Green's Operative Hand Surgery E-Book

 
 
Elsevier (Verlag)
  • 7. Auflage
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  • erschienen am 24. Februar 2016
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  • 2100 Seiten
 
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978-0-323-29534-5 (ISBN)
 

Widely recognized as the gold standard text in hand, wrist, and elbow surgery, Green's Operative Hand Surgery, 7th Edition, by Drs. Scott Wolfe, William Pederson, Robert Hotchkiss, Scott Kozin, and Mark Cohen, continues the tradition of excellence. High-resolution photos, innovative videos, new expert authors, and more ensure that Green's remains your go-to reference for the most complete, authoritative guidance on the effective surgical and non-surgical management of upper extremity conditions. Well-written and clearly organized,it remains the most trusted reference in hand surgery worldwide



Academic Appointment:

Associate Professor, Department of

Orthopaedic Surgery, Temple University

School of Medicine

Hand Surgeon, Shriners Hospital

for Children

Education:

Undergraduate: Duke University

Durham, North Carolina

Degree: B.S. Computer Science 1978-1982

Medical: Hahnemann University School of Medicine

Philadelphia, Pennsylvania

Degree: M.D. 1982-1986

Internship: Albert Einstein Medical Center

Philadelphia, Pennsylvania

Preliminary General Surgery

July 1986 to June 1987

Residency: Albert Einstein Medical Center

Philadelphia, Pennsylvania

Orthopaedic Surgery

July 1987 to June 1991

Shriners Hospital for Crippled Children

Philadelphia, Pennsylvania

Pediatric Orthopaedic Surgery

January 1989 to July 1989

Thomas Jefferson University Hospital

Hand Rehabilitation Center

Philadelphia, Pennsylvania

Hand Surgery

January 1990 to March 1990

Fellowship: Mayo Clinic

Rochester, Minnesota

Hand & Microvascular Surgery

July 1991 - July 1992

Curriculum Vitae Scott H. Kozin, MD

Board Certification:

Certificate of Added Qualifications in

Hand Surgery, August 1995

Re-certification, November 2004

Board Certification, American Board of

Orthopaedic Surgeons, July 15, 1994

Re-certification, November 2004

Diplomate, American Board of Orthopaedic

Surgeons

Diplomate, National Board of Medical

Examiners

Organization Memberships:

Alpha Omega Alpha, Honor Medical Society (1986)

American Academy of Orthopaedic Surgeons

American Society for Surgery of the Hand (1996)

American Association for Hand Surgery

Temple-Shriners Alumni Association (1995)

Pennsylvania Orthopaedic Society

Philadelphia Orthopaedic Society

AO Teaching Faculty (1995)

International Wrist Investigators Workshop (1998)

Philadelphia Hand Society (1992)

Orthopaedic Overseas

New Millennium Hand Club (1992)

American Orthopaedic Association (2001)

Awards/ Honors:

Sterling Bunnell Travelling Fellow 2001-2002, American Society for Surgery of the Hand

