Fractures of the Foot and Ankle: Diagnosis and Treatment of Injury and Disease

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ISBN: 9780824759162 | 0824759168
Cover: Hardcover
Copyright: 3/29/2005

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With contributions from an established team of experts on the subject, this reference illustrates current practices and techniques in the care of patients with foot and ankle fractures--demonstrating treatment methods for fractures and dislocations, pediatric injuries, soft tissue management, crush injury, and post-traumatic reconstruction.

Ankle Fractures

(26)

Stuart D. Miller

Steven A. Herbst

Introduction

(1)

Anatomy

(2)

Classification of Ankle Fractures

(1)

Physical Examination

(1)

Radiographic Examination

(1)

Outcome of Ankle Fractures

(1)

Comparison of Operative and Nonoperative Results

(1)

Results of Operative Intervention

(1)

Historical and Research Considerations for Treatment of Ankle Fracture Subtypes: A Brief Review

(4)

Isolated Lateral Malleolus

(1)

Posterior Malleolar Fracture

(1)

Medial Malleolar Fracture

(1)

Syndesmosis Involvement

(1)

Talar Shift without Fracture

(1)

Osteochondral Injury

(1)

Open Fractures

(1)

Techniques of Closed Reduction and Subsequent Care

(1)

Surgical Techniques

(6)

Lateral Malleolus

(1)

Medial Malleolus

(1)

Bimalleolar

(4)

Trimalleolar

(1)

Osteoporosis and Ankle Fractures

(2)

Ankle Dislocation or Ligamentous Disruption

(2)

Conclusion

(4)

References

(4)

Pilon Fractures

(22)

Richard T. Laughlin

Introduction

(1)

Fracture Classification

(1)

Soft Tissue Classification

(2)

Temporary Fixation

(3)

Fixation of The Tibial Articular Surface

(3)

Plate Fixation

(1)

External Fixation

(6)

Postoperative Care

(1)

Results

(1)

Complications

(1)

Conclusion

(3)

Acknowledgment

(1)

References

(3)

Talar Fractures and Dislocations

(44)

Saul G. Trevino

Vinod K. Panchbhavi

Introduction

(1)

History

(1)

Anatomy

(4)

The Head of the Talus

(1)

The Neck of the Talus

(1)

The Body of the Talus

(1)

Blood Supply

(2)

Posterior Tibial Artery

(1)

Dorsalis Pedis Artery and Peroneal Artery

(1)

Intraosseous Circulation

(1)

Fractures of the Talar Neck

(7)

Clinical Features

(1)

Classification

(1)

Imaging Studies

(2)

Categories

(1)

Group I Fractures

(1)

Group II Fractures

(2)

Group III Fractures

(1)

Surgical Techniques

(3)

Hawkins III Open Fractures

(2)

Hawkins Type IV Injuries

(1)

Total Dislocation of the Talus

(2)

Shear Fractures of the Talar Body

(1)

Complications

(6)

Skin Problems

(1)

Osteomyelitis

(4)

Avascular Necrosis (AVN)

(1)

Nonunion

(1)

Malunions of the Talar Neck

(1)

Posttraumatic Arthritis

(1)

Surgical Treatment

(3)

Principles of Arthrodesis

(1)

Ankle Arthrodesis

(1)

Tibiotalar Fusion with Partial Talectomy

(1)

Talectomy and Tibiocalcaneal Fusion

(1)

Osteochondral Lesions (OCLS) of the Talus

(5)

Treatment

(2)

Prognosis

(1)

Fractures of the Posterior Process

(1)

Anatomy

(1)

Mechanism of Injury

(1)

Clinical Features

(1)

Treatment

(1)

Fracture of the Medial Tubercle (Cedell's Fracture)

(2)

Fractures of the Lateral Process

(2)

Clinical Evaluation

(1)

Mechanism of Injury

(2)

Clinical Evaluation

(1)

Treatment

(1)

Conclusion

(4)

References

(4)

Calcaneal Fractures

(24)

Paul J. Juliano

Hoan-Vu Nguyen

History

(1)

Anatomy

(1)

Mechanism of Injury

(3)

Classification

(3)

Initial Presentation

101

(1)

Initial Management

101

(1)

Radiographic Examination

101

(3)

Definitive Management

104

(4)

Extra-Articular Fractures

104

(2)

Intra-Articular Fractures

106

(2)

Surgical Approach

108

(1)

Lateral Approach

108

(1)

Medial Approach

108

(1)

Preferred Method of Treatment

108

(1)

Postoperative Management

109

(1)

Complications

109

(5)

Open Calcaneal Fractures

114

(1)

