Table Of ContentOrthopedic Traumatology
Manish K. Sethi A. Alex Jahangir
●
William T. Obremskey
Editors
Mohit Bhandari Mitchel B. Harris
●
Michael D. McKee Steven A. Olson
●
Paul Tornetta, III Roy W. Sanders
●
Andrew H. Schmidt
Section Editors
Orthopedic Traumatology
An Evidence-Based Approach
Editors
Manish K. Sethi A. Alex Jahangir
Department of Orthopedic Surgery Department of Orthopedic Surgery
and Rehabilitation and Rehabilitation
Vanderbilt University Medical Center Vanderbilt University Medical Center
Nashville, TN, USA Nashville, TN, USA
William T. Obremskey
Department of Orthopedic Surgery
and Rehabilitation
Vanderbilt University Medical Center
Nashville, TN, USA
ISBN 978-1-4614-3510-5 ISBN 978-1-4614-3511-2 (eBook)
DOI 10.1007/978-1-4614-3511-2
Springer New York Heidelberg Dordrecht London
Library of Congress Control Number: 2012940415
© Springer Science+Business Media New York 2013
This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of
the material is concerned, specifi cally the rights of translation, reprinting, reuse of illustrations, recitation,
broadcasting, reproduction on microfi l ms or in any other physical way, and transmission or information
storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology
now known or hereafter developed. Exempted from this legal reservation are brief excerpts in connection
with reviews or scholarly analysis or material supplied specifi c ally for the purpose of being entered and
executed on a computer system, for exclusive use by the purchaser of the work. Duplication of this
publication or parts thereof is permitted only under the provisions of the Copyright Law of the
Publisher’s location, in its current version, and permission for use must always be obtained from
Springer. Permissions for use may be obtained through RightsLink at the Copyright Clearance Center.
Violations are liable to prosecution under the respective Copyright Law.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication
does not imply, even in the absence of a speci fi c statement, that such names are exempt from the relevant
protective laws and regulations and therefore free for general use.
While the advice and information in this book are believed to be true and accurate at the date of
publication, neither the authors nor the editors nor the publisher can accept any legal responsibility for
any errors or omissions that may be made. The publisher makes no warranty, express or implied, with
respect to the material contained herein.
Printed on acid-free paper
Springer is part of Springer Science+Business Media (www.springer.com)
Foreword
Orthopedic surgeons who manage the injured patient have always sought the best
information on which to make treatment decisions. In the past, this has generally
consisted of large textbooks with a comprehensive listing of all articles on a particu-
lar injury, with an author’s expert opinion and treatment recommendations synthe-
sizing this information. With the evolution of higher quality clinical research
methods, orthopedic trauma surgeons have been in the lead and the paradigm has
shifted. Because levels of evidence are now routinely inserted into the medical
literature and has scienti fi c presentations, the desire to have the strongest case for
treatment decisions has increased. As the number of Level I and Level II studies has
proliferated in the orthopedic trauma literature, the need for aggregation of this
information into easily accessible formats has escalated. This need is speci fi cally for
surgeons treating patients at the point of care.
Drs. Sethi, Jahangir, and Obremskey have taken the next step in the synthesis of
higher levels of evidence for the practicing orthopedic surgeon. The fi eld of ortho-
pedic trauma surgery is wonderfully diverse in the types and locations of skeletal
and soft tissue injury. This is one of the attractions of a career in orthopedic trauma-
tology: the fact that while some injuries are common and managed frequently, oth-
ers are extremely rare. The authors have taken the practical approach of taking the
most commonly seen orthopedic injures, in which the most comprehensive evi-
dence base exists, and aggregating the information in a useful format. They have
organized the chapters around common clinical scenarios taken from real-life expe-
rience. The case scenarios are then followed by a synthesis of the best clinical litera-
ture focusing on Level I and Level II studies. The scienti fi c technique of meta-analysis
and the structured literature review are strictly employed to provide the reader with
the best recommendations for management of an individual injury. Those principles
of literature synthesis using scienti fi c methodology are explained in an introductory
chapter to enhance the utility of the individual chapters.
The progression of clinical research and orthopedic traumatology has de fi nitely
moved towards collaborative focused research using multicenter teams. Each year
the number and quality of clinical research articles improves. This book is a wonder-
ful fi rst step in synthesizing this information into a format useful to the individual
v
vi Foreword
surgeon working with the patient and their family in making treatment decisions.