Joseph H. Boyes Award, American Society for Surgery of the Hand, 2002

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  • 9780323295345v1_WEB.pdf
  • Front Cover
  • Inside Front Cover
  • Green's Operative Hand Surgery, 2-Volume Set
  • Copyright Page
  • Contributors
  • Foreword for the Seventh Edition
  • Preface
  • Acknowledgments
  • Table Of Contents
  • Video Contents
  • I Basic Principles
  • 1 Anesthesia
  • Acknowledgments:
  • General Anesthesia
  • Regional Anesthesia
  • Contraindications
  • Absolute Contraindications
  • Relative Contraindications
  • Need for Assessing Postoperative Nerve Status or Compartment Syndrome.
  • Aggravating a Preexisting Nerve Injury.
  • Anticoagulation Therapy.
  • Bilateral Procedures.
  • Relative Indications
  • Microvascular Surgery Patients
  • Pediatric Patients
  • Pregnant Patients
  • Patients With Rheumatoid Arthritis
  • Advantages and Disadvantages (Box 1.1)
  • Equipment and Pharmacologic Requirements
  • Local Anesthetic Additives
  • Historical Techniques
  • Continuous Peripheral Nerve Catheters
  • Minimum Effective Volume
  • Specific Blocks
  • Interscalene Block
  • Supraclavicular Block
  • Infraclavicular Block
  • Axillary Block
  • Supplementary Blocks
  • Elbow Block
  • Wrist Block
  • Digital Block
  • Use of Epinephrine in Digital Nerve Blockade.
  • Intravenous Regional Block
  • Author's Preferred Method of Treatment: Regional Anesthesia
  • Complications
  • Neurapraxia (Box 1.3)
  • Incidence.
  • Management (Figure 1.14).
  • Allergy and Sepsis
  • References
  • II Hand
  • 2 Acute Infections of the Hand
  • General Principles
  • Types of Infections
  • Methicillin-Resistant Staphylococcus aureus Infections
  • Nosocomial Infections
  • Patient Evaluation
  • Treatment Principles
  • Specific Types of Common Hand Infections
  • Acute Paronychia
  • Clinical Presentation and Preoperative Evaluation
  • Pertinent Anatomy
  • Treatment Options
  • Operative Methods.
  • Authors' Preferred Method of Treatment
  • Postoperative Management and Expectations
  • Chronic Paronychia
  • Clinical Presentation and Preoperative Evaluation
  • Pertinent Anatomy and Pathophysiology
  • Treatment
  • Operative Treatment.
  • Authors' Preferred Methods of Treatment
  • Postoperative Management and Expectations
  • Felon
  • Clinical Presentation and Evaluation
  • Pertinent Anatomy
  • Treatment
  • Operative Treatment.
  • Authors' Preferred Methods of Treatment
  • Postoperative Management and Expectations
  • Pyogenic Flexor Tenosynovitis
  • Clinical Presentation and Preoperative Evaluation
  • Pertinent Anatomy
  • Treatment
  • Operative Treatment.
  • Authors' Preferred Methods of Treatment
  • Postoperative Management and Expectations
  • Radial and Ulnar Bursal and Parona Space Infections
  • Pertinent Anatomy
  • Radial Bursa.
  • Ulnar Bursa.
  • Parona Space
  • Clinical Presentation and Preoperative Evaluation
  • Treatment
  • Open Treatment.
  • Authors' Preferred Method of Treatment
  • Postoperative Management and Expectations
  • Deep Space Infections
  • Palmar Space Infections
  • Clinical Presentation and Preoperative Evaluation.
  • Pertinent Anatomy.
  • Treatment.
  • Thenar Space.
  • Volar Approach (Thenar Crease).
  • Dorsal Longitudinal Approach.
  • Combined Dorsal and Volar Approach.
  • Midpalmar Space.
  • Distal Palmar Approach Through the Lumbrical Canal.
  • Dorsal Approach.
  • Hypothenar Space.
  • Deep Subfascial Space Infections
  • Clinical Presentation and Evaluation
  • Dorsal Subcutaneous and Dorsal Subaponeurotic Space Abscess.
  • Web Space Abscess (Collar-Button Abscess).
  • Pertinent Anatomy.
  • Treatment
  • Dorsal Subcutaneous and Subaponeurotic Space Abscess.
  • Interdigital Web Space (Collar-Button Abscess).
  • Curved Longitudinal Incision.
  • Volar Zigzag Approach.
  • Volar Transverse Approach.
  • Authors' Preferred Method of Treatment
  • Thenar Space.
  • Midpalmar Space.
  • Interdigital Web Space Abscess (Collar-Button Abscess).
  • Postoperative Management and Expectations.
  • Septic Arthritis
  • Clinical Presentation and Patient Evaluation
  • Treatment
  • Infections of the Wrist Joint (Radiocarpal, Ulnocarpal, and Midcarpal Joints)
  • Metacarpophalangeal Joint
  • Proximal Interphalangeal Joint
  • Distal Interphalangeal Joint
  • Postoperative Management and Expectations
  • Septic Boutonnière and Mallet Deformity
  • Osteomyelitis
  • Clinical Presentation and Evaluation
  • Treatment
  • Complications
  • Specific Types of Infections and Vectors
  • Animal Bites
  • Marine Organisms
  • Leeches
  • Human Bites
  • Prosthetic and Implant Infections
  • Shooter's Abscesses: Infections Caused by Parenteral Drug Abuse
  • Septic Thrombophlebitis
  • Herpetic Whitlow (Herpes Simplex Virus Infection of the Fingers)
  • Clinical Presentation and Diagnosis
  • Upper Extremity Infections Associated With HIV Infection
  • Diabetic Hand Infections
  • Necrotizing Soft Tissue Infections and Gas Gangrene
  • Cutaneous Anthrax Infections
  • High-Pressure Injection Injuries
  • Mimickers of Infection
  • References
  • 3 Chronic Infections
  • Acknowledgment:
  • General Principles
  • Diagnosis
  • Laboratory Techniques
  • Guidelines for Specimen Collection and Handling
  • Direct Visualization of the Organism by Staining
  • Detection of Pathogenic-Specific Antigens and Antibodies (Serology)
  • Detection of Specific Microbial Nucleotide Sequences
  • Organism Isolation in Culture and Drug-Susceptibility Testing
  • Drug-Susceptibility Tests
  • Additional Evaluation
  • Treatment
  • Chronic Bacterial Infections
  • Actinobacillosis
  • Clinical Findings
  • Diagnosis
  • Treatment
  • Actinomycosis
  • Etiology and Epidemiology
  • Clinical Findings
  • Diagnosis
  • Treatment
  • Anthrax
  • Etiology and Epidemiology
  • Clinical Findings
  • Diagnosis
  • Treatment
  • Botryomycosis
  • Etiology and Epidemiology
  • Diagnosis
  • Treatment
  • Brucellosis
  • Etiology and Epidemiology
  • Clinical Findings
  • Diagnosis
  • Treatment
  • Mycetoma (Actinomycetoma and Eumycetoma)
  • Etiology and Epidemiology
  • Microbiology
  • Clinical Findings
  • Staging
  • Diagnosis
  • Differential Diagnosis
  • Treatment
  • Actinomycetoma.
  • Eumycetoma.
  • Syphilis
  • Etiology
  • Clinical Findings
  • Differential Diagnosis of a Hand Ulcer
  • Diagnosis
  • Treatment
  • Tularemia
  • Etiology and Epidemiology
  • Clinical Presentation
  • Diagnostic Testing
  • Treatment
  • Yaws
  • Etiology and Epidemiology
  • Clinical Findings
  • Diagnosis
  • Treatment
  • Neutrophilic Dermatoses and Pyoderma Gangrenosum
  • Etiology and Epidemiology
  • Clinical Findings
  • Diagnosis
  • Treatment
  • Fungal Infections
  • Etiology, Epidemiology, and Classification
  • Diagnosis
  • Treatment
  • Cutaneous Fungal Infections
  • Etiology and Epidemiology
  • Diagnosis
  • Treatment
  • Subcutaneous Fungal Infections
  • Classification
  • Chronic Paronychia
  • Etiology and Epidemiology.
  • Clinical Findings.
  • Differential Diagnosis.
  • Diagnosis.
  • Treatment.
  • Surgical Technique of Marsupialization.
  • Sporotrichosis (Rose Thorn Disease)
  • Etiology and Epidemiology.
  • Clinical Findings.
  • Diagnosis.
  • Treatment.
  • Phaeomycotic Cysts
  • Deep Fungal Infections
  • Aspergillosis
  • Etiology.
  • Clinical Findings.
  • Diagnosis.
  • Treatment.
  • Blastomycosis
  • Etiology and Epidemiology.
  • Clinical Findings.
  • Diagnosis.
  • Treatment.
  • Candidiasis
  • Etiology and Epidemiology.
  • Clinical Findings.
  • Diagnosis.
  • Treatment.
  • Coccidioidomycosis
  • Etiology and Epidemiology.
  • Clinical Findings.
  • Diagnosis.
  • Treatment.
  • Cryptococcosis
  • Etiology and Epidemiology.
  • Clinical Findings.
  • Diagnosis.
  • Treatment.
  • Histoplasmosis
  • Etiology and Epidemiology.
  • Clinical Findings.
  • Diagnosis.
  • Treatment.
  • Mucormycosis
  • Etiology and Epidemiology.
  • Clinical Findings.
  • Diagnosis.
  • Treatment.
  • Deep (Extracutaneous) Sporotrichosis
  • Etiology and Epidemiology.
  • Diagnosis.
  • Treatment.
  • Fungal Infections Following Large Upper Extremity Burns
  • Fungal Osteomyelitis
  • Newly Emerging Hand Fungal Infections
  • Etiology and Epidemiology
  • Treatment
  • Mycobacterial Infections (Tuberculous and Nontuberculous)
  • Cutaneous Tuberculosis
  • Clinical Findings
  • Diagnosis
  • Differential Diagnosis
  • Treatment
  • Subcutaneous Tuberculosis
  • Mycobacterium Ulcerans (Buruli Ulcer)
  • Etiology and Epidemiology.
  • Clinical Findings.
  • Diagnosis.
  • Treatment.
  • Deep Infections
  • Mycobacterial Tenosynovitis
  • Etiology and Epidemiology.
  • Clinical Findings.
  • Diagnosis.
  • Treatment.
  • Tuberculous Bursitis
  • Tuberculous Arthritis
  • Clinical Findings.
  • Diagnosis.
  • Treatment.
  • Tuberculous Osteomyelitis
  • Etiology and Epidemiology.
  • Diagnosis.
  • Tuberculous Osteomyelitis of Children's Hands.
  • Tuberculous Osteomyelitis of Adult Hands.
  • Treatment.
  • Antituberculous Drugs and Multidrug Therapy Regimens
  • Indications for Treatment
  • Regimens
  • Special Features and Treatment of Nontuberculous Mycobacteria
  • Author's Preferred Method of Treatment
  • Treatment.
  • Additional Information on M. Tuberculosis.
  • Hansen Disease (Leprosy)
  • Etiology
  • Epidemiology
  • Clinical Pathology
  • Classification
  • Early Diagnosis
  • Cardinal Signs
  • Anesthetic Skin Patch.
  • Thickened Nerves.
  • Skin Lesions.
  • Diagnostic Tests
  • Lepromin Skin Test.
  • Slit-Skin Smears.
  • Slit-Skin Smear Technique.
  • Skin Biopsy.
  • Skin Biopsy Technique.
  • Nerve Biopsy.
  • Fine-Needle Nerve Aspiration Technique.
  • Open Nerve Biopsy Technique.
  • Electrophysiological Studies.
  • Imaging Studies.
  • Treatment
  • Elimination of Infecting Bacteria With MDT
  • Paucibacillary Hansen Disease.
  • Multibacillary Hansen Disease.
  • Relief of Pain
  • Reactions.
  • Reversal Reaction (Leprae Type 1).
  • ENL Reaction (Leprae Type 2).
  • Lucio Reaction.
  • Treatment of Reactions.
  • Compression Neuropathy.
  • Nerve Abscess.
  • Treatment of a Nerve Abscess.
  • Nerve Abscess Drainage Technique.
  • Preservation of Sensation
  • Silent Neuritis.
  • Restoration of Sensibility
  • Treatment of Deformities
  • Rehabilitation
  • Resource Materials
  • Protothecal, Protozoal, and Parasitic Infections
  • Protothecosis (Algae Infections)
  • Etiology and Epidemiology
  • Clinical Findings
  • Diagnosis
  • Treatment
  • Protozoal Infections
  • Leishmaniasis Infection
  • Etiology and Epidemiology.
  • Clinical Findings.
  • Diagnosis.
  • Treatment.
  • Parasitic Worm (Nematode) Infection
  • Gnathostomiasis (Round Worm) Infection
  • Onchocerciasis (Onchocercosis, Filarial, Round Worm) Infection
  • Tapeworm (Cysticercosis, Taenia Solium) Infection
  • Occupational Infections
  • Barber's Interdigital Pilonidal Sinus
  • Etiology and Epidemiology
  • Clinical Findings and Diagnosis
  • Treatment
  • Shearer's Disease
  • Milker's Interdigital Granuloma
  • Slaughterman's Interdigital Granuloma
  • Scabies
  • Etiology and Epidemiology
  • Clinical Findings
  • Diagnosis
  • Treatment
  • Prevention
  • Viral Infections
  • Acquired Immunodeficiency Syndrome
  • Etiology and Epidemiology
  • Classification and Clinical Diagnosis
  • Cellular Immune Responses.
  • Clinical Features.
  • Clinical Manifestations of AIDS Infection in the Hands
  • Herpes Simplex Virus.
  • Bacillary Angiomatosis.
  • Kaposi Sarcoma.
  • Treatment.
  • Treatment of AIDS
  • Warts
  • Classification
  • Pathogenesis of Human Papillomavirus
  • Diagnosis
  • Common Verrucated Wart.
  • Flat (Plane) Warts.
  • Multiple Warts.
  • Treatment
  • Keratolytic Therapy.
  • Cryotherapy.
  • Intralesional Injection of Bleomycin.
  • Electrosurgery.
  • Surgical Excision.
  • Prognosis.
  • Author's Preferred Method of Treatment
  • Human Orf (Farm Yard Pox, Milker's Nodule, Ecthyma Contagiosum, Contagious Pustular Dermatitis)
  • Clinical Findings
  • Diagnosis
  • Differential Diagnosis
  • Treatment
  • Milker's Nodule (Paravaccinia Virus, Pseudocowpox)
  • Treatment
  • Conclusion
  • References
  • 4 Dupuytren Disease
  • Demographics
  • Heritability
  • Associated Conditions
  • Genetic Biomarkers
  • Preoperative Evaluation
  • Physical Examination
  • Staging
  • Luck Classification and Related Histology
  • Tubiana Staging
  • Individual Joint Measurements
  • Location of Disease
  • Diathesis Score and Severity
  • Treatment Outcome Score
  • Recurrence Assessment
  • Diagnostic Imaging
  • Pertinent Anatomy
  • Normal Anatomy
  • Palm
  • Web Spaces
  • Digits
  • Pathologic Anatomy
  • Primary Pathology
  • Secondary Pathology
  • Synergistic Pathology
  • Neurovascular Spiral Bundle
  • Little Finger PIP Joint
  • Historical Review
  • Types of Operations
  • Minimally Invasive Procedures
  • Percutaneous Needle Fasciotomy
  • Indications.
  • Contraindications.
  • Preoperative Planning.
  • Technique.
  • Enzymatic Fasciotomy With Collagenase Clostridium Histolyticum
  • Indications.
  • Contraindications.
  • Preoperative Planning.
  • Technique.
  • Open Surgical Procedures
  • Fasciectomy
  • Indications.
  • Contraindications.
  • Preoperative Planning.
  • Technique
  • Segmental Fasciectomy.
  • Regional Fasciectomy.
  • Dermofasciectomy
  • Indications.
  • Contraindications.
  • Preoperative Planning.
  • Technique.
  • Special Cases
  • Dorsal Dupuytren Nodules.
  • Severe PIP Contracture.
  • Severe Composite Contracture.
  • Author's Preferred Method of Treatment
  • Patient Instructions
  • Before the Procedure
  • During the Procedure
  • After the Procedure
  • Planning
  • Planning Portals
  • Dimples
  • Digital Cords
  • Spiral Bundles
  • Procedure
  • Positioning
  • Assistance
  • Antisepsis
  • Anesthetic
  • Needle Size
  • Portal Sequence
  • Needle Maneuvers
  • Cord Traction