Salvage Procedures

114

(1)

Conclusions

114

(3)

References

115

(2)

Lisfranc Injuries and Midfoot Fractures

117

(48)

Kent Heady

Saul G. Trevino

Tarsometatarsal (TMT) (Lisfranc) Injuries

118

(27)

Introduction

118

(1)

History

118

(1)

Anatomy

118

(3)

Biomechanics

121

(1)

Mechanism of Injury

122

(2)

Classification

124

(2)

Diagnosis

126

(3)

Treatment

129

(1)

Principles

129

(1)

Timing of Surgery

130

(1)

Closed Reduction and Casting

131

(1)

Closed Reduction and Percutaneous Fixation

131

(1)

External Fixation

132

(1)

Open Reduction and Internal Fixation

132

(1)

Extensile Dorsomedial Approach to the Midfoot

132

(3)

Postoperative Care

135

(1)

Prognosis

136

(4)

Midfoot Sprains in Athletes

140

(3)

Salvage Procedures

143

(1)

Complications

143

(1)

Devascularization

143

(2)

Skin Compromise

145

(1)

Other Complications

145

(1)

Midfoot Fractures

145

(14)

Introduction

145

(1)

Anatomy

145

(1)

Navicular Fractures

146

(1)

Classification and Mechanism of Injury

146

(2)

Diagnosis

148

(2)

Treatment

150

(9)

Conclusion

159

(6)

References

159

(6)

Fractures of the Metatarsals and Phalanges of the Foot

165

(14)

Bryan J. Hawkins

Introduction

165

(1)

Anatomy

166

(1)

Mechanism of Injury

166

(1)

Radiographic Evaluation

166

(1)

Fractures of the First Metatarsal

167

(1)

Fractures of the Lesser Metatarsals

167

(8)

Shaft Fractures

167

(5)

Fractures of the Proximal Aspect of the Fifth Metatarsal

172

(3)

Phalangeal Fractures

175

(2)

Hallucal Fractures

175

(1)

Lesser Toe Fractures

176

(1)

Conclusion

177

(2)

References

177

(2)

Foot and Ankle Fractures in Diabetic Patients

179

(16)

Michael S. Pinzur

Introduction

179

(1)

Wound Healing in the Diabetic Patient

179

(1)

Fracture Susceptibility in the Diabetic Patient

180

(1)

Undisplaced Fractures

180

(2)

Displaced or Unstable Fractures

182

(3)

Charcot Foot

185

(1)

Fractures of the Calcaneus

185

(1)

Fractures of the Hindfoot

185

(3)

Fractures of the Midfoot (Tarsometatarsal)

188

(1)

Fractures of the Forefoot

188

(2)

Summary

190

(5)

References

191

(4)

Dislocations of the Ankle, Subtalar, and Great Toe Metatarsal--Phalangeal Joints

195

(16)

David A. Porter

Todd Arnold

Introduction

196

(1)

Ankle Dislocation

196

(3)

Historical Review

196

(1)

Epidemiology and Anatomy

197

(1)

Pathogenesis and History

197

(1)

Clinical Findings

197

(1)

Radiographic Findings

198

(1)

Treatment Options

199

(1)

Prognosis and Long-Term Follow-Up

199

(1)

Subtalar Joint Dislocation

199

(4)

Historical Review

199

(1)

Epidemiology and Anatomy

200

(1)

Pathogenesis and History

200

(1)

Clinical Findings

200

(1)

Radiographic Findings

200

(1)

Treatment Options

201

(2)

Long-Term Results and Prognosis

203

(1)

Great Toe MTP Dislocation

203

(4)

Historical Review

203

(1)

Epidemiology and Anatomy

203

(1)

Pathogenesis and History

203

(1)

Clinical Findings

204

(1)

Radiographic Findings

205

(1)

Treatment Options

205

(2)

Prognosis and Long-Term Outcome

207

(1)

Conclusion

207

(4)

References

208

(3)

Pediatric Foot and Ankle Fractures

211

(54)

Kelly D. Carmichael

Introduction

212

(1)

Ankle Fractures

212

(35)

Anatomy of the Distal Tibia and Fibula Region

212

(1)

Etiology, Prevalence, Diagnosis, and Natural History of Fractures about the Ankle Region

213

(1)

Classification Systems

214

(1)

Treatments

215

(1)

Distal Tibia Metaphyseal Fractures

215

(1)

Salter--Harris Type I Fractures

215

(1)

Salter--Harris Type II Fractures

215

(7)

Salter--Harris Type III and IV Fractures

222

(6)

