Table Of ContentTrauma and
Orthopaedics
at a Glance
For Erika
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Trauma and
Orthopaedics
at a Glance
Henry Willmott
Consultant Trauma and Orthopaedic Surgeon
East Sussex Healthcare NHS Trust
United Kingdom
iv
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Library of Congress Cataloging‐in‐Publication Data
Willmott, Henry, author.
Trauma and orthopaedics at a glance / Henry Willmott.
p. ; cm. – (At a glance series)
Includes bibliographical references and index.
ISBN 978-1-118-80253-3 (pbk.)
I. Title. II. Series: At a glance series (Oxford, England)
[DNLM: 1. Musculoskeletal Diseases–therapy. 2. Orthopedic Procedures.
3. Musculoskeletal System–injuries. 4. Wounds and Injuries–therapy. WE 140]
RC925
616.7–dc23
2014033409
A catalogue record for this book is available from the British Library.
Wiley also publishes its books in a variety of electronic formats. Some content that appears in print
may not be available in electronic books.
Cover image: iStock/ © Philartphace
Set in 9.5/11.5pt Minion by SPi Publisher Services, Pondicherry, India
1 2016
Contents
Preface vii
Acknowledgements viii
How to use your revision guide ix
About the companion website x
Part 1 Basic sciences 1
1 Musculoskeletal tissues 2
2 Bone metabolism 4
3 Osteoarthritis 6
4 Rheumatoid arthritis 8
5 Imaging in orthopaedics: X‐rays 10
6 Imaging in orthopaedics: other modalities 12
7 Infection 14
8 Clinical anatomy of the upper limb 16
9 Clinical anatomy of the lower limb 19
10 Clinical anatomy of the spine 22
11 Examination of the upper limb 24
12 Examination of the lower limb 26
13 Examination of the spine 28
14 The brachial plexus 30
Part 2 Adult orthopaedics 33
Upper limb 34
15 Shoulder 1 34
16 Shoulder 2 36
17 Elbow 38
18 Wrist and hand 1 40
19 Wrist and hand 2 42
20 Wrist and hand 3 44
Lower limb 46
21 Hip 46
22 Hip replacement 48
23 Knee 1 50
24 Knee 2 52
25 Foot and ankle 54
26 Spine 56
27 Tumours 58
28 Rehabilitation 60
v
Part 3 Paediatric orthopaedics 63
29 Developmental dysplasia of hip (DDH) 64
30 Other paediatric hip conditions 66
31 Paediatric spinal disorders 68
32 Paediatric foot conditions 70
33 Neuromuscular conditions 72
34 Lower limb alignment 74
Part 4 Trauma 77
35 General principles 1 78
36 General principles 2 80
37 Advanced trauma life support (ATLS) 82
38 Upper limb trauma 1 84
39 Upper limb trauma 2 86
40 Upper limb trauma 3 88
41 Lower limb trauma 1 90
42 Lower limb trauma 2 92
43 Lower limb trauma 3 94
44 Proximal femoral fracture 1 96
45 Proximal femoral fracture 2 98
46 Cervical spine trauma 100
47 Thoracolumbar spine trauma 102
48 Trauma in children 1 104
49 Trauma in children 2 106
50 Compartment syndrome 108
51 Non‐union and malunion 110
Part 5 Working as a junior doctor in orthopaedics 113
52 Being an orthopaedic F2 114
53 Assessment of patients 116
54 The operating theatre 118
Part 6 Practical procedures 121
55 Practical procedures 1 122
56 Practical procedures 2 124
Index 126
vi
vii
Preface
This compact book provides a general overview of the most first. Therefore many junior doctors start their foundation job
common orthopaedic problems encountered on wards and in feeling underprepared. This book addresses that deficit. It is aimed
clinics. It is not an exhaustive tome, but will furnish the reader with at senior medical students and foundation doctors, though those
key facts on which to base further reading. It is also suitable as a in other professions such as nurses, physiotherapists and
revision guide for medical school finals. occupational therapists will find it helpful. I would suggest that
Orthopaedics is a fascinating and hugely varied speciality. foundation doctors spend around 15 minutes on each chapter, and
The patients range from newborn infants to the elderly. The read two every day. By the end of the first month you will have read
pathologies vary from minor aches and pains to life‐threatening the whole book and have a good understanding of the main
trauma. Orthopaedic operations are hands‐on procedures, conditions you are likely to encounter.
combining knowledge of anatomy and biomechanics. Working as I have followed the proven at a Glance format: full‐page
a junior doctor in orthopaedics should be one of the best jobs of illustrations are paired with concise text. There are six sections:
the foundation years: there is something for everyone. Those basic sciences; adult orthopaedics; paediatric orthopaedics;
leaning towards a future in general medicine will enjoy managing trauma; a section for a junior doctor in orthopaedics and finally
the many medical conditions encountered on the ward, while a simple guide on performing a selected range of practical
those looking to a career as a GP will have the opportunity to learn procedures. The last two sections are unique and will be helpful
about the myriad musculoskeletal injuries that we treat. Finally, to those starting out in clinical orthopaedics. I have tried to use
those intending to pursue a career as a surgeon will have the as many X‐rays as possible throughout, all taken from real
opportunity to acquire surgical skills in theatre. patients with genuine problems. The online material consists of
Sadly, many medical schools still spend far too little time multiple‐choice questions and case studies, which will help
teaching orthopaedics. This speciality is quite different from any reinforce knowledge.
other. The nature of the work is unique and the terminology is I hope that this book fuels your interest in orthopaedics and
different. It is often the first time many foundation doctors are helps you deliver compassionate care to your patients. Good luck
given significant responsibility on the wards. and enjoy the job!
In addition, new doctors will be expected to present cases in the
morning trauma meetings, invariably a harrowing experience at Henry Willmott
vii
Acknowledgements
Many of the X‐rays in the illustrations have been provided by professional images. Finally, I want to express my gratitude to
colleagues. Particular thanks are due to Om Lahoti who Chris Ferguson whose critical eye and attention to detail kept
supplied images for the paediatric section. I am indebted to Matt my grammar and syntax on the straight and narrow!
Stephenson who kindly put me in touch with the publishers. The Material is used from the following source, with permission:
editorial and production staff at Wiley have been tireless in
converting my vision into reality. I am also very grateful to Faiz O, Blackburn S & Moffat D. Anatomy at a Glance, 3rd edn, 2011.
the illustrators who converted my cartoon‐like scrawlings into Wiley‐Blackwell: Oxford.
viii