  • Needle Problems
  • Flexor Tendon Issues
  • Nerve Issues
  • Pain or Paresthesia With Needle Movement
  • Portal-Level Goal
  • Needling the PIP
  • Joint Anesthetic Injection
  • Manipulation
  • Postprocedure
  • The Future
  • References
  • 5 Extensor Tendon Injury
  • Acknowledgments:
  • Anatomy
  • Muscles
  • Anatomic Variations of Extensor Muscles
  • Wrist Extensors.
  • Finger Extensors.
  • Tendons at the Wrist Level
  • Juncturae Tendinum
  • Independent Extension of the Index and Small Fingers
  • Variations of Extensor Tendons of the Fingers
  • Sagittal Bands
  • Extensor Digitorum Communis Insertion
  • Anatomy of the Extensor Mechanism Over the Proximal Phalanx
  • Anatomy of the Extensor Mechanism Over the Middle Phalanx
  • Extension of the Fingers
  • Testing the Anatomic Integrity of the Central Slip: Elson Test
  • Oblique Retinacular Ligament
  • Biomechanics of Finger Extension
  • Zones of Injury
  • Treatment of Extensor Tendon Lacerations
  • Suture Repair Techniques
  • Author's Preferred Treatment
  • Postoperative Management
  • Outcomes
  • Complications After Extensor Tendon Repair
  • Specific Extensor Tendon Injuries
  • Acute Mallet Finger Injury (Zone 1: Distal Interphalangeal Joint Level) (Case Study 5.2)
  • Mechanism of Injury
  • Incidence
  • Anatomy
  • Classification
  • Management of Type I Acute Mallet Injuries
  • Nonoperative Treatment.
  • Operative Treatment
  • Tendon Suture.
  • Kirschner Wire Fixation.
  • Management of Types II and III Open Mallet Finger Injuries
  • Management of Type IV Mallet Finger Injuries
  • Nonoperative Treatment.
  • Operative Treatment.
  • Complications.
  • Author's Preferred Method of Treatment of Acute Mallet Injuries
  • Type I Injuries.
  • Types II and III Injuries.
  • Type IV Injuries (Mallet Fractures).
  • Chronic Mallet Injuries
  • Technique of Skin Imbrication
  • Technique of Fowler Tenotomy
  • Results of Fowler Tenotomy.
  • Treatment of Swan Neck Deformity Associated With Chronic Mallet Injury
  • Technique of Spiral Oblique Retinacular Ligament Reconstruction
  • Author's Preferred Treatment of Chronic Mallet Injury
  • Mallet Thumb Injury
  • Zone 2 Extensor Tendon Injuries
  • Zone 3 (Proximal Interphalangeal Joint) Injuries (Case Study 5.3)
  • Open Injuries
  • Author's Preferred Method of Treatment of Zone 3 Injuries
  • Open Thumb Metacarpophalangeal Joint Lacerations (Zone 3 Lacerations).
  • Chronic Zone 3 Closed Injuries (Chronic Boutonnière Deformities)
  • Surgical Techniques to Correct Supple Boutonnière Deformity
  • Terminal Tendon Tenotomy (Distal Fowler or Dolphin Tenotomy).
  • Tendon Grafts.
  • Lateral Band Mobilization and Relocation.
  • Author's Preferred Method: The Curtis Staged Reconstruction
  • Zone 4 Injuries
  • Author's Preferred Method of Zone 4 Repairs
  • Zone 5 Injuries
  • Human Bite Wounds
  • Lacerations
  • Sagittal Band Lacerations
  • Closed Sagittal Band Rupture
  • Author's Preferred Method of Treatment of Closed Sagittal Band Disruption
  • Thumb Zone 5 Injuries (Carpometacarpal Joint)
  • Finger Zone 6 Injuries at the Metacarpal Level (Case Study 5.5)
  • Author's Preferred Method of Treatment of Zone 6 Injuries
  • Chronic Zone 6 Injuries
  • Lacerations.
  • Chronic Blunt Trauma to the Dorsal Hand: Secretan Disorder.
  • Zone 7 Injuries (Dorsal Wrist Injuries)
  • Chronic Injuries and Ruptures in Zone 7
  • Transfer of the Extensor Indicis Proprius Tendon to the Extensor Pollicis Longus Tendon.
  • Author's Preferred Method of Treatment of Zone 7 Injuries
  • Zone 8 Injuries (Distal Forearm Injuries) (Case Study 5.6)
  • Zone 9 Injuries (Proximal Forearm Injuries)
  • References
  • 6 Flexor Tendon Injury
  • Acknowledgments:
  • Repair of Acute Flexor Tendon Injuries
  • Preoperative Evaluation
  • Systematic Examination
  • Integument Examination.
  • Musculoskeletal Examination.
  • Neurologic Examination.
  • Vascular Examination.
  • Diagnostic Imaging
  • Anatomy
  • Surgical Treatment
  • Preoperative Considerations
  • Repair of Zone 1 Tendon Lacerations or Avulsions
  • Tendon-to-Bone Repair.
  • Flexor Digitorum Profundus Avulsion.
  • Repair of Zone 2 Tendon Lacerations
  • Core Sutures.
  • Epitendinous Suture.
  • Gap Formation.
  • Biologic Considerations.
  • Role of Postoperative Passive Motion Rehabilitation.
  • Future Concepts.
  • Flexor Pollicis Longus Lacerations.
  • Repair of Tendon Lacerations in Zones 3, 4, and 5
  • Repair of Partial Tendon Lacerations
  • Author's Preferred Technique: Zone 1 Tendon-to-Bone Repair
  • Author's Preferred Technique: Primary Tendon Repair in Zones 1 and 2
  • Surgical Techniques for Tendon Repairs in Zones 3, 4, and 5.
  • Expected Outcomes of Flexor Tendon Repair
  • Postoperative Management: Rehabilitation
  • Author's Preferred Technique: Postoperative Rehabilitation of Repairs in Zones 1 and 2
  • Complications Following Flexor Tendon Repair
  • Acknowledgments:
  • Flexor Tendon Reconstruction
  • Patient Selection
  • Flexor Tenolysis
  • Preoperative Evaluation
  • Agents That May Limit Adhesion Formation
  • Authors' Preferred Technique: Tenolysis
  • Postoperative Care Following Tenolysis
  • Expectations Following Tenolysis
  • Single-Stage Flexor Tendon Grafting: Flexor Digitorum Profundus and Flexor Digitorum Superficialis Tendons Disrupted
  • Indications for Tendon Grafting
  • Initial Exploration
  • Biology of Tendon Graft Incorporation
  • Obtaining Donor Tendon Grafts
  • Palmaris Longus Tendon.
  • Technique of Palmaris Longus Tendon Harvest.
  • Plantaris Tendon.
  • Technique of Plantaris Tendon Harvest.
  • Long Toe Extensor Tendon.
  • Technique of Long Toe Extensor Tendon Harvest.
  • Extensor Proprius Tendons.
  • Technique of Extensor Indicis Proprius Tendon Harvest.
  • Flexor Digitorum Longus Tendon of the Foot.
  • Technique of Flexor Digitorum Longus Tendon Harvest.
  • Distal Tendon Juncture
  • Pull-Out Sutures (Around the Bone)
  • Proximal Tendon Juncture
  • Authors' Preferred Technique: Single-Stage Grafting Technique
  • Placement of the Graft
  • Distal Juncture Technique
  • Proximal Juncture Technique
  • Postoperative Care
  • Graft Incorporation
  • Single-Stage Flexor Tendon Grafting: Flexor Digitorum Profundus Tendon Disrupted, Flexor Digitorum Superficialis Tendon Intact
  • Indications
  • Single-Stage Grafting Technique With an Intact Flexor Digitorum Superficialis Tendon (Zone 1 Injuries)
  • Postoperative Care of Tendon Grafts With an Intact Flexor Digitorum Superficialis Tendon (Zone 1 Injuries)
  • Expectations
  • Two-Stage Flexor Tendon Reconstruction
  • Indications
  • Tissue Response to a Silicone Implant.
  • Alternative Techniques.
  • Composite Tissue Transfer Methods.
  • Authors' Preferred Technique: Staged Tendon Grafting: Stage I
  • Postoperative Care
  • Stage II
  • Technique.
  • Postoperative Care.
  • Thumb Flexor Tendon Reconstruction
  • Indication
  • Thumb Free Tendon Graft
  • Technique.
  • Flexor Digitorum Superficialis Tendon Transfer
  • Technique.
  • Staged Tendon Reconstruction in the Thumb
  • Technique.
  • Other Options After Loss of Flexor Pollicis Longus Function
  • Secondary Reconstruction of Tendon Injuries in Zones 3, 4, and 5
  • Indications
  • Interposition Graft
  • Flexor Digitorum Superficialis Tendon Transfer
  • End-to-Side Flexor Digitorum Profundus Tendon Juncture
  • Postoperative Care
  • Expectations
  • Reconstruction of the Pulley System
  • Indications
  • Pulley Reconstruction Using a Free Tendon Graft
  • Pulley Reconstruction Using a Flexor Digitorum Superficialis Tendon
  • Pulley Reconstruction Using the Extensor Retinaculum
  • Pulley Reconstruction Using the Volar Plate
  • Pulley Reconstruction Using Artificial Materials
  • Authors' Preferred Technique: Pulley Reconstruction
  • Postoperative Care
  • Flexor Tendon Reconstruction in Children
  • Indications
  • Authors' Preferred Technique: Tendon Graft in Children
  • Complications Following Flexor Tendon Grafting
  • Adhesion Formation
  • Mechanical Failure of the Implant
  • Graft Rupture
  • Pulley Disruption
  • Quadriga Syndrome
  • Hyperextension of the Proximal Interphalangeal Joint
  • Lumbrical-Plus Finger
  • Synovitis
  • Infection
  • Late Flexion Deformity
  • Future Concepts
  • Flexor Digitorum Superficialis Finger: Salvage Procedure
  • Technique
  • Postoperative Care
  • References
  • 7 Fractures of the Metacarpals and Phalanges
  • Acknowledgment:
  • Metacarpal Fractures (Excluding the Thumb)
  • Metacarpal Head Fractures
  • Author's Preferred Method of Treatment
  • Metacarpal Neck Fractures
  • Closed Reduction of Metacarpal Neck Fractures
  • Open Reduction of Metacarpal Neck Fractures
  • Author's Preferred Method of Treatment
  • Metacarpal Shaft Fractures
  • Closed Reduction and Plaster Immobilization
  • Closed Reduction and Percutaneous Pinning
  • Open Reduction
  • Techniques of Open Reduction.
  • Kirschner Wires.
  • Composite (Tension Band) Wiring.
  • Cerclage and Interosseous Wiring.
  • Intramedullary Fixation.
  • Interfragmentary Compression Screws.
  • Plate Fixation.
  • External Fixation.
  • Author's Preferred Method of Treatment
  • Expected Outcomes: Metacarpal Shaft Fractures
  • Segmental Metacarpal Loss
  • Author's Preferred Method of Treatment: Segmental Loss
  • Metacarpal Base Fractures and Carpometacarpal Fracture-Dislocations
  • Avulsion Fractures of the Second and Third Metacarpal Bases
  • Fracture-Dislocations of the Ring Finger Carpometacarpal Joint
  • Fracture-Dislocations of the Small Finger Carpometacarpal Joint
  • Multiple Carpometacarpal Dislocations
  • Author's Preferred Method of Treatment
  • Complications of Metacarpal Fractures
  • Malunion
  • Dorsal Angulation.
  • Malrotation.
  • Articular Malunions.
  • Osteomyelitis
  • Nonunion
  • Other Complications
  • Phalangeal Fractures
  • Fractures of the Distal Phalanx
  • Tuft Fractures
  • Shaft Fractures
  • Epiphyseal Fractures of the Distal Phalanx
  • Complications of Distal Phalangeal Fractures
  • Fractures of the Middle and Proximal Phalanges
  • Articular Fractures of the Phalanges
  • Condylar Fractures.
  • Other Fractures of the Head of the Phalanx.
  • Dorsal, Volar, or Lateral Base Fractures.
  • Shaft Fractures Involving the Joint.
  • Author's Preferred Method of Treatment: Articular Fractures
  • Nonarticular Fractures of the Phalanges
  • Neck Fractures.
  • Shaft Fractures.
  • Healing Time
  • Closed Reduction With a Cast or Splint
  • Closed Reduction and Percutaneous Pinning
  • Open Reduction and Internal Fixation
  • Surgical Approaches
  • Open Reduction With Pin Fixation
  • Intramedullary Fixation
  • Screw Fixation
  • Plate Fixation
  • External Fixation
  • Biomechanical Testing
  • Author's Preferred Method of Treatment: Phalangeal Shaft Fractures
  • Nondisplaced and Stable Fractures of the Phalanges
  • Displaced Fractures: Stable After Closed Reduction
  • Displaced Fractures: Unstable After Closed Reduction
  • Spiral and Oblique Fractures.
  • Transverse Fractures.
  • Displaced Fractures: Unstable and Comminuted
  • Expected Outcomes: Phalangeal Shaft Fractures
  • Base Fractures of the Proximal Phalanx
  • Complications of Phalangeal Fractures
  • Malunion
  • Malrotation
  • Apex Volar Angulation
  • Lateral Angulation
  • Shortening
  • Articular Malunion
  • Outcomes.
  • Nonunion
  • Loss of Motion
  • Proximal Interphalangeal Joint Extensor Lag
  • Flexor Tendon Rupture or Entrapment
  • Infection
  • Role of Antibiotics in the Management of Phalangeal Fractures
  • Treatment of Infected Phalangeal Fractures
  • Fractures of the Thumb
  • Thumb Phalangeal Fractures
  • Extraarticular Thumb Fractures
  • Articular Fractures and Avulsions of the Thumb
  • Fractures of the Thumb Metacarpal
  • Metacarpal Head Fractures
  • Shaft Fractures of the Thumb
  • Articular Fractures of the Thumb Metacarpal Base: Bennett Fracture
  • Author's Preferred Method of Treatment
  • Complications.
  • Expected Outcomes for Bennett Fractures.
  • Rolando Fractures of the Thumb
  • Author's Preferred Method of Treatment
  • References
  • 8 Dislocations and Ligament Injuries of the Digits
  • Proximal Interphalangeal Joint
  • Pertinent Anatomy
  • Preoperative Evaluation of the Injured PIP Joint
  • Radiographic Evaluation
  • Clinical Evaluation
  • Dislocations of the Proximal Interphalangeal Joint
  • Acute Dorsal Proximal Interphalangeal Dislocations
  • Open Reduction.
  • Lateral Proximal Interphalangeal Dislocations
  • Volar Proximal Interphalangeal Dislocations
  • Authors' Preferred Method of Treatment of Volar Rotatory Dislocation
  • Technique of Closed Treatment of Volar Rotatory Proximal Interphalangeal Dislocation.
  • Technique of Open Reduction of Volar Rotatory Proximal Interphalangeal Dislocation.
  • Expected Outcomes.
  • Dorsal Dislocations and Fracture-Dislocations of the Proximal Interphalangeal Joint
  • Pilon Fracture
  • Treatment of Unstable Proximal Interphalangeal Fracture-Dislocation and Pilon Injuries
  • Extension Block Splinting.
  • Extension Block Pinning.
  • Dynamic Skeletal Traction.
  • Open Reduction With Internal Fixation.
  • Cerclage Wiring.
  • Volar Plate Arthroplasty.
  • Hemihamate Autogenous Grafting.
  • Authors' Preferred Methods of Treatment
  • Dynamic Skeletal Traction.
  • Postoperative protocol.
  • Expected outcomes.
  • Open Reduction and Internal Fixation.
  • Postoperative protocol.
  • Expected outcomes.
  • Volar Plate Arthroplasty.
  • Postoperative management.
  • Complications
  • Redisplacement.
  • Angulation.
  • Flexion contractures.
  • Distal interphalangeal joint stiffness.
  • Cerclage Wiring.
  • Postoperative protocol.
  • Authors' preferred technique for hemihamate reconstruction
  • Postoperative protocol.
  • Expected outcomes.
  • Chronic Proximal Interphalangeal Fracture-Dislocations
  • Authors' Preferred Method of Treatment