Salter--Harris Type V Fractures

228

(1)

Isolated Fibula Growth Plate Injuries and Fibula Fractures

229

(1)

Transitional Fractures

229

(1)

Juvenile Tillaux Fractures

229

(7)

Triplane Fractures

236

(7)

Adolescent Pilon Fractures

243

(3)

Complications of Ankle Fractures

246

(1)

Pediatric Foot Fractures

247

(10)

Anatomy

247

(1)

Talus Fractures

247

(1)

General Features

247

(1)

Talar Neck Fractures

248

(3)

Body Fractures and Other Injuries of the Talus

251

(1)

Calcaneus Fractures

252

(1)

Lesser Tarsal Fractures and Tarsometatarsal Injuries

253

(1)

Metatarsal Fractures

254

(3)

Phalanx Fractures

257

(1)

Summary

257

(8)

References

257

(8)

Soft Tissue Coverage of the Foot and Ankle

265

(22)

R. Michael Johnson

Steven Schmidt

Introduction

266

(1)

Wound Evaluation

266

(1)

Patient Evaluation

266

(1)

Mechanism

267

(1)

Wound Management Principles

267

(1)

Reconstruction

267

(1)

Nonoperative Treatment

267

(1)

Nonoperative Coverage of Foot and Ankle Wounds

268

(1)

Platelet-Derived Growth Factor (PDGF)

268

(1)

Topical Negative Pressure

268

(1)

Hyperbaric Oxygen (HBO)

268

(1)

Operative Treatment

268

(14)

Primary Closure

269

(1)

Skin Grafts

269

(1)

Local (Pedicle) Flaps

269

(1)

Lateral Calcaneal Artery Flap

269

(2)

Medial Plantar Flaps

271

(1)

Sural Fasciocutaneous Flap

271

(1)

Flexor Digitorum Brevis

271

(1)

Extensor Digitorum Brevis

271

(2)

Dorsalis Pedis

273

(1)

Free-Flap Reconstruction

273

(1)

Vascular Disease and Free-Tissue Transfer

274

(1)

Diabetes and Free-Tissue Transfer

274

(1)

Sensitivity and Foot and Ankle Reconstruction

274

(1)

Free Flaps and the Elderly

275

(1)

Long-term Results of Free-Flap Foot Reconstruction

275

(1)

Failures and Revisions

275

(1)

Gait

275

(1)

Specific Free Flaps

276

(1)

Radial Forearm Flap

276

(1)

Rectus Abdominus

277

(1)

Latissimus Dorsi (LD)

278

(1)

Parascapular

279

(1)

Serratus Anterior

279

(1)

Gracilis

279

(1)

Lateral Arm Flap

280

(1)

Other Flaps

280

(2)

Conclusion

282

(5)

Acknowledgment

282

(1)

References

283

(4)

Burns to the Feet

287

(22)

Sidney F. Miller

Matthew R. Talarczyk

Introduction

288

(1)

Development of Modern Burn Care and the Burn Team Concept

288

(1)

Initial Evaluation

289

(2)

Inhalation Injury and Associated Injuries

289

(1)

Pathophysiology of the Burn Injury

289

(1)

Evaluation of the Burn Wound

289

(1)

Assessing the Extent and Depth of the Burn Wound

289

(2)

Treatment

291

(6)

Resuscitation

291

(1)

Escharotomy

292

(1)

Initial Wound Care

292

(2)

Definitive Wound Coverage

294

(2)

Hyperbaric Oxygen

296

(1)

Reconstruction and Rehabilitation, Hypertrophic Scars, and Contractures

297

(5)

Classification of Contractures

299

(1)

Treatment

300

(1)

External Fixators

300

(1)

Limb Suspension

301

(1)

Garments

301

(1)

Orthotics

302

(1)

Special Orthopedic Issues

302

(1)

Bone and Achilles Tendon Exposure

302

(1)

Fractures

302

(1)

Involved Joints

303

(1)

Complications

303

(2)

Dystrophic Calcification

303

(1)

Osteoporosis

303

(1)

Pigmentation

303

(1)

Marjolin's Ulcers

303

(2)

Special Types of Burns

305

(2)

Electrical Burns

305

(1)

Chemical Burns

306

(1)

Prevention

307

(1)

Summary

307

(2)

References

308

(1)

Tendon Ruptures and Lacerations

309

(36)

Lew C. Schon

Steven A. Herbst

Introduction

310

(1)

Anterior Tibial Tendon

310

(3)

Etiology of Rupture

311

(1)

Nonoperative Treatment

311

(2)

Operative Treatment

313

(1)

EHL Tendon

313

(4)

