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ORTHOPAEDIC SURGERY ESSENTIALS
HAND AND WRIST
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ORTHOPAEDIC SURGERY ESSENTIALS
HAND AND WRIST
ORTHOPAEDICSURGERYESSENTIALS
AdultReconstruction
DanielJ.Berry,MD
ScottP.Steinmann,MD
FootandAnkle
DavidB.Thordarson,MD
HandandWrist
JamesR.Doyle,MD
OncologyandBasicScience
TimothyA.Damron,MD
CarolD.Morris,MD
Pediatrics
KathrynE.Cramer,MD
SusanA.Scherl,MD
Spine
ChristopherM.Bono,MD
StevenR.Garfin,MD
SportsMedicine
AnthonyA.Schepsis,MD
BrianD.Busconi,MD
Trauma
CharlesCourt-Brown,MD
MargaretMcQueen,MD
PaulTornettaIII,MD
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ORTHOPAEDIC SURGERY ESSENTIALS
HAND AND WRIST
SeriesEditors Author
PAUL TORNETTA III, MD JAMES R. DOYLE, MD
Professor EmeritusProfessorofSurgery(Orthopaedics)
DepartmentofOrthopaedicSurgery JohnA.BurnsSchoolofMedicine
BostonUniversitySchoolofMedicine; UniversityofHawaii
DirectorofOrthopaedicTrauma Honolulu,Hawaii
BostonUniversityMedicalCenter
Boston,Massachusetts
THOMAS A. EINHORN, MD
ProfessorandChairman
DepartmentofOrthopaedicSurgery
BostonUniversitySchoolofMedicine
Boston,Massachusetts
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ThistextbookisdedicatedtotheorthopaedicteachingstaffoftheJohnA.Burns
SchoolofMedicineattheUniversityofHawaii.Itisdedicatedtothememoryofthe
illustriouspastchairsoftheDivisionofOrthopaedics,IvarLarsonandAllen
Richardson,aswellasalivingemerituschair,friend,andmentor,
LawrenceGordon.
Itisdedicatedtothememoryofthoseoutstandingteachers,EugeneLanceand
AlanPavel,whotaughtallofusthevalueofscholarshipandexcellenceinsurgery.
Itisdedicatedtothosewhocontinuethetraditionofexcellenceinteaching,
RobertAtkinson,DanielSinger,JohnSmith,andallthosewhocontinuetogive
theirtimeandenergytotheadvancementoftheorthopaedicresidencytraining
programattheUniversityofHawaii.
Itisdedicatedtothosewhomadethepathstoexcellencestraightandlevelinso
manyways,includingAlbertChunHoon,TomWhelan,RuthOno,
SueArakakiHaradaandToriMarciel.
Itisdedicatedtomyresidents—theytaughtmemorethantheywilleverknow.
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CONTENTS
KeytoAbbreviations InsideFrontCover
ContributingAuthors ix
SeriesPreface xi
Preface xiii
SECTION I: BASIC ANATOMY
1 Anatomy 1 1.2 SystemsAnatomy 7
1.1 SurfaceAnatomy 1 1.3 TerminologyofMovement 13
SECTION II: OUTPATIENT CLINIC
2 CongenitalDeformities 14 6 TenosynovitisandEpicondylitis 88
7 EntrapmentNeuropathies 98
3 Tumors 37
7.1 MedianNerve 98
4 Dupuytren’sDisease 64
7.2 UlnarNerve 106
5 Infections 78 7.3 RadialNerve 111
SECTION III: EMERGENCY DEPARTMENT
8 Anesthesia 116 12 TendonInjuries 179
CharlesL.McDowellandKevinCunningham
12.1 FlexorTendon 179
9 HandFracturesandFracture-Dislocations 128 12.2 ExtensorTendon 190
13 NerveInjuries 208
10 DislocationandLigamentInjuries 144
14 Amputations 226
11 CarpalInjuries 158
15 CompartmentSyndrome 242
11.1 CarpalFractures 158
16 InjectionInjuries 250
11.2 CarpalInstabilitiesandFracture-Dislocations
oftheCarpus 169 Index 253
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CONTRIBUTING
AUTHORS
KevinCunningham,MD CharlesL.McDowell,MD
AttendingAnesthesiologist ClinicalProfessorofOrthopaedic
McGuireVeteransAdministrationHospital andPlastic(Hand)Surgery
Richmond,Virginia MedicalCollegeofVirginia
ChiefofHandSurgeryService
McGuireVeteransAdministrationHospital
Richmond,Virginia
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Description:Written by an outstanding hand surgeon, this volume of our Orthopaedic Surgery Essentials Series presents all the information residents need during hand and wrist surgery rotations or services. It can easily be read cover to cover during a rotation or used for quick reference before a patient workup