  • Chronic Proximal Interphalangeal Subluxations (Hyperextension)
  • Treatment
  • Technique of Lateral Band Tenodesis.
  • Postoperative Management.
  • Expected Outcomes.
  • Complications.
  • Posttraumatic Fibrosis and Contracture of the Proximal Interphalangeal Joint
  • Flexion Contracture
  • Preoperative Evaluation.
  • Authors' Preferred Method of Treatment
  • Postoperative Management.
  • Expected Outcomes.
  • Distal Interphalangeal Joints of the Finger and Interphalangeal Joints of the Thumb
  • Metacarpophalangeal Joint of the Finger
  • Anatomy
  • Dorsal Metacarpophalangeal Dislocations
  • Anatomy
  • Simple Metacarpophalangeal Subluxation
  • Complete (Complex) Metacarpophalangeal Dislocation
  • Preoperative Evaluation.
  • Surgical Techniques
  • Authors' Preferred Method of Treatment
  • Postoperative Management
  • Complications
  • Expected Outcomes
  • Volar Metacarpophalangeal Dislocations
  • Isolated Radial Collateral Ligament Ruptures of the Metacarpophalangeal Joints
  • Locked Metacarpophalangeal Joints
  • Metacarpophalangeal Joint of the Thumb
  • Anatomy
  • Acute Ulnar Collateral Ligament Injuries (Skier's Thumb)
  • Preoperative Evaluation
  • Stener Lesion
  • Historical Review
  • Treatment
  • Types of Operations
  • Authors' Preferred Method of Treatment
  • Technique of Open Repair of the Thumb Metacarpophalangeal Ulnar Collateral Ligament.
  • Postoperative Management and Expectations
  • Chronic Ulnar Collateral Ligament Injuries (Gamekeeper's Thumb)
  • Preoperative Evaluation
  • Types of Operations
  • Authors' Preferred Method of Treatment
  • Postoperative Management and Expectations.
  • Radial Collateral Ligament Injuries
  • Anatomy
  • Preoperative Evaluation
  • Treatment
  • Types of Operations
  • Authors' Preferred Method of Treatment
  • Postoperative Management and Expectations
  • Metacarpophalangeal Dislocations
  • Historical Perspective
  • Preoperative Evaluation
  • Treatment Options
  • Authors' Preferred Method of Treatment
  • Postoperative Management and Expectations
  • Chronic Volar Instability of the Thumb Metacarpophalangeal Joint
  • Preoperative Assessment
  • Types of Operations
  • Thumb Carpometacarpal Joint
  • Carpometacarpal Joint Dislocations
  • Anatomy
  • Historical Review
  • Preoperative Evaluation
  • Treatment
  • Authors' Preferred Method of Treatment
  • Technique of Volar Ligament Reconstruction of the Thumb Carpometacarpal Joint.
  • Postoperative Management and Expectations
  • References
  • 9 Perionychium
  • Acknowledgment:
  • Anatomy
  • Preoperative Evaluation
  • Types of Operations
  • Subungual Hematoma
  • Nail Bed Repair
  • Avulsion
  • Nail Bed Defect
  • Harvest of Nail Bed Graft
  • Fracture
  • Amputation
  • Delayed Treatment of Acute Injuries
  • Postoperative Management
  • Complications
  • Nail Ridges
  • Split Nail
  • Nonadherence
  • Absence
  • Nail Spikes, Cysts, and Cornified Nail Bed
  • Eponychial Deformities
  • Hyponychial Deformities
  • Dull Nail
  • Pincer Nail
  • Acute Infections
  • Fungal Infections
  • Bacterial Infections
  • Chronic Infections
  • Tumors of the Perionychium
  • Benign Tumors
  • Pyogenic Granuloma
  • Subungual Nevi
  • Verruca Vulgaris
  • Ganglion
  • Glomus Tumor
  • Malignant Tumors
  • References
  • 10 Treatment of the Stiff Finger and Hand
  • Acknowledgments:
  • Anatomy
  • Metacarpophalangeal Joint
  • Proximal Interphalangeal Joint
  • Distal Interphalangeal Joint
  • Interosseous and Hypothenar Muscles
  • Lumbrical Muscles
  • Extrinsic Extensors
  • Pathophysiologic Findings
  • Digit Function and Mobility
  • Treatment
  • Evaluation and Planning
  • Status of the Articular Surface of the Metacarpophalangeal and Proximal Interphalangeal Joints
  • Capsular Contracture, Tendon Adherence, and Extrinsic and Intrinsic Assessment
  • Nonoperative Intervention
  • Nonoperative Treatment of Metacarpophalangeal Joint Contractures
  • Nonoperative Treatment of Proximal Interphalangeal Joint Contractures
  • Operative Intervention
  • Skin and Soft Tissue
  • Anesthesia
  • Release of Metacarpophalangeal Joint Extension Contracture
  • Decisions Regarding When to Stop Excising and Releasing Tissue.
  • Closure and Postoperative Management.
  • Expectations and Complications.
  • Release of Flexion Contractures of the Proximal Interphalangeal Joint
  • Volar Surgical Approach.
  • Author's Preferred Approach: Proximal Interphalangeal Flexion Contractures
  • Expectations and Outcomes of Proximal Interphalangeal Joint Flexion Contracture Release.
  • External Fixation Devices for Proximal Interphalangeal Joint Contractures.
  • Release of Posttraumatic Proximal Interphalangeal Joint Extension Contractures
  • Release of Intrinsic Contracture After Trauma.
  • Late Posttraumatic Intrinsic Contracture of the Proximal Interphalangeal Joint.
  • Technique of distal intrinsic release.
  • Late Posttraumatic Interosseous Contracture of the Metacarpophalangeal and Proximal Interphalangeal Joints.
  • Technique of release of severe posttraumatic intrinsic contractures with muscle fibrosis.
  • References
  • 11 Treatment of the Osteoarthritic Hand and Thumb
  • Osteoarthritis of the Small Joints of the Hand
  • Preoperative Evaluation
  • Physical Examination
  • Diagnostic Imaging
  • Pertinent Anatomy and Biomechanics
  • Historical Review
  • Distal Interphalangeal Joint Arthrodesis
  • Indications and Contraindications
  • Preoperative Planning
  • Technique
  • Author's Preferred Method of Treatment
  • Postoperative Management and Expectations
  • Expected Outcomes.
  • Complications.
  • Proximal Interphalangeal Joint Arthrodesis
  • Indications and Contraindications
  • Preoperative Planning
  • Technique
  • Author's Preferred Method of Treatment
  • Postoperative Management and Expectations
  • Expected Outcomes.
  • Complications.
  • Metacarpophalangeal Joint Arthrodesis
  • Indications and Contraindications
  • Preoperative Planning
  • Technique
  • Postoperative Management and Expectations
  • Expected Outcomes.
  • Complications.
  • Proximal Interphalangeal Joint Arthroplasty
  • Indications and Contraindications
  • Preoperative Planning
  • Technique
  • Author's Preferred Method of Treatment
  • Postoperative Management and Expectations
  • Expected Outcomes
  • Surface Replacement Arthroplasty.
  • Pyrocarbon Implant.
  • Silastic Implant.
  • Complications.
  • Metacarpophalangeal Joint Arthroplasty
  • Indications and Contraindications
  • Expected Outcomes
  • Pyrocarbon Implant.
  • Silastic Implant.
  • Other Procedures.
  • Complications
  • Osteoarthritis of the Carpometacarpal Joint of the Thumb
  • Epidemiologic Findings
  • Evaluation
  • Physical Examination
  • Diagnostic Imaging
  • Anatomy and Biomechanics
  • Treatment
  • Indications and Contraindications
  • Nonoperative Treatment.
  • First Metacarpal Osteotomy.
  • Ligament Reconstruction.
  • Resection Arthroplasty.
  • Carpometacarpal Thumb Arthrodesis.
  • Carpometacarpal Thumb Arthroplasty.
  • Other Procedures and Devices
  • Artelon Implant.
  • Carpometacarpal Arthroscopy.
  • Operative Techniques
  • First Metacarpal Osteotomy.
  • Ligament Reconstruction.
  • Resection Arthroplasty.
  • Carpometacarpal Arthrodesis.
  • Carpometacarpal Arthroscopy.
  • Author's Preferred Method of Treatment
  • Postoperative Management and Expectations
  • Expected Outcomes
  • First Metacarpal Osteotomy.
  • Resection Arthroplasty.
  • Carpometacarpal Arthrodesis.
  • Carpometacarpal Arthroplasty.
  • Complications.
  • References
  • III Wrist
  • 12 Wrist Arthrodesis and Arthroplasty
  • Acknowledgment:
  • Preoperative Assessment
  • Physical Examination of the Wrist
  • Radiographic Evaluation
  • Common Radiographic Patterns of Disease
  • Osteoarthritis.
  • Rheumatoid Arthritis.
  • The Conservative Wrist.
  • The Restorative Wrist.
  • The Reconstructive Wrist.
  • The Salvage Wrist.
  • Surgical Techniques
  • Partial Wrist Fusions
  • History of Limited Wrist Arthrodesis
  • Radiolunate Fusion
  • Indications
  • Technique for Radiolunate Fusion
  • Author's Preferred Method of Treatment: Radiolunate Arthrodesis
  • Pitfalls
  • Postoperative Management
  • Net Analysis of the Literature
  • Scaphocapitate Arthrodesis
  • Indications
  • Contraindications
  • Fixation
  • Author's Preferred Method of Treatment: Scaphocapitate Arthrodesis
  • Postoperative Management
  • Postoperative Expectations
  • Athletic Participation
  • What Patients Should Be Told
  • Radioscapholunate Arthrodesis
  • Indications and Contraindications
  • Author's Preferred Method of Treatment: Radioscapholunate Arthrodesis
  • Complications
  • Postoperative Care
  • What Patients Should Be Told
  • Scapholunate Arthrodesis
  • Lunotriquetral Arthrodesis
  • Indications and Contraindications
  • Author's Preferred Method of Treatment: Lunotriquetral Arthrodesis
  • Postoperative Management
  • Pearls
  • Pitfalls
  • What Patients Should Be Told
  • Triquetrohamate Fusion
  • Scaphotrapeziotrapezoidal Fusion
  • Indications
  • Contraindications
  • Author's Preferred Method of Treatment: Scaphotrapeziotrapezoid Fusion
  • Postoperative Management
  • Alternative Techniques
  • Staple Fixation
  • Circular Plate Fixation
  • Screw Fixation
  • What Patients Should Be Told
  • Reconstruction of Wrists With Scapholunate/Scaphoid Nonunion Advanced Collapse (Scaphoid Excision, Capitate-Lunate- Hamate-Triquetrum Fusion)
  • Indications
  • Contraindications
  • Author's Preferred Method of Treatment: Scaphoid Excision and Four-Corner Fusion
  • Postoperative Management
  • Alternative Methods of Fixation
  • Kirschner Wire Fixation
  • Staple Fixation
  • Screw Fixation
  • What Patients Should Be Told
  • Scaphoid Excision With Capitolunate Arthrodesis
  • Total Wrist Arthrodesis
  • History of Wrist Arthrodesis
  • Plates, Wires, and Staples
  • Intramedullary Fixation
  • Author's Preferred Method of Treatment: Total Wrist Arthrodesis
  • Closure
  • Postoperative Management
  • Complications
  • Intramedullary Pin Fusion for Patients With Rheumatoid Arthritis
  • What Patients Should Be Told
  • Wrist Arthrodesis After Failed Total Wrist Arthroplasty
  • Total Wrist Replacement
  • History of Modern Total Wrist Arthroplasty
  • Preoperative Evaluation
  • Clinical Examination.
  • Surgical Technique (Universal II Implant)
  • Surgical Technique (Re-Motion Implant) (Video 12.1)
  • Centralization of the Extensor Tendons
  • What Patients Should Be Told
  • Wrist Hemiarthroplasty
  • References
  • 13 Wrist Instabilities, Misalignments, and Dislocations
  • Terminology.
  • Wrist Anatomy
  • Osseous Anatomy
  • Ligamentous Anatomy
  • Extrinsic Ligaments
  • Intrinsic Ligaments
  • Wrist Biomechanics
  • Carpal Kinematics
  • Flexion-Extension
  • Radioulnar Inclination
  • Dart-Thrower's Motion
  • Reversed Dart-Thrower's Motion
  • Intracarpal Pronosupination
  • Carpal Kinetics
  • The Role of Ligaments in Carpal Stabilization
  • The Role of Muscles in Carpal Stabilization
  • Wrist Disorders
  • Pathomechanics
  • Stage I: SL Dissociation or Scaphoid Fracture
  • Stage II: Perilunate Dislocation
  • Stage III: LTq Disruption or Triquetrum Fracture
  • Stage IV: Lunate Dislocation
  • Diagnosis of Wrist Disorders
  • Clinical Examination
  • Radiological Examination
  • Routine Radiograph Views.
  • Posteroanterior (Palm Down) Projection.
  • Lateral Projection.
  • Scaphoid Projection.
  • Semipronated (Oblique) Projection.
  • Additional Radiograph Views.
  • Carpal Bone Alignment Measurement.
  • Other Diagnostic Tests
  • Computed Tomography.
  • Distraction Views.
  • Stress Views.
  • Cineradiography.
  • Arthrography.
  • Magnetic Resonance Imaging.
  • Ultrasonography.
  • Arthroscopy.
  • Carpal Instability
  • Definition
  • Analysis of Carpal Instability
  • Classification of Carpal Instability
  • Dissociative Carpal Instability
  • Scapholunate Dissociation.
  • Pathomechanics of SL Dissociation.
  • Diagnosis of SL Dissociation.
  • Physical examination.
  • Scaphoid shift test.
  • Resisted finger extension test.
  • SL Ballottement Test.
  • Radiological examination.
  • Increased SL joint space.
  • Scaphoid ring sign.
  • Increased SL angle.
  • Palmar V sign.
  • Advanced imaging.
  • Treatment of SL Dissociation.
  • Stage I: partial SL ligament injury.
  • Percutaneous Kirschner wire fixation of the SL joint.
  • Reeducation of wrist proprioception.
  • Arthroscopic debridement of torn ligament edges and electrothermal ligament shrinkage.
  • Stage II: complete SL ligament injury, repairable.
  • Open reduction, internal fixation, and dorsal SL ligament repair.
  • Stage III: complete SL ligament injury, nonrepairable, normally aligned scaphoid and lunate.
  • Dorsal capsulodesis.
  • Soft tissue reconstruction of the dorsal SL ligament.
  • Bone-ligament-bone grafts.
  • Dynadesis.
  • Stage IV: complete SL ligament injury, nonrepairable, reducible flexion deformity of the scaphoid.
  • SL ligamentoplasty using a tendon graft.
  • Reduction-association of the SL joint.
  • Stage V: reducible carpal collapse due to chronic SL ligament injury, plus instability of radiolunate joint and normal joint cartilage.
  • Spiral Tenodesis.
  • Stage VI: irreducible carpal collapse due to chronic SL ligament injury, with normal joint cartilage.
  • Scaphoid-trapezium-trapezoid arthrodesis.
  • SL arthrodesis.
  • Scaphoid-capitate arthrodesis.
  • Scaphoid-lunate-capitate arthrodesis.
  • Radioscaphoid-lunate fusion and distal scaphoidectomy.
  • Stage VII: complete SL ligament injury with irreducible misalignment and cartilage degeneration.
  • Arthroscopy.
  • Radial styloidectomy.
  • Scaphoidectomy and midcarpal fusion.
  • Proximal row carpectomy.
  • Total wrist arthroplasty.
  • Total wrist arthrodesis.
  • Authors' Preferred Method of Treatment: SL Dissociation
  • Lunotriquetral Dissociation.
  • Pathomechanics of LTq Dissociation.
  • Diagnosis of LTq Dissociation.
  • Physical examination.
  • Radiographic examination.
  • Other diagnostic tests.
  • LTq Dissociation Treatment.
  • Acute LTq injury without carpal collapse.
  • Chronic LTq injury without carpal collapse.
  • Chronic LTq dissociation with carpal collapse.
  • Acute perilunate instability (combined SL and LTq instability).
  • Chronic perilunate instability (SL plus LTq instability).
  • Authors' Preferred Method of Treatment: LTq Dissociation
  • Nondissociative Carpal Instability
  • Radiocarpal Instability.
  • Isolated Midcarpal Instability.
  • Volar Instability of the Proximal Row (CIND-VISI).
  • Pathomechanics.
  • Diagnosis.
  • Physical examination.
  • Radiographic examination.
  • Differential diagnosis.
  • Treatment.
  • Dorsal Instability of the Proximal Row.
  • Authors' Preferred Method of Treatment: Nondissociative Instability
  • Carpal Misalignments
  • Carpal Misalignment Secondary to Deformity of the Distal Radius
  • Carpal Misalignment Secondary to Deformity of the Scaphoid
  • Carpal Misalignment Secondary to STT Arthritis
  • Carpal Misalignment Secondary to Deformity of the Lunate.
  • Wrist Dislocations and Fracture-Dislocations
  • Definition
  • Dorsal Perilunate Dislocations (Lesser-Arc Injuries)
  • Treatment of Perilunate Dislocations.
  • Closed Reduction and Cast Immobilization.
  • Closed Reduction and Percutaneous Fixation Under Arthroscopic Control.
  • Open Reduction and Internal Fixation.
  • Authors' Preferred Method of Treatment: Perilunate Dislocations
  • Dorsal Perilunate Fracture-Dislocations
  • Transscaphoid Perilunate Fracture-Dislocations.
  • Closed Reduction and Cast Immobilization.
  • Closed Reduction and Percutaneous Fixation.
  • Open Reduction and Internal Fixation.
  • Transscaphoid-Transcapitate-Perilunate Fracture-Dislocations.
  • Transtriquetrum-Perilunate Fracture-Dislocations.
  • Late Treatment of Unreduced Fracture-Dislocations.
  • Palmar-Perilunate Dislocations
  • Radiocarpal Dislocations
  • Axial Fracture-Dislocations
  • Isolated Carpal Bone Dislocations
  • References
  • 14 Distal Radioulnar Joint
  • Anatomy and Biomechanics
  • Physical Examination
  • Imaging
  • Radiography
  • Ultrasonography
  • Arthrography
  • Computed Tomography
  • Magnetic Resonance Imaging
  • Scintigraphy
  • Arthroscopy
  • Triangular Fibrocartilage Complex Lesions
  • Palmer's Classification of TTFC Lesions
  • Class 1A Tear
  • Class 1B Tear
  • Class 1C Tear
  • Class 1D Tear
  • Authors' Preferred Method of Treatment: Open Triangular Fibrocartilage Complex Repair ± Ulnar-Shortening Osteotomy for Class 1B Tear
  • Outcomes
  • Acute Distal Radioulnar Joint Instability
  • Evaluation
  • Simple Dislocations
  • TFCC Repair (Class 1B Injury)
  • Ulnar Styloid Fractures
  • Outcomes
  • Chronic Distal Radioulnar Joint Instability
  • Evaluation
  • Treatment
  • Authors' Preferred Method of Treatment: Distal Radioulnar Ligament Reconstruction
  • Outcomes
  • Osteoplasty of the Sigmoid Notch and Ulna
  • Distal Radius and Forearm Malunions
  • Ulnar Impaction Syndrome
  • Evaluation
  • Treatment
  • Partial Distal Ulnar Resection (Wafer Procedure)
  • Outcomes.
  • Diaphyseal and Metaphyseal Ulnar-Shortening Osteotomy
  • Authors' Preferred Method of Treatment: Ulnar-Shortening Osteotomy
  • Outcomes.
  • Distal Radioulnar Joint Arthritis
  • Operative Technique
  • Hemiresection-Interposition Arthroplasty
  • Authors' Preferred Method of Treatment: Hemiresection-Interposition Technique Arthroplasty
  • Outcomes.
  • Sauvé-Kapandji Procedure
  • Authors' Preferred Method of Treatment: Sauvé-Kapandji Procedure
  • Outcomes.
  • Distal Ulnar Resection (Darrach Procedure)
  • Authors' Preferred Method of Treatment: Distal Ulnar Resection
  • Outcomes.
  • Stabilization of the Resected Distal Ulna
  • Authors' Preferred Method of Treatment: Stabilization of Resected Distal Ulna
  • Failed Distal Ulnar Resection
  • Distal Ulnar Head Implant Arthroplasty
  • Operative Technique for Ulnar Head Arthroplasty
  • Outcomes
  • Distal Radioulnar Joint Contracture
  • Operative Technique
  • Dorsal DRUJ Capsulectomy
  • Volar DRUJ Capsulectomy
  • Outcomes
  • ECU Tenosynovitis and Subluxation
  • Operative Technique
  • Sixth Dorsal Compartment Release
  • Extensor Carpi Ulnaris Tendon Stabilization
  • Outcomes
  • References
  • 15 Distal Radius Fractures
  • Acknowledgments:
  • The Rationale for Modern Treatment
  • Fracture Evaluation
  • Pertinent Anatomy
  • Radiographic Pathoanatomy
  • Recognition of Fracture Patterns
  • Fracture Classifications
  • Frykman Classification
  • Melone Classification
  • AO Classification
  • Mayo Clinic Classification
  • "Fragment-Specific" Classification
  • Columnar Classification
  • The Fernandez Classification
  • Associated Injuries to the Distal Radioulnar Joint
  • Fracture Stability
  • Treatment Options and Techniques
  • Closed Reduction
  • Closed Reduction Technique
  • Percutaneous Pin Fixation
  • External Fixation
  • External-Fixation Technique
  • Augmented External Fixation
  • Arthroscopic Reduction and Percutaneous Fixation
  • Arthroscopic Reduction and Percutaneous Fixation Technique
  • Additional Soft Tissue Injuries
  • Bone Graft and Bone Graft Substitutes
  • Iliac Bone Graft Harvesting Technique
  • Tibial Bone Graft Harvesting Technique
  • Open Reduction and Internal Fixation
  • Dorsal Plate Fixation
  • "Universal" Dorsal Approach to the Distal Radius.
  • Volar Plate Fixation Technique.
  • Fragment-Specific Fixation
  • Surgical Approach to the Volar-Ulnar Fragment.
  • Other Fixation Methods
  • Distraction Plating Technique.
  • Intramedullary Implants.
  • The Ulnar Column
  • Ulnar Styloid Fixation
  • The Coronal Shift (Radial Translation)
  • Distal Radioulnar Joint Injury Treatment Options
  • Author's Preferred Method of Treatment: Ulnar Column Instability
  • Evidence-Based Decision Making
  • Treatment of the Elderly
  • Author's Preferred Method of Treatment: The Elderly
  • Author's Preferred Method of Treatment: A Case-Based Approach to Operative Management
  • Treatment of Nondisplaced Distal Radius Fractures
  • Type I-Bending Fractures
  • Minimizing Hand and Shoulder Stiffness
  • Algorithm for Management of Articular Distal Radius Fractures
  • Type II-Shear Fractures
  • Type III-Joint Surface Compression Fractures
  • Intermediate Column Single-Fragment Fractures.
  • Three- and Four-Part Injuries.
  • Type IV-Radiocarpal Fracture-Dislocation
  • Type V-Combined/Complex Injury
  • Associated Injuries
  • Open Fractures
  • Associated Median Nerve Injury
  • Associated Carpal Ligament Injuries
  • Outcome and Patient Expectations
  • Complications
  • Chronic Regional Pain Syndrome
  • Tendon Rupture
  • Nonunion
  • Malunion
  • Extraarticular Radial Osteotomy Technique
  • Dorsal Approach for Osteotomy of Malunited Distal Radius Fractures
  • Volar Approach for Osteotomy of a Malunited Distal Radius Fracture
  • Ulnar-Shortening Osteotomy
  • Watson's Trapezoidal Osteotomy
  • Malunited Smith Fractures
  • Articular Osteotomies
  • Distal Radioulnar Joint Procedures
  • Distal Radioulnar Joint Contracture
  • References
  • 16 Fractures of the Carpal Bones
  • Acknowledgments:
  • Scaphoid Fractures and Nonunion
  • General Considerations in Fractures and Nonunion of the Scaphoid
  • Incidence and Cause of Scaphoid Fractures
  • Pertinent Anatomy of the Scaphoid
  • Bony and Ligamentous Anatomy.
  • Vascular Anatomy.
  • Biomechanics of Scaphoid Fractures and Implications of Nonunion
  • Examination and Imaging of the Scaphoid
  • Clinical Presentation
  • Physical Examination
  • Diagnostic Imaging of Scaphoid Fractures and Nonunion
  • Computed Tomography.
  • Magnetic Resonance Imaging.
  • Preferred Modes of Diagnostic Imaging.
  • Scaphoid Fracture Classification and Implications for Treatment
  • Preferred Method of Classification
  • Management of Scaphoid Fractures
  • Stable Acute Fractures
  • Distal Pole Fractures.
  • Incomplete Fracture Through the Waist, Negative Radiographs, Positive MRI Studies.
  • Unstable Acute Fractures
  • Waist Fracture, "Nondisplaced."
  • Proximal Pole Fracture.
  • Mechanics of Fracture Fixation
  • Techniques for Rigid Fixation
  • Implants for Rigid Fixation of Scaphoid Fractures
  • Kirschner Wires
  • Screws
  • Other Implants.
  • Staple Fixation.
  • Plate Fixation.
  • Surgical Treatment Methods
  • Author's Preferred Treatment Method: Dorsal Approach (Figure 16.10)
  • Scaphoid Open Reduction and Internal Fixation From the Dorsal Approach/Mini-Open Approach.
  • Dorsal Percutaneous Slade Technique
  • Unstable Acute Fractures: Waist Fracture, Displaced
  • Scaphoid Open Reduction and Internal Fixation From the Palmar Approach
  • Palmar Percutaneous Method
  • Author's Preferred Method: Scaphoid Mini-Open Screw From the Palmar Approach
  • Palmar Percutaneous Method of Scaphoid Fixation (Alternate Method)
  • Postoperative Care.
  • Arthroscopy-Assisted Percutaneous Scaphoid Fixation
  • Delayed (Subacute) Presentation of Waist Fracture
  • Managing Scaphoid Fractures in Athletes
  • Complex Scaphoid Injuries
  • Combined Fractures of the Scaphoid and Distal Radius
  • Transscaphoid Perilunate Fracture-Dislocations
  • Open and Arthroscopic Treatment.
  • Complications of Scaphoid Fracture Treatment
  • Use of Fluoroscopy and Surgical Navigation to Reduce Screw Malposition
  • Cost of Surgical or Nonsurgical Treatment
  • Bone Growth Stimulators
  • Biologic Stimulation of Scaphoid Nonunions
  • Scaphoid Fracture in Children
  • Management of Scaphoid Nonunion
  • Evaluation of Scaphoid Nonunion
  • Fracture Site.
  • Amount of Scaphoid Deformity and Carpal Malalignment.
  • Stability of Nonunion
  • Amount of Bone Loss.
  • Previous Treatment.
  • Vascularity of Fragments.
  • Salvageability of the Fragment.
  • Presence and Location of Arthritis.
  • Length of Time Nonunion Has Been Present.
  • Age of the Patient.
  • Amount of Pain or Dysfunction.
  • Activity Level.
  • Presence of Comorbidities.
  • Operative Treatment of Scaphoid Nonunion (Table 16.4)
  • Type I: Delayed or Fibrous Union, No Deformity.
  • Type II: Scaphoid Waist Nonunion, Without Arthritis.
  • Surgical Fixation With Nonvascularized Bone Graft (Local).
  • Matti Technique, Matti-Russe Technique, and Green's Modification of the Russe Technique.
  • Author's Preferred Method: Hybrid Russe Procedure
  • Hybrid Russe Procedure.
  • Surgical Fixation of Scaphoid Nonunion With Nonvascularized Bone Graft (Distant) Wedge Graft
  • Fernandez-Fisk wedge graft.
  • Arguments against the wedge graft.
  • Technique of anterior wedge grafting.
  • Type III: Proximal Pole Nonunion, No Arthritis
  • Open Dorsal Technique for Scaphoid Nonunions.
  • Percutaneous Bone Graft or Bone Graft Substitute, Arthroscopic Technique (Video 16.1).
  • Percutaneous Bone Grafting of Scaphoid Nonunions.
  • Percutaneous harvesting of bone graft.
  • Postoperative care.
  • Dysvascular Nonunion, Waist or Proximal Pole Fracture.
  • Vascularized Bone Grafting.
  • 1,2 Intercompartmental Supraretinacular Artery Pedicle
  • Vascular anatomy of dorsal radius grafts.
  • Technique for surgical preparation of the 1,2 ICSRA graft.
  • Outcomes.
  • Vascularized Bone Graft Pedicled on the Volar Carpal Artery.
  • Other Pedicled Bone Grafts
  • Surgical fixation of scaphoid nonunion with vascularized bone graft
  • dorsal capsular pedicle.
  • Surgical fixation of scaphoid nonunion with vascularized bone graft
  • thumb metacarpal based on first dorsal metacarpal artery.
  • Free Vascularized Bone Grafts
  • Iliac crest vascularized bone graft.
  • Surgical fixation of scaphoid nonunion with vascularized bone graft
  • free medial femoral condyle graft.
  • Vascularized medial femoral trochlea osteocartilaginous flap reconstruction.
  • Prognosis for Healing of Scaphoid Nonunion
  • Author's Preferred Method: Scaphoid Nonunion (Table 16.5)
  • Unsalvageable Scaphoid Proximal Pole Nonunion
  • Rib osteochondral autograft reconstruction of the proximal pole.
  • Treatment of Scaphoid Malunion
  • Nonunion of Distal Pole Scaphoid Fractures
  • Salvage Procedures for Scaphoid Nonunion Advanced Collapse
  • Radial Styloidectomy.
  • Distal Scaphoid Resection Arthroplasty.
  • Surgical Technique for Distal Scaphoid Resection.
  • Proximal Row Carpectomy.
  • Indications and Contraindications.
  • Surgical Technique.
  • Intercarpal Fusion.
  • Technique.
  • Fractures of Carpal Bones Other Than the Scaphoid
  • Fractures of the Triquetrum
  • Triquetral Fracture Patterns
  • Dorsal Cortical Fracture.
  • Triquetral Body Fracture.
  • Palmar Cortical Fracture.
  • Clinical and Radiographic Features
  • Treatment
  • Fractures of the Trapezium
  • Mechanism of Injury
  • Imaging
  • Treatment
  • Fractures of the Capitate
  • Mechanism of Injury
  • Radiographic Features
  • Treatment
  • Fractures of the Hamate
  • Fractures of the Hook of the Hamate
  • Clinical and Radiographic Presentation.
  • Blood Supply.
  • Treatment.
  • Postoperative Care.
  • Fractures of the Body of the Hamate
  • Fractures of the Pisiform
  • Fractures of the Trapezoid
  • Fractures of the Lunate
  • Mechanism of Injury and Radiographic Presentation
  • Treatment
  • Blood Supply
  • Osteonecrosis
  • Kienböck Disease
  • Etiologic Findings
  • Clinical and Radiographic Presentation.
  • Staging.
  • Imaging.
  • Treatment.
  • Stage I, II, or IIIA Kienböck Disease with Ulnar-Negative Variance.
  • Joint-leveling procedures.
  • Radial-shortening osteotomy.
  • Vascularized bone grafting.
  • Technique based on the fourth and fifth extensor compartment arteries.
  • Technique based on the second or third metacarpal.
  • Technique for vascularized bundle implantation.
  • Stage I, II, or IIIA Kienböck Disease With Ulnar-Positive or Ulnar-Neutral Variance.
  • Technique for capitate shortening with capitate-hamate fusion.
  • Technique for closing wedge radial osteotomy.
  • Core decompression.
  • Stage IIIB Kienböck Disease.
  • Stage IV Disease.
  • Author's Preferred Method
  • Preiser Disease
  • Avascular Necrosis of the Capitate
  • References
  • 17 Wrist Arthroscopy
  • Introduction
  • General Setup for Wrist Arthroscopy
  • Portal Placement
  • Radiocarpal Portals
  • Midcarpal Portals
  • Distal Radioulnar Joint Portals
  • Trapeziometacarpal Arthroscopy
  • Accessory Thumb Carpometacarpal Portals
  • Dry Arthroscopy
  • Arthroscopic Anatomy
  • DRUJ Arthroscopy
  • Carpal Instability
  • Fracture Management
  • Scaphoid Fractures
  • Author's Preferred Treatment: Arthroscopic Reduction and Internal Fixation of Scaphoid Fractures
  • Geissler Technique
  • Slade Technique
  • Herbert-Whipple Technique
  • Arthroscopic Reduction of Selected Scaphoid Nonunions
  • Transscaphoid Perilunate Fracture-Dislocations
  • Fractures of the Distal Radius
  • Operative Technique
  • Treatment of Triangular Fibrocartilage Complex Injuries
  • Arthroscopic Management of Traumatic Injuries
  • Degenerative Lesions Class II
  • Arthroscopic Wafer Resection of the Ulnar Head
  • Arthroscopic Ganglionectomy
  • Surgical Technique: Arthroscopic Ganglion Excision
  • Wrist Arthritis
  • Wrist Synovectomy
  • Intercarpal Arthrodesis
  • Arthroscopic Arthrolysis
  • Contraindications
  • Technique
  • Kienböck's Disease
  • Thumb Carpometacarpal Arthroscopy
  • Indications
  • Contraindications
  • Technique: Arthroscopic Capsular Shrinkage
  • Technique: Arthroscopic Hemitrapeziectomy
  • Small Joint Arthroscopy
  • Small Joint Arthroscopy
  • Complications
  • Conclusion
  • References
  • IV Elbow and Forearm
  • 18 Fractures of the Distal Humerus
  • General Considerations in Distal Humerus Fractures
  • Preoperative Evaluation
  • History and Physical Examination
  • Radiographic Examination
  • Anatomy
  • Classification of Distal Humerus Fractures
  • Comprehensive Classification Systems
  • Column Concept of Classification.
  • Intraarticular Fractures
  • Single-column fractures.
  • Bicolumnar fractures.
  • Extraarticular Intracapsular Fractures.
  • AO/ASIF Classification.
  • Classification of Fracture Patterns Unique to the Articular Surface
  • Fractures of the Capitellum.
  • Fractures of the Trochlea.
  • Other Articular Fracture Patterns.
  • Historical Review
  • Operative Management of Distal Humerus Fractures
  • Timing of Operative Intervention
  • Polytrauma Patients
  • Open Fractures
  • Fractures in Elderly Adults
  • Open Reduction and Internal Fixation in Elderly Adults.
  • Total Elbow Replacement in Elderly Adults.
  • Patient Position and Anesthesia
  • Operative Exposures
  • Paratricipital Approach
  • Olecranon Osteotomy
  • Triceps-Splitting Approach
  • Bryan-Morrey "Triceps-Sparing" Approach
  • Triceps-Reflecting Anconeus Pedicle Approach
  • Anconeus Flap Transolecranon Approach
  • Lateral Approach
  • Fixation Principles
  • Implant Biomechanics
  • Authors' Preferred Method of Treatment
  • General Considerations and Potential Pitfalls
  • Supracondylar and Transcondylar Fractures: Proximal Patterns
  • Bicolumnar Fractures in an Active Patient With Healthy Bone
  • Minimally Comminuted Fractures.
  • Multiplanar Articular Involvement.
  • Simple Supracondylar Involvement.
  • Combined Articular and Supracondylar Comminution.
  • Technique for Olecranon Osteotomy.
  • Creation of Osteotomy.
  • Fixation of Osteotomy.
  • Fixation Sequence.
  • Unicolumnar Fractures
  • Capitellar and Articular Variant Fractures
  • Simple Fractures of the Capitellum
  • Complex Capitellar Fractures and Articular Fracture Variants
  • Distal Humerus Fractures With Extensive Related Injuries
  • Massive Bone Loss.
  • Nonarticular Bone Loss.
  • Articular Bone Loss.
  • Ballistic Injuries.
  • Postoperative Care
  • Expectations
  • Complications
  • Nonunion of the Distal Humerus
  • Nonunion of the Olecranon Osteotomy
  • Infection
  • Ulnar Neuropathy
  • Stiffness and Heterotopic Ossification
  • References
  • 19 Fractures of the Radial Head
  • Evaluation
  • Clinical Assessment
  • Imaging
  • Associated Injuries
  • Anatomy and Biomechanics
  • Historical Review
  • Treatment Options
  • Nonoperative Management
  • Operative Management
  • Open Reduction and Internal Fixation
  • Excision of Fragments of the Radial Head
  • Delayed Excision of the Radial Head
  • Excision of the Radial Head
  • Arthroplasty of the Radial Head
  • Author's Preferred Treatment
  • Surgical Approach.
  • Fragment Excision.
  • Open Reduction and Internal Fixation.
  • Excision of the Radial Head.
  • Implant Arthroplasty of the Radial Head.
  • Closure.
  • Postoperative Management and Expectations
  • Outcome Data
  • Nonoperative Management
  • Open Reduction and Internal Fixation
  • Fragment Excision
  • Delayed Radial Head Excision
  • Primary Resection of the Radial Head
  • Arthroplasty of the Radial Head
  • Postoperative Protocol
  • Complications
  • Nerve Injury
  • Avascular Necrosis
  • Nonunion
  • Malunion
  • Osteoarthritis
  • Stiffness and Heterotopic Bone
  • Valgus Instability
  • Axial Instability
  • References
  • 20 Fractures of the Proximal Ulna
  • Acknowledgment:
  • Preoperative Evaluation
  • Anatomy
  • Trochlear Notch of the Ulna
  • Coronoid Process
  • Olecranon Process
  • Radial Head
  • Anatomy of Elbow Stability
  • Classification and Patterns of Injury
  • Monteggia Fractures
  • Olecranon Fractures
  • Olecranon Fracture-Dislocations
  • Historical Review
  • Operative Procedure
  • Skin Incision
  • Excision and Triceps Advancement
  • Tension Band Wiring
  • Kirschner Wire Technique
  • Screw Technique
  • Plate and Screws
  • Standard Techniques
  • Monteggia Fractures
  • Fracture-Dislocations
  • Authors' Preferred Method of Treatment
  • Nondisplaced, Stable Fractures (Type I)
  • Displaced Fractures Without Comminution and Proximal to the Midpoint of the Olecranon (Type llA)
  • Displaced Fractures With Comminution and/or Dislocation of the Elbow
  • Coronoid Fractures
  • Postoperative Management and Expectations
  • Postoperative Protocol
  • Expected Outcome
  • Complications
  • Early Failure of Fixation
  • Infection
  • Instability
  • Nonunion
  • Ulnar Neuropathy
  • Stiffness of Heterotopic Ossification
  • Arthrosis
  • References
  • 21 Disorders of the Forearm Axis
  • Acknowledgments:
  • Forearm Functional Anatomy
  • Radial Shaft Fractures
  • General Evaluation and Preoperative Considerations
  • Pertinent Anatomy
  • Surgical Approaches for Fractures of the Radial Shaft
  • Anterior Approach
  • Posterior Approach for Radial Shaft Fixation
  • Fracture Stabilization
  • Bone Grafting
  • Fixation of Galeazzi-Type Fracture-Dislocations
  • Alternative Fixation Methods for Fractures of the Radial Shaft: Intramedullary Rods and External Fixation
  • Author's Preferred Method of Treatment: Radial Shaft Fractures
  • Postoperative Management and Expectations
  • Complications
  • Distal and Midshaft Ulnar Fractures
  • Preoperative Evaluation
  • Pertinent Anatomy
  • Surgical Alternatives for Fractures of the Ulnar Shaft
  • Direct Ulnar Approach for Distal and Midshaft Ulnar Fixation
  • Plate Fixation for Ulnar Shaft Fractures
  • Intramedullary Rods for Ulnar Shaft Fractures
  • Preoperative Planning
  • Author's Preferred Method of Treatment: Direct Ulnar Approach for Plate Fixation of Distal and Midshaft Ulnar Fractures
  • Postoperative Management and Expectations
  • Complications
  • Fractures of Both Bones of the Forearm
  • Preoperative Evaluation
  • Author's Preferred Method of Treatment: Anterior Approach for Radial Shaft Fixation and Direct Ulnar Approach for Ulnar Shaft Fixation
  • Postoperative Management and Expectations
  • Removal of Hardware from the Radius and Ulna
  • Nonunion and Malunion of the Radial and Ulnar Shafts
  • Preoperative Evaluation
  • Author's Preferred Method of Treatment: Open Reduction and Internal Fixation of Nonunion of the Radius or Ulna
  • Rotational or Angular Osteotomies for Malunion of the Radius or Ulna
  • Treatment of Nonunion of Forearm Bones Using Distraction-Compression Osteogenesis
  • Postoperative Management and Expectations
  • Radioulnar Synostosis
  • Author's Preferred Method of Treatment: Radioulnar Synostosis
  • Postoperative Management and Expectations
  • Longitudinal Instability of the Forearm Axis
  • Pertinent Anatomy
  • Types of Operations
  • Prevention of Longitudinal Instability of the Forearm
  • Restoration of the Length of the Radius and Ulna With Reduction of the Distal and Proximal Radioulnar Joints
  • Reconstruction of the Central Band of the Interosseous Membrane
  • One-Bone Forearm Technique
  • Author's Preferred Methods of Treatment
  • Acute Injuries
  • Interosseous Ligament Reconstruction
  • One-Bone Forearm Technique
  • Postoperative Expectations
  • Complications
  • References
  • 22 Complex Traumatic Elbow Dislocation
  • Acknowledgment:
  • Functional Anatomy
  • Ulnar-Humeral Joint
  • Radiocapitellar Joint
  • Capsuloligamentous Components
  • Musculotendinous Components
  • Preoperative Evaluation
  • Clinical Assessment
  • Acute Injury
  • Delayed Treatment or Previous Surgery
  • Imaging
  • Acute Injury
  • Delayed Treatment or Previous Surgery
  • Classification and Patterns of Injury
  • Posterolateral Rotational Injury
  • Dislocation With Radial Head Fracture
  • Dislocation With Radial Head and Coronoid Fracture ("Terrible Triad")
  • Olecranon Fracture-Dislocations
  • Transolecranon Fracture-Dislocation
  • Posterior Monteggia Lesion
  • Varus Posteromedial Rotational Injury
  • Historical Review
  • Treatment Options
  • Acute Injuries (Less Than 2 Weeks)
  • Dislocation
  • Fracture-Dislocation (Radial Head)
  • Nonoperative Management.
  • Operative Treatment: Repair, Arthroplasty, and Lateral Collateral Ligament Complex Repair.
  • Technique of Lateral Collateral Ligament Repair.
  • Fracture-Dislocation (Coronoid)
  • Examination Under Anesthesia.
  • Technique: Open Reduction and Internal Fixation.
  • Authors' Preferred Technique
  • Dislocation With Radial Head and Coronoid Fractures (Terrible Triad Injuries)
  • Nonoperative Management.
  • Operative Management.
  • Authors' Preferred Technique
  • Olecranon Fracture-Dislocations
  • Operative Technique.
  • Hinged External Fixation
  • Operative Technique.
  • Delayed Treatment
  • Authors' Preferred Technique
  • Positioning and Incision.
  • Reconstruction.
  • Postoperative Management and Outcome
  • Postoperative Management
  • Expected Outcomes
  • Complications
  • Recurrent Instability
  • Heterotopic Ossification
  • Stiffness
  • Posttraumatic Arthritis
  • References
  • 23 Chronic Elbow Instability
  • Chronic Lateral Instability
  • Preoperative Evaluation
  • Physical Examination
  • Diagnostic Imaging
  • Pertinent Anatomy
  • Indications
  • Contraindications
  • Technique
  • Author's Preferred Technique
  • Postoperative Management and Expectations
  • Expected Outcomes
  • Complications
  • Chronic Medial Instability
  • Preoperative Evaluation
  • Physical Examination
  • Diagnostic Imaging
  • Pertinent Anatomy
  • Indications
  • Contraindications
  • Technique
  • Author's Preferred Technique
  • Postoperative Management and Expectations
  • Expected Outcomes
  • Complications
  • References
  • 24 Treatment of the Stiff Elbow
  • Causes and Prevention of the Stiff and Contracted Elbow
  • Preoperative Assessment
  • Patient History
  • Age of the Patient
  • Duration of Contracture and Timing of Operative Release
  • Pain and the Stiff Elbow
  • Assessment of Motion Loss and the Effect on Function
  • What Degree of Motion Is Necessary?
  • Indications for Contracture Release
  • Physical Examination of the Ulnar Nerve
  • Assessment of the Ulnohumeral Joint Surface After Trauma
  • Imaging the Stiff Elbow
  • The Preoperative Discussion
  • Classifying the Contracture and Matching the Operative Plan
  • Anesthesia for Contracture Release
  • Operative Techniques and Approaches
  • Arthroscopic Release
  • Open Release
  • Medial "Over-the-Top" Approach
  • Patient Position and Preparation.
  • Skin Incision and Superficial Exposure.
  • Anterior Capsular Exposure.
  • Posterior Capsular Exposure.
  • Structures That Require Repair
  • Flexor-Pronator Muscle Origin.
  • Ulnar Nerve Transposition.
  • Lateral Approach
  • Patient Position, Preparation, and Skin Incision.
  • Anterior Capsular Exposure.
  • Posterior Capsular Exposure From the Lateral Side.
  • Immediate Postoperative Care
  • Closed Suction Drainage.
  • The First 24 Hours.
  • Special Circumstances
  • Fracture of the Distal Humerus After Open Reduction and Internal Fixation
  • Nonunion of the Distal Humerus
  • Head Trauma and Brain Injury
  • Hinged Fixation After Contracture Release
  • Instability After Release
  • Excessive Muscle Tightness
  • Distraction (Interposition) Arthroplasty
  • Postoperative Management
  • Use of Intravenous Dexamethasone for Postoperative Swelling
  • Adjuvant Therapy for Heterotopic Ossification
  • Physical Therapy and Splinting
  • Static Splints
  • Resting Extension Splint.
  • Turnbuckle Splint (for Extension or Flexion).
  • "Come-Along" Flexion Splint.
  • Continuous Passive Motion (or Slow Intermittent Passive Positioning) Device
  • Expectations and Results
  • Complications and Obstacles
  • Acute Recurrent Stiffness: "Gelling"
  • Nerve Palsy
  • Heterotopic Ossification
  • Pin Tract Infections
  • Joint Infection
  • Soft Tissue Deficiencies or Wound Necrosis
  • Failure to Achieve Improved Motion
  • References
  • 25 Elbow Tendinopathies and Tendon Ruptures
  • Lateral Epicondylitis
  • History
  • Etiology, Associations, and Pathophysiology
  • Presentation
  • Diagnosis
  • Medial Epicondylitis
  • Presentation
  • Etiology and Pathogenesis
  • Diagnosis