Etiology of Rupture

313

(1)

Nonoperative Treatment

313

(3)

Operative Treatment

316

(1)

EDL Tendon

317

(1)

Ruptures of the EDL

317

(1)

Achilles Tendon

317

(11)

Prerupture Conditions and Treatment

318

(1)

Nonoperative Treatment

318

(1)

Operative Treatment

319

(2)

Achilles Tendon Rupture

321

(1)

Conservative Treatment

322

(1)

Comparison of Operative and Nonoperative Treatment

322

(1)

Operative Treatment

323

(1)

Percutaneous Repair

323

(1)

Chronic Rupture

323

(2)

Operative Treatment

325

(3)

Peroneals

328

(8)

Anatomy

328

(1)

Peroneal Tenosynovitis, Attritional Tears, and Rupture

328

(1)

Peroneus Brevis Tears

329

(1)

Os Perineum and Peroneus Longus Tears

329

(2)

Peroneus Brevis Subluxation or Dislocation

331

(2)

Chronic Repairs

333

(3)

Flexor Digitorum Longus

336

(1)

Flexor Hallucis Longus

336

(2)

Etiology

337

(1)

Nonoperative Treatment

337

(1)

Operative Treatment

337

(1)

Posterior Tibial Tendon

338

(3)

Etiology

338

(1)

Nonoperative Treatment

339

(1)

Operative Treatment

339

(1)

Dislocation of the Posterior Tibial Tendon

340

(1)

Conclusion

341

(4)

References

341

(4)

Posttraumatic Infections in the Foot and Ankle

345

(26)

Maria Guidry

Brian Hutchinson

Richard T. Laughlin

Hongbao Ma

Jason H. Calhoun

Introduction

346

(7)

Classification

347

(1)

Microbiology

347

(1)

Diagnosis

347

(1)

Clinical Evaluation

347

(1)

Laboratory Evaluation

347

(1)

Evaluation for Blood and Oxygen Supply to Tissues

348

(1)

Imaging Studies

348

(1)

Management

349

(1)

Cultures

349

(1)

Antimicrobial Therapy

350

(1)

Surgical Treatment

351

(2)

Adjunctive Therapy

353

(1)

Posttraumatic Skin and Soft Tissue Infections

353

(4)

Puncture Wounds

353

(1)

Clinical Evaluation

353

(1)

Treatment

353

(1)

Necrotizing Fasciitis

354

(1)

Clinical Presentation

354

(1)

Diagnosis

354

(1)

Treatment

355

(1)

Postoperative Wound Infections

355

(1)

Pin Track Infections

355

(1)

Clinical Presentation

356

(1)

Diagnosis

357

(1)

Management

357

(1)

Foot and Ankle Osteomyelitis

357

(3)

Classification

357

(1)

Etiology

357

(1)

Postoperative Osteomyelitis

358

(1)

Posttraumatic Osteomyelitis

359

(1)

Principles of Osteomyelitis Management

359

(1)

Postoperative Infections Following Fractures

360

(5)

Fractures of the Plafond

360

(1)

Incidence and Risk Factors

360

(1)

Treatment

360

(1)

Ankle Fractures

361

(1)

Incidence and Risk Factors

361

(1)

Treatment

361

(1)

Talus

362

(1)

Incidence and Risk Factors

362

(2)

Treatment

364

(1)

Calcaneus

364

(1)

Incidence and Risk Factors

364

(1)

Treatment

364

(1)

Midfoot and Forefoot

364

(1)

Conclusion

365

(6)

References

367

(4)

Complex Regional Pain Syndrome or Reflex Sympathetic Dystrophy

371

(10)

William A. Vitello

Introduction

371

(1)

History

372

(1)

Definitions

372

(1)

Pathophysiology

372

(1)

Stages

373

(1)

Stage I (Acute)

374

(1)

Stage II (Dystrophic)

374

(1)

Stage III (Atrophic)

374

(1)

Clinical Diagnosis

374

(1)

Diagnostic Testing

375

(1)

Radiographs

375

(1)

Three-Phase Radionuclide Bone Scan

375

(1)

Sympathetic Blockade

376

(1)

Thermoregulatory Testing

376

(1)

Psychological Evaluation

376

(1)

Treatments

376

(2)

Pharmacological Treatment

376

(1)

Antidepressants

377

(1)

Narcotic Analgesics

377

(1)

Oral Nifedipine

377

(1)

Nerve Blocks

377

(1)

Intravenous Regional Blocks

377

(1)

Surgical Sympathectomy

378

(1)

Physical Therapy

378

(1)