As the clinical research and datasets expand, the work will need to expand. I expect
that this work will be frequently revised on a regular basis to help all of us in the
orthopedic community to deliver the best care for our patients.
I enthusiastically recommend this book to orthopedic surgeons everywhere.
Marc Swiontkowski
Contents
Part I Evidence-Based Medicine in Orthopedic Trauma Surgery
Mohit Bhandari
1 Introduction to Evidence-Based Medicine ............................................ 3
Clary Foote and Mohit Bhandari
Part II Spine Trauma
Mitchel B. Harris
2 Cervical Spine Clearance ....................................................................... 23
Andrew K. Simpson and Mitchel B. Harris
3 Cervical Spine Fracture Dislocation ..................................................... 41
Kevin R. O’Neill, Jesse E. Bible, and Clinton James Devin
4 Lumbar Burst Fractures ........................................................................ 55
Robert Greenleaf and Mitchel B. Harris
Part III Upper Extremity Trauma
Michael D. McKee
5 Scapula Fractures ................................................................................... 71
Peter A. Cole and Brian W. Hill
6 Clavicle Fractures ................................................................................... 87
Christopher R. Geddes and Michael D. McKee
7 Proximal Humerus Fracture .................................................................. 103
Daniel J. Stinner, Philipp N. Streubel, and William T. Obremskey
8 Humeral Shaft Fractures........................................................................ 129
Bill Ristevski and Jeremy Hall
vii
viii Contents
9 Distal Humerus Fractures ...................................................................... 141
Andrew Jawa and David Ring
10 Distal Radius Fractures .......................................................................... 151
Cameron T. Atkinson, Philipp N. Streubel, and Jeffry Watson
Part IV Acetabular, Hip and Pelvic Trauma
Steven A. Olson
11 Acetabular Fractures in the Elderly ...................................................... 169
John C. Weinlein, Edward A. Perez, Matthew I. Rudloff,
and James L. Guyton
12 Pelvic Ring Injury I................................................................................. 185
Damien G. Billow and Steven A. Olson
13 Pelvic Ring Injury II ............................................................................... 195
Matthew D. Karam and David C. Templemen
14 Femoral Neck Fractures in the Elderly ................................................. 207
Dave Polga and Robert T. Trousdale
15 Intertrochanteric Femur Fractures ....................................................... 219
Hassan R. Mir and George J. Haidukewych
Part V Lower Extremity Trauma
Paul Tornetta, III
16 Diaphyseal Femur Fractures .................................................................. 235
Manish K. Sethi, Kyle Judd, A. Alex Jahangir,
and William T. Obremskey
17 Distal Femur Fractures........................................................................... 247
A. Alex Jahangir and William M. Ricci
18 Knee Dislocations .................................................................................... 261
Samuel N. Crosby Jr., Manish K. Sethi, and William T. Obremskey
19 Tibial Plateau Fractures ......................................................................... 277
Jodi Siegel and Paul Tornetta III
20 Closed Diaphyseal Tibia Fractures........................................................ 291
Marlis T. Sabo and David W. Sanders
21 Open Diaphyseal Tibia Fractures .......................................................... 303
Scott P. Ryan, Christina L. Boulton, and Robert V. O’Toole
Contents ix
Part VI Foot and Ankle Trauma
Roy W. Sanders
22 Pilon Fractures ........................................................................................ 323
David P. Barei
23 Ankle Fractures ....................................................................................... 345
Conor P. Kleweno and Edward K. Rodriguez
24 Calcaneus Fractures ............................................................................... 359
Theo Tosounidis and Richard Buckley
25 Talus Fractures ........................................................................................ 373
Hassan R. Mir and Roy W. Sanders
Part VII Polytrauma, Infection, and Perioperative Management
of the Orthopedic Trauma Patient
Andrew H. Schmidt
26 Damage Control ...................................................................................... 389
Laurence B. Kempton and Michael J. Bosse
27 DVT Prophylaxis in Orthopedic Trauma ............................................. 405
Keith D. Baldwin, Surena Namdari, and Samir Mehta
28 The Infected Tibial Nail .......................................................................... 417
Megan A. Brady and Brendan M. Patterson
29 Perioperative Optimization in Orthopedic Trauma ............................ 431
Clifford Bowens Jr. and Jesse M. Ehrenfeld
Index ................................................................................................................. 445