  • Treatment of Medial and Lateral Epicondylitis
  • Nonoperative Treatment
  • Surgical Treatment
  • Lateral Epicondylitis Surgery
  • Surgery for Recurrent Lateral Epicondylitis
  • Surgical Treatment for Medial Epicondylitis
  • Expected Outcomes
  • Authors' Preferred Method of Treatment: Elbow Epicondylitis
  • Arthroscopic Technique
  • Surgical Technique for Treatment of Medial Epicondylitis
  • Distal Biceps Rupture
  • Diagnosis
  • Treatment
  • Pertinent Anatomy
  • Complications
  • Expected Outcomes
  • Authors' Preferred Method of Treatment: Partial Biceps Tears
  • Treatment of Acute Complete Biceps Ruptures
  • Single-Incision Technique
  • Two-Incision Repair
  • Postoperative Treatment Protocol
  • Triceps Avulsions and Rupture
  • Authors' Preferred Method of Treatment: Repair of Complete Avulsion Injuries
  • References
  • 26 Elbow Arthroscopy
  • Acknowledgment:
  • Preoperative Evaluation
  • Physical Examination
  • Diagnostic Imaging
  • Anesthesia and Positioning
  • Pertinent Anatomy and Portals
  • Anterior Compartment Portals
  • Anteromedial Portals
  • Proximal Anteromedial Portal.
  • Anteromedial Portal.
  • Anterolateral Portals
  • Proximal Anterolateral Portal.
  • Midanterolateral Portal.
  • Distal Anterolateral Portal.
  • Posterior Compartment Portals
  • Posterior Central Portal
  • Proximal Posterolateral Portal
  • Midposterolateral Portal
  • Posterolateral Compartment Portals
  • Midposterolateral Portal
  • Distal Posterolateral Portal
  • Distal Ulnar Portal
  • Instrumentation
  • Historical Review
  • Types of Operations
  • Loose Body Removal
  • Indications and Contraindications
  • Preoperative Planning
  • Technique
  • Postoperative Management
  • Outcomes
  • Débridement for Osteoarthritis
  • Indications and Contraindications
  • Preoperative Planning
  • Technique
  • Postoperative Management
  • Outcomes
  • Synovectomy for Rheumatoid Arthritis
  • Indications and Contraindications
  • Preoperative Planning
  • Technique
  • Postoperative Management
  • Outcomes
  • Arthroscopy for Lateral Epicondylitis
  • Indications and Contraindications
  • Preoperative Planning
  • Technique
  • Postoperative Management
  • Outcomes
  • Fracture Management by Arthroscopic Fixation
  • Indications and Contraindications
  • Preoperative Planning
  • Technique for Arthroscopic Fixation of Capitellar Fractures
  • Technique for Arthroscopic Fixation of Coronoid Fractures
  • Technique for Arthroscopic Fixation of Radial Head Fractures
  • Outcomes
  • Arthroscopic Release of Elbow Stiffness Caused by Trauma or Developing Following Surgery
  • Indications and Contraindications
  • Preoperative Planning
  • Technique
  • Outcomes
  • Advanced Arthroscopic Procedures
  • Complications
  • References
  • 27 Total Elbow Arthroplasty
  • Acknowledgments:
  • Rheumatoid Arthritis
  • Preoperative Evaluation
  • Multiple Joint Involvement
  • Physical Examination
  • Nerve Status.
  • Medications.
  • Preoperative Planning
  • Posttraumatic Arthritis
  • Preoperative Assessment
  • Soft Tissue Envelope
  • Preoperative Planning
  • Fractures of the Distal Humerus
  • Preoperative Assessment
  • Radiographs
  • Primary Osteoarthritis
  • Hemophilic Arthropathy
  • Preoperative Considerations
  • Perioperative Management of Blood Clotting
  • Contraindications to Total Elbow Arthroplasty
  • Presence of Infection at the Elbow
  • Complete Ankylosis of the Neuropathic Joint
  • Poor-Quality Soft Tissue at the Elbow
  • Historical Review of Total Elbow Arthroplasty
  • Types of Implants
  • Authors' Preferred Method of Treatment
  • Postoperative Management and Expectations
  • Prosthesis Longevity
  • Complications of Total Elbow Arthroplasty
  • Mechanical Failure
  • Infection
  • Mortality Rates
  • References
  • V Nerves
  • 28 Compression Neuropathies
  • Acknowledgment:
  • Pathophysiology of Chronic Nerve Compression
  • Double-Crush Mechanism
  • Systemic Conditions and Personal Factors
  • Longitudinal Nerve Mobility
  • Authors' Opinion
  • Evaluation of Compression Neuropathies
  • Use of Provocation Tests
  • Shoulder and Scapular Movement Examination
  • Sensory Evaluation
  • Light Moving Touch
  • Vibration Thresholds
  • Cutaneous Pressure Thresholds
  • Two-Point Discrimination
  • Electrodiagnostic Studies
  • Electromyography
  • Nerve Conduction Studies
  • Electrodiagnostic Studies and Nerve Compression
  • Compression of the Median Nerve
  • Median Nerve Compression at the Wrist: Carpal Tunnel Syndrome
  • Anatomy
  • Nonoperative Management
  • Operative Treatment
  • Chow Two-Portal Endoscopic Technique.
  • Agee Single-Portal Endoscopic Technique.
  • Authors' Preferred Method of Treatment: Open Carpal Tunnel Release
  • Expected Outcome After Carpal Tunnel Decompression
  • Postoperative Care
  • Median Nerve Compression at the Elbow and Forearm
  • Anatomy
  • Pronator Syndrome
  • Anterior Interosseous Nerve Syndrome
  • Operative Technique
  • Authors' Preferred Method of Treatment
  • Postoperative Care
  • Compression of the Ulnar Nerve
  • Compression of the Guyon Canal
  • Anatomy
  • Nonoperative Management
  • Operative Technique
  • Authors' Preferred Method of Treatment
  • Postoperative Care
  • Cubital Tunnel Syndrome
  • Anatomy
  • Nonoperative Management
  • Operative Treatment
  • Technique of in Situ Decompression.
  • Medial Epicondylectomy for Ulnar Neuritis.
  • Subcutaneous Anterior Transposition of the Ulnar Nerve.
  • Intramuscular Transposition of the Ulnar Nerve.
  • Submuscular Transposition of the Ulnar Nerve.
  • Authors' Preferred Method of Treatment
  • Expected Outcome After Anterior Transposition of the Ulnar Nerve With Release of the Flexor-Pronator Muscle Origin for Cubital Tunnel Syndrome
  • Postoperative Care
  • Compression of the Radial Nerve
  • Superficial Radial Nerve Compression
  • Anatomy
  • Authors' Preferred Method of Treatment: Radial Sensory Nerve Decompression
  • Postoperative Care
  • Posterior Interosseous Nerve Syndrome and Radial Tunnel Syndrome
  • Anatomy
  • Operative Techniques
  • Transmuscular Brachioradialis-Splitting Approach
  • Posterior (Henry or Thompson) Approach
  • Anterior (Modified Henry) Approach
  • Authors' Preferred Method of Treatment
  • Postoperative Care
  • Proximal Radial Nerve Compression
  • Operative Technique
  • Postoperative Care
  • Surgery for Previously Failed Procedures
  • Recurrent Carpal Tunnel Syndrome
  • Revision Surgery
  • Recurrent Cubital Tunnel Syndrome
  • Revision Surgery
  • Recurrent Guyon Canal Compression
  • References
  • 29 Thoracic Outlet Compression Syndrome
  • Acknowledgment:
  • History
  • Classification
  • Arterial Thoracic Outlet Syndrome
  • Venous Thoracic Outlet Syndrome
  • Neurogenic Thoracic Outlet Syndrome
  • Electrically Negative Neurogenic Thoracic Outlet Syndrome
  • Epidemiology
  • Pertinent Anatomy
  • Interscalene Triangle
  • Costoclavicular Triangle
  • Subcoracoid or Pectoralis Minor Space
  • Clinical Findings
  • Physical Examination
  • Inspection and Palpation
  • Provocative Tests for Thoracic Outlet Syndrome
  • The Roos Test
  • Upper-Limb Tension Test
  • Scalene Injection
  • Diagnostic Studies
  • Radiologic Evaluation
  • Electrodiagnostic Evaluation
  • Treatment
  • Nonoperative Treatment
  • Operative Treatment
  • Author's Preferred Method of Treatment: Neurogenic Thoracic Outlet Syndrome
  • Complications
  • Results
  • Recurrent Symptoms After Surgical Treatment.
  • Conclusion
  • References
  • Index
  • A
  • B
  • C
  • D
  • E
  • F
  • G
  • H
  • I
  • J
  • K
  • L
  • M
  • N
  • O
  • P
  • Q
  • R
  • S
  • T
  • U
  • V
  • W
  • X
  • Y
  • Z
  • Inside Back Cover
  • 9780323295345v2_WEB
  • Front Cover
  • Green's Operative Hand Surgery, 2-Volume Set
  • Copyright Page
  • Contributors
  • Foreword for the Seventh Edition
  • Preface
  • Acknowledgments
  • Table Of Contents
  • Video Contents
  • V Nerves
  • 30 Nerve Injury and Repair
  • Indications
  • Anatomy
  • Voltage-Gated Ion Channels
  • Axonal Transport
  • Connective Tissue Elements
  • Functional Segregation
  • Features of Connective Tissue
  • Responses to Injury
  • Conduction Block (Also Called Neurapraxia)
  • Transient Ischemic Conduction Block
  • Persistent Anoxic Conduction Block
  • Persistent Conduction Block in Focal Myelin Deformation and Demyelination
  • Persisting Conduction Block in Projectile Injuries
  • Wallerian Degeneration
  • The Distal Segment
  • The Proximal Segment and the Cell Body
  • Stretch Injury
  • Clinical Diagnosis
  • Physical Examination of Nerve Injury
  • Tinel Sign
  • Injury
  • Neurologic Examination
  • Electrodiagnosis
  • Imaging
  • Lesions in Continuity
  • Considerations Before Surgical Intervention
  • Consultation and Operative Record
  • Operative Techniques
  • Nerve Resection and Neurolysis
  • Exposure
  • Resection of a Damaged Nerve
  • Technical Aspects.
  • Apparatus and Instruments.
  • Neurolysis
  • Methods of Suturing
  • Preparation of the Nerve Bed.
  • Direct Suture or Graft?
  • Palliative Musculotendinous Transfer or Distal Nerve Transfer?
  • Direct Suture.
  • Epineurial Repair.
  • Delayed Suture.
  • Use of Fibrin Clot Glue in Suturing.
  • Closure and Postoperative Care
  • Nerve Grafting
  • Choice of Graft
  • Postoperative Care
  • Other Methods of Grafting and Alternative Methods of Repair
  • Vascularized Nerve Graft
  • Freeze-Thawed Muscle Graft
  • Entubulation
  • Homografts
  • Nerve Transfer
  • Direct Muscular Neurotization
  • Recovery after Repair
  • Measurement of Recovery and Grading of Outcomes
  • Grading of Outcomes
  • Factors in Prognosis.
  • Age.
  • Level of the Lesion.
  • Nature of the Nerve Injury.
  • Delay From Injury to Repair.
  • Cause of the Injury.
  • Results
  • Radial Nerve
  • Spontaneous Recovery.
  • Duration of Follow-Up.
  • Delay.
  • The Nerve Defect.
  • Conclusions.
  • Median and Ulnar Nerves
  • Factors That Affect Recovery
  • Age.
  • Level and Nature of Injury.
  • Nerve Gap.
  • Concomitant Arterial Injury.
  • Primary Versus Delayed Repair.
  • Distal Transfers to the Ulnar Nerve.
  • Digital Nerve Repair
  • Conduits and Homografts for Digital Nerve Repair.
  • Authors' Preferred Method of Treatment: Digital Nerve Repair
  • Rehabilitation
  • War Wounds-Current Experience
  • Severity of Injury
  • Distribution and Diagnosis of Lesion
  • Prolonged Conduction Block
  • Axonotmesis
  • Repairs
  • Neuropathic Pain
  • Pathophysiological Basis of Neuropathic Pain
  • Cellular and Molecular Events
  • Outcomes of Surgical Intervention
  • Causalgia
  • Neurostenalgia-58 Patients
  • Posttraumatic Neuralgia-42 Patients
  • PTN in Amputation Stump
  • Some General Lessons
  • The Peripheral Neuroma
  • Pathophysiology
  • Prevention
  • Treatment
  • Chemical Methods
  • Operations
  • General Principles.
  • Authors' Preferred Method of Treatment
  • Operations for Terminal Neuroma.
  • Repair of the Nerve.
  • Repair by Synthetic Conduit.
  • Containment of the neuroma.
  • Epineurial sleeve.
  • Translocation of the nerve
  • Without excision of the neuroma.
  • Transposition into bone.
  • Transposition into vein.
  • Transposition into a conduit.
  • Silicone tubes.
  • Translocation of nerve into muscle.
  • References
  • 31 Principles of Tendon Transfers of Median, Radial, and Ulnar Nerves
  • Acknowledgment:
  • Principles
  • Prevention and Correction of Contracture
  • Tissue Equilibrium
  • Adequate Strength
  • Amplitude of Motion
  • Straight Line of Pull
  • One Tendon-One Function
  • Synergism
  • Expendable Donor
  • Median Nerve Palsy
  • Low Median Nerve Palsy
  • Biomechanics of Thumb Opposition
  • The Deficit and the Deformity
  • Tendon Transfers to Restore Thumb Opposition
  • History.
  • Patient Counseling.
  • General Principles of Tendon Transfer With Reference to Opponensplasty
  • Prevention and Preoperative Treatment of Contractures.
  • Selection of Motor for Transfer.
  • Pulley Design.
  • Opponensplasty Insertions.
  • Results.
  • Four Standard Opponensplasties.
  • Superficialis Opponensplasties.
  • Superficialis tendon harvest.
  • The pulley.
  • Surgical techniques
  • Royle-Thompson opponensplasty.
  • Results.
  • Bunnell's opponensplasty.
  • Technique.
  • Results.
  • EIP Opponensplasty.
  • Technique.
  • Results.
  • ADM (Huber) Opponensplasty.
  • Technique.
  • Results.
  • Palmaris Longus Opponensplasty (Camitz).
  • Technique.
  • Results.
  • Other Opponensplasties.
  • ECU Opponensplasty.
  • Technique.
  • Results.
  • ECRL Opponensplasty.
  • Technique.
  • Results.
  • EDM Opponensplasty.
  • Technique.
  • Results.
  • Tendon Transfers ("Compromise Opponensplasty") for Severe Nerve Deficits
  • FPL Opponensplasty.
  • Technique.
  • Results.
  • Alternative FPL Opponensplasties.
  • EPL Opponensplasty.
  • Technique.
  • Results.
  • Alternative EPL Opponensplasties.
  • Mennen's Technique of EPL Opponensplasty.
  • Results.
  • Adductor Pollicis and FPB Opponensplasties.
  • Postoperative Management of Opponensplasty.
  • Author's Preferred Method of Treatment: Low Median Nerve Palsy
  • Expectations and Patient Counseling for Low Median Nerve Palsy
  • High Median Nerve Palsy
  • Timing and Selection of Extrinsic and Intrinsic Transfers
  • Extrinsic Transfers
  • Restoration of Thumb Opposition
  • Restoration of Opposition in High Median Nerve Palsy
  • Brachioradialis-to-FPL Transfer
  • ECRL-to-Index Profundus Transfer
  • Complications
  • High Median Nerve Palsy Summary
  • Author's Preferred Method of Treatment: High Median Nerve Palsy
  • Expectations and Patient Counseling for High Median Nerve Palsy
  • High Median Nerve Palsy Summary
  • Ulnar Nerve Palsy
  • Patterns of Paralysis
  • Anomalous Innervation Patterns
  • Clinical Signs of Ulnar Nerve Palsy
  • Restoration of Function in Ulnar Nerve Palsy
  • The Ulnar Claw Hand and Its Management
  • Low Ulnar Nerve Palsy
  • Outcome of Surgery Assessments
  • Surgical Techniques for Correction of the Ulnar Claw Hand
  • Static Techniques.
  • Palmar Capsulodesis of the MP Joint (Zancolli).
  • Results.
  • Riordan Static Tenodesis.
  • Parkes Static Tenodesis.
  • Fowler's Wrist Tenodesis Technique.
  • Disadvantages.
  • Dynamic Tendon Transfers.
  • Insertions for Dynamic Transfers.
  • Superficialis Tendon Transfer Techniques and Modifications.
  • Modified Stiles-Bunnell procedure.
  • Modifications of the superficialis transfer.
  • Results.
  • Extensor Indicis Proprius and Extensor Digiti Minimi Transfers.
  • Transfers Using Wrist Flexor and Extensor Muscles.
  • Dorsal route transfer of ECRB/ECRL.
  • Results.
  • Burkhalter and Strait.
  • Flexor route transfer of ECRL (Brand method modified by Omer).
  • Results.
  • Disadvantages.
  • Flexor carpi radialis transfer.
  • Disadvantage.
  • Palmaris longus four-tail transfer.
  • Postoperative Management of Tendon Transfers for Claw Finger Correction
  • Restoration of Thumb-Index Key Pinch and Tip Pinch
  • Dynamic Procedures to Restore Thumb Adduction
  • ECRB as Motor (Smith).
  • Results.
  • FDS as Motor (Edgerton and Brand).
  • Extensor Indicis as a Motor (Brown).
  • Combination of EIP and EDC (Little) Tendon Transfers for Pinch
  • Index Abduction Techniques
  • Accessory Slip of APL Transfer.
  • EIP Transfer to First Dorsal Interosseous.
  • Disadvantages.
  • Palmaris Longus to the First Dorsal Interosseous.
  • Other Techniques for Restoring Index Finger Abduction.
  • Arthrodesis of Thumb MP and IP Joints to Restore Pinch
  • Arthrodesis of the MP Joint.
  • Arthrodesis of the IP Joint.
  • Split FPL Tenodesis.
  • Restoration of the Transverse Metacarpal Arch
  • Bunnell's "Tendon T" Operation.
  • EDM Transfer (Ranney).
  • Palande's Modification of Brand's Flexor Route Transfer of ECRL.
  • Correction of Little Finger Abduction Deformity
  • Split EDM Transfer.
  • Junctura Tendinum and Medial EDC Slip of Ring Finger Transfer (Voche and Merle).
  • High Ulnar Nerve Palsy
  • Restoration of Ring and Little Finger Flexion and Strength
  • Little and Ring Finger FDP Suture to the Middle Finger FDP.
  • Restoration of Sensibility
  • Digital Nerve Transfer.
  • Wasted Intermetacarpal Spaces
  • Early Tendon Transfers (Internal Splints) for Nerve Injuries
  • Author's Preferred Method of Treatment: Isolated Ulnar Nerve Palsy, Including Patient Counseling
  • Combined Median and Ulnar Nerve Palsies
  • Radial Nerve Palsy
  • Anatomy
  • Requirements for a Patient With Radial Nerve Palsy
  • Nonoperative Treatment
  • Early Transfers (Internal Splint)
  • Operative Treatment
  • Nerve Repair and Graft Versus Tendon Transfers
  • Timing of Tendon Transfers
  • Historical Review
  • Tendon Transfers
  • Flexor Carpi Ulnaris Transfer.
  • Postoperative Management.
  • Potential Problems
  • Excessive radial deviation after FCU harvest.
  • Avoidance.
  • Alter the insertion.
  • Absence of the palmaris longus.
  • Superficialis Transfer (Boyes).
  • Postoperative Management.
  • Flexor Carpi Radialis Transfer (Brand, Tsuge).
  • Single-Tendon Transfer.
  • Outcome of Radial Transfers.
  • Author's Preferred Method of Treatment
  • Radial Nerve Palsy Associated With Fractures of the Humerus
  • Early Exploration of the Nerve
  • Nerve Exploration for Failure to Improve Spontaneously
  • Author'S Preferred Method of Treatment
  • Nerve Transfer as an Alternative to Tendon Transfer
  • Restoration of Radial Nerve Function
  • Technique.
  • Outcome.
  • References
  • 32 Spasticity
  • Acknowledgment:
  • Cerebral Palsy
  • Traumatic Brain Injury
  • Treatment Considerations
  • Evaluation
  • Physical Examination
  • Physical Examination Key Points and Clinical Guidelines
  • Shoulder.
  • Elbow.
  • Forearm.
  • Wrist and Digits.
  • Thumb.
  • Diagnostic Testing
  • Imaging
  • Electromyography
  • Nonoperative Management
  • Therapy
  • Medical Management
  • Botulinum Toxin
  • Authors' Preferred Technique for Botulinum Toxin Injection
  • Operative Management
  • Shoulder
  • Types of Operative Procedures
  • Soft Tissue Release of Shoulder Internal Rotation Deformity
  • Indications.
  • Contraindications.
  • Preoperative Planning.
  • Technique.
  • Rotation Osteotomy of the Humerus
  • Indications.
  • Contraindications.
  • Preoperative Planning.
  • Technique.
  • Glenohumeral Joint Arthrodesis
  • Indications.
  • Contraindications.
  • Preoperative Planning.
  • Technique.
  • Authors' Preferred Method of Treatment
  • Elbow
  • Types of Operative Procedures
  • Musculocutaneous Neurectomy
  • Indications.
  • Contraindications.
  • Preoperative Planning.
  • Technique.
  • Elbow Flexor Lengthenings for Dynamic Spasticity
  • Indications.
  • Contraindications.
  • Preoperative Planning.
  • Technique.
  • Elbow Contracture Release for Fixed Deformity
  • Indications.
  • Contraindications.
  • Technique.
  • Authors' Preferred Method of Treatment
  • Forearm
  • Types of Operative Procedures
  • Flexor-Pronator Origin Muscle Slide
  • Indication.
  • Contraindication.
  • Technique.
  • Release of Pronator Insertion
  • Indication.
  • Contraindication.
  • Technique.
  • Pronator Teres Rerouting
  • Indication.
  • Contraindication.
  • Technique.
  • Authors' Preferred Method of Treatment
  • Wrist and Digital Extension
  • Types of Operations
  • Flexor Carpi Ulnaris to Extensor Carpi Radialis Brevis Transfer (Green's Transfer)
  • Indication.
  • Contraindication.
  • Technique.
  • Extensor Carpi Ulnaris to Extensor Carpi Radialis Brevis Transfer
  • Indications.
  • Contraindication.
  • Technique.
  • Flexor Carpi Ulnaris to Extensor Digitorum Communis Transfer
  • Indication.
  • Contraindication.
  • Technique.
  • Pronator Teres to Extensor Carpi Radialis Brevis Transfer
  • Indication.
  • Contraindications.
  • Technique.
  • Brachioradialis to Extensor Carpi Radialis Brevis Transfer
  • Indication.
  • Technique.
  • Authors' Preferred Method of Treatment
  • Wrist and Digital Flexor Tendon Tightness
  • Condition
  • Types of Operative Procedures
  • Flexor-Pronator Muscle Slide
  • Indications.
  • Technique.
  • Fractional Tendon Lengthening
  • Indications.
  • Contraindication.
  • Technique.
  • Tendon "Z"-Lengthening
  • Indication.
  • Contraindication.
  • Technique.
  • Superficialis to Profundus Tendon Transfer
  • Indication.
  • Contraindication.
  • Technique.
  • Authors' Preferred Method of Treatment
  • Thumb-in-Palm Deformity
  • Condition
  • Types of Operative Procedures
  • Release or Slide of the Origin of Spastic Thumb Intrinsic Muscles
  • Indication.
  • Contraindication.
  • Technique.
  • Release of the Insertion of the Spastic Thumb Adductor
  • Indications.
  • Technique.
  • Extensor Pollicis Longus Transfer
  • Indication.
  • Contraindication.
  • Technique.
  • Extensor Pollicis Longus Rerouting
  • Indication.
  • Contraindication.
  • Technique.
  • Brachioradialis to Extensor Pollicis Brevis Transfer
  • Indication.
  • Contraindication.
  • Technique.
  • Flexor Pollicis Longus Abductorplasty
  • Indication.
  • Contraindications.
  • Technique.
  • Imbrication of the Abductor Pollicis Longus and Extensor Pollicis Brevis Tendons
  • Indication.
  • Technique.
  • Thumb Metacarpophalangeal Joint Epiphyseal Arthrodesis (Chondrodesis)
  • Indication.
  • Contraindication.
  • Technique.
  • Authors' Preferred Method of Treatment
  • Intrinsic Muscle Spasticity and Digital Swan Neck Deformity
  • Condition
  • Types of Operative Procedures
  • Interosseous Muscle Slide
  • Indication.
  • Contraindication.
  • Technique.
  • Intrinsic Lateral Band Release
  • Ulnar Motor Neurectomy
  • Indication.
  • Contraindication.
  • Technique.
  • Flexor Digitorum Superficialis Tenodesis of the Proximal Interphalangeal Joint
  • Indication.
  • Contraindication.
  • Technique.
  • Fractional Palmar Intrinsic Lengthening
  • Indication.
  • Contraindication.
  • Technique.
  • Central Slip Tenotomy
  • Indication.
  • Contraindication.
  • Technique.
  • Metacarpophalangeal Joint Arthrodesis
  • Indication.
  • Contraindication.
  • Technique.
  • Authors' Preferred Method of Treatment
  • Intrinsic-Minus Deformities
  • Outcome Studies
  • References
  • 33 Tetraplegia
  • General Considerations in Tetraplegia
  • Pathogenesis
  • Preoperative Evaluation
  • Physical Examination
  • Diagnostic Imaging
  • Pertinent Anatomy
  • Historical Review
  • Indications and Contraindications for Operative Intervention
  • Types of Operations for Tetraplegia
  • Tendon Transfer
  • Tenodesis
  • Arthrodesis
  • Elbow Extension Tendon Transfer
  • Biceps to Triceps Tendon Transfer
  • Posterior Deltoid to Triceps Tendon Transfer
  • Procedures for Producing Forearm Pronation
  • Biceps Rerouting Procedure
  • Operations for Group 0 Patients
  • Operations for Group 1 Patients
  • Brachioradialis to Extensor Carpi Radialis Brevis Tendon Transfer
  • Passive Key Pinch Reconstruction
  • Author's Preferred Method of Treatment
  • Operations for Patients in Groups 2 and 3
  • Zancolli's Staged Reconstruction for Group 3 Patients
  • Stage 1: Extensor Tenodesis
  • Stage 2: Extensor Carpi Radialis Longus to Flexor Digitorum Profundus Transfer
  • Author's Preferred Method of Treatment
  • House's One-Stage Key Pinch Reconstruction for Patients in Groups 2 and 3
  • Carpometacarpal Fusion
  • Brachioradialis to Flexor Pollicis Longus Tendon Transfer
  • Extensor Pollicis Longus Tenodesis
  • Split Flexor Pollicis Longus Transfer
  • Operations for Patients in Groups 4 and 5
  • Author's Preferred Method of Treatment
  • House's Two-Stage Grasp, Pinch, and Release Procedure
  • Stage 1: Extensor Phase
  • Extensor Digitorum Communis Tenodesis.
  • Intrinsic Tenodesis.
  • Postoperative Casting and Rehabilitation.
  • Stage 2: Flexor Phase
  • Pronator Teres to Flexor Pollicis Longus Tendon Transfer.
  • Opponensplasty.
  • Postoperative Casting and Rehabilitation
  • Alternative Techniques for Patients in Groups 4 and 5
  • ABCDEFG Procedure (Alphabet Reconstruction)
  • Extensor Carpi Ulnaris Tenodesis
  • Tendon Transfer Technique
  • Postoperative Rehabilitation.
  • Operations for Patients in Groups 6 and 7
  • Author's Preferred Method of Treatment
  • Extensor Pollicis Longus to Extensor Digitorum Communis Transfer (Group 6 Patients)
  • Thumb Control Options
  • Intrinsic Reconstruction: The Lasso Procedure
  • Postoperative Casting and Rehabilitation
  • Operations for Group 8 Patients
  • Author's Preferred Method of Treatment
  • Stage 1: Extrinsic Transfers
  • Flexor Digitorum Profundus Side-to-Side Transfer.
  • Brachioradialis to Flexor Pollicis Longus Transfer.
  • Stage 2: Intrinsic Reconstruction
  • Opponensplasty.
  • Intrinsic Tenodesis.
  • Zancolli's Lasso Procedure.
  • Operations for Group 9 Patients
  • Intrinsic Reconstruction
  • Author's Preferred Method of Treatment
  • Digital Clawing
  • Lasso Procedure.
  • Proximal Interphalangeal Central Slip Deficiency
  • Intrinsic Tenodesis.
  • Further Areas of Research
  • Outcomes
  • Conclusion
  • References
  • 34 Traumatic Brachial Plexus Injury
  • Acknowledgments:
  • Surgical Anatomy
  • Classification of Nerve Injuries
  • Mechanisms of Traumatic Brachial Plexus Injury
  • Traction Injury
  • Gunshot Injury
  • Penetrating Trauma
  • Common Patterns of Brachial Plexus Injury
  • C5-C6 Injury
  • C5-C7 Injury
  • C8-T1 Injury
  • Pan-Plexus (C5-T1) Injury
  • Infraclavicular and Terminal Branch Injury
  • Preoperative Evaluation
  • History
  • Physical Examination
  • Imaging Evaluation
  • Pulmonary Function Tests
  • Electrodiagnostic Evaluation
  • Indications for Surgery
  • Contraindications to Surgery
  • Timing of Surgery
  • Primary (Nerve) Reconstruction
  • Immediate Surgery
  • Delayed Surgery
  • Secondary Reconstruction
  • Operative Considerations
  • Informed Consent
  • Preparation and Positioning
  • Surgical Approaches to the Brachial Plexus
  • Supraclavicular Exploration
  • Infraclavicular Exploration
  • Intraoperative Concerns
  • Intraoperative Assessment
  • Somatosensory and Motor Evoked Potentials
  • Nerve Action Potentials
  • Choline Acetyltransferase Activity
  • Intraoperative Decisions and Priorities of Repair
  • C5-C6 Injury
  • Authors' Preferred Treatment of C5-C6 Injury
  • C5-C7 Injury
  • C8-T1 Injury
  • Pan-Plexal Injury
  • Authors' Preferred Treatment of Pan-plexus Injury
  • Infraclavicular and Terminal Branch Injuries
  • Primary Nerve Reconstruction
  • Neurolysis
  • Direct Nerve Repair
  • Nerve Grafting
  • Indications
  • Operative Procedure
  • Conventional Nerve Grafting With the Sural Nerve
  • Other Nerve Graft Options
  • Coaptation
  • Nerve Conduits
  • Processed Nerve Allografts
  • Nerve Transfer
  • Spinal Accessory Nerve Transfer
  • Surgical Anatomy
  • Spinal Accessory Nerve Dissection.
  • Contraindications.
  • Complications.
  • Transfer to the Suprascapular Nerve.
  • Expected Outcomes.
  • Transfer to the Musculocutaneous Nerve.
  • Operative Procedure.
  • Expected Outcomes.
  • Ulnar Nerve Fascicular Transfer to the Biceps Motor Branch
  • Surgical Anatomy
  • Dissection and Transfer.
  • Contraindications.
  • Complications.
  • Expected Outcomes.
  • Median Nerve Fascicular Transfer to the Brachialis Motor Branch
  • Dissection and Transfer.
  • Contraindications.
  • Complications.
  • Intercostal Nerve Transfer
  • Surgical Anatomy
  • Intercostal Nerve Dissection.
  • Transfer to the Musculocutaneous Nerve.
  • Postoperative Care Specific to Intercostal Nerve to Musculocutaneous Nerve Transfer.
  • Contraindications.
  • Complications.
  • Expected Outcomes.
  • Transfer of the Triceps Motor Branch to the Axillary Nerve
  • Dissection and Transfer.
  • Contraindications.
  • Complications.
  • Expected Outcomes.
  • Contralateral C7 Nerve Transfer
  • Surgical Anatomy
  • Contralateral C7 Nerve Dissection and