Summary

378

(3)

References

378

(3)

Late Reconstruction

381

(12)

Mark D. Perry

Arthur Manoli II

Introduction

381

(1)

General Considerations

382

(1)

Late Reconstruction

382

(1)

Specific Injuries

383

(7)

Talus Fractures

383

(1)

Calcaneus

384

(3)

Midfoot

387

(1)

Cuboid

387

(2)

Syndesmotic Injuries

389

(1)

Compartment Syndrome

389

(1)

Flexion Contractures

390

(1)

Summary

390

(3)

References

390

(3)

Traumatic Amputations of the Foot and Ankle

393

(30)

Jason H. Pleimann

Robert B. Anderson

W. Hodges Davis

Bruce E. Cohen

Introduction

394

(1)

Initial Assessment and Acute Treatment

395

(3)

Foot Salvageability

395

(1)

Acute Management --- Preoperative

396

(1)

Acute Management --- Operative

397

(1)

Subacute Management

398

(3)

Chronic Management

401

(3)

Rehabilitation

401

(1)

Complications

402

(2)

Specific Amputation Levels

404

(16)

Terminal Syme

404

(1)

Technique

404

(1)

Complications

405

(1)

Orthotic and Prosthetic Issues

405

(1)

Great Toe Amputation

405

(1)

Technique

406

(1)

Complications

406

(1)

Orthotic and Prosthetic Issues

406

(1)

Lesser Toe Amputation

406

(1)

Technique

406

(1)

Complications

406

(1)

Orthotic and Prosthetic Issues

407

(1)

Ray Resections

407

(1)

Technique

408

(1)

Complications

408

(2)

Orthotic and Prosthetic Issues

410

(1)

Transmetatarsal Amputations

410

(1)

Technique

410

(3)

Complications

413

(1)

Orthotic and Prosthetic Issues

413

(1)

Lisfranc's Amputation

413

(1)

Chopart's Amputation

413

(1)

Technique

414

(1)

Complications

415

(1)

Orthotic and Prosthetic Issues

416

(1)

Syme's Amputation

417

(1)

Technique

417

(1)

Complications

418

(1)

Orthotic and Prosthetic Issues

419

(1)

Conclusion

420

(3)

References

421

(2)

Orthotic Management of Foot and Ankle Fractures

423

(16)

Geza F. Kogler

Introduction

423

(6)

Prefabricated vs. Custom-Molded

424

(1)

Mechanical Function and Control Mechanisms

424

(1)

Arch Support Mechanisms

424

(1)

Wedges

425

(1)

Heel Lifts and Elevations

425

(1)

Orthotic Principles and Biomechanical Considerations

425

(1)

Diagnostic Tests to Determine Pain Reduction Potential

426

(1)

Medial Column Load-Bearing Test

426

(1)

Lateral Column Load-Bearing Test

426

(2)

Hindfoot Load-Bearing Test

428

(1)

Negative Impression Technique Considerations

428

(1)

Orthotic Treatment of Fractures

429

(7)

Phalanges

429

(1)

Metatarsals

430

(1)

Stress Fractures

430

(1)

Sesamoid Bones of the Great Toe

430

(1)

Navicular, Cuneiforms, and Cuboid

431

(1)

Talus

432

(1)

Calcaneus

433

(1)

Ankle

433

(3)

Conclusion

436

(3)

References

437

(2)

Treatment of Foot and Ankle Deformities with the Ilizarov Fixator

439

(20)

Daniel M. Thompson

Jason H. Calhoun

Introduction

439

(1)

Classification of Deformities

440

(1)

Simple Deformities

440

(10)

Equinus Contracture

440

(3)

Distal Tibial Angular Deformity

443

(1)

Osteotomy with Internal Fixation

444

(2)

External Fixation Technique

446

(2)

Simple Nonunion

448

(2)

Arthrodesis

450

(1)

Complex Deformities

450

(7)

Complex Equinus Deformity

450

(1)

Cavus Deformity

450

(1)

Rocker-Bottom Deformity

451

(2)

Infection

453

(2)

Amputation

455

(1)

Special Patient Populations

455

(2)

Summary

457

(2)

References

458

(1)

Index

459

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Fractures of the Foot and Ankle: Diagnosis and Treatment of Injury and Disease

Summary

Table of Contents

Supplemental Materials

FREE SHIPPING

Rent More, Save More! Use code: BBRENTAL

5% off 1 book, 7% off 2 books, 10% off 3+ books

Fractures of the Foot and Ankle: Diagnosis and Treatment of Injury and Disease

Summary

Table of Contents

Supplemental Materials

Digital License