauma, most often motor vehicle accidents.1-8 Examples of specific injuries include scapulothoracic dissociation,1,2,6,7 scapular fractures,3,4,8-12…
Fractures of the scapula are produced as a result of violent high energy trauma to the upper extremity. These fractures are often overlooked due to other life-threatening injuries, such as associated thoracic rib…
The mechanical properties of an external fixation frame, used to treat any bone defect, determine the biomechanical environment in the healing bone gap.1-11 Mechanical properties of various external fixators have been…
The knee joint is a hinged joint that permits flexion and extension. The proximal tibia is composed of both a medial and lateral tibial plateau. The medial plateau is concave and the lateral plateau is convex. It is…
It is essential to understand the bony anatomy of Lisfranc's joint to avoid missing subtle injuries to the midfoot. The second metatarsal base is recessed with respect to the first and third metatarsal bases, yielding…
Metacarpal fractures are common and account for 30% of all hand fractures. The ulnar aspect of the hand is more commonly affected than the radial aspect. These fractures can be subdivided into fractures of the…
The finger metacarpophalangeal (MCP) joint is a condyloid-type joint, which allows motion in extension, flexion, adduction, and some circumduction. The metacarpal head is wider on the palmar aspect than it is dorsally…
Amputation in hand fractures is an extreme measure. While digits should not be wantonly amputated, it is a hollow victory to save a stiff, malaligned, painful, dysvascular, cold-sensitive, or insensate digit that…
The hip is the most structurally stable joint in the body. Acetabular stability is enhanced by three thickenings in the hip capsule, the iliofemoral, ischial-femoral and pubo-femoral ligaments. The iliofemoral ligament…
The knee joint consists of three articulations (medial tibial-femoral, lateral tibial-femoral and patella-femoral). The knee functions as a modified hinge which allows for flexion, extension and some rotation. The knee…
The anterior compartment of the lower leg (Slide 1) contains the tibialis anterior, the extensor hallucis longus and the perineus tertius muscles. These muscles are innervated by the deep perineal branch of the sciatic…
Great toe extra-articular fractures usually occur from striking the unprotected toe against an object or from dropping an object onto the toe. Most of these fractures have minimal displacement and can be treated with…
Fractures of the phalanges are very common. When first evaluating a patient, it is important to note age, hand dominance, occupation, other associated medical problems, and the mechanism of injury. A thorough physical…
In 1984, an estimated 238,000 hip fractures occurred in the United States.1 By 1993, more than 307,000 hospitalizations for hip fractures were recorded in the United States, and more than 90% occurred in people older…
While most fractures of the proximal humerus are minimally displaced and can be treated nonoperatively,1-6 severely displaced fractures and fracture-dislocations require operative treatment. Early surgical options…
Statically locked antegrade reamed intramedullary nailing inserted with a closed technique is an effective treatment for femoral shaft fractures. Multiple large clinical studies have reported excellent union rates with…
The scaphoid, or carpal navicular, is the most commonly fractured carpal bone, compromising up to 75% of all carpal fractures. More than 90% of these fractures heal, but there is still an annual incidence of 35,000…
The function of spinal orthoses is to restrict spinal motion, realign spinal segments, prevent/correct deformity, and prevent further neurological/mechanical instability in a patient whose spine is compromised due to…
Subtalar dislocations most commonly occur with the foot dislocated medially with respect to the ankle. Less commonly, lateral dislocation occurs. Inversion causes medial dislocation, while eversion results in lateral…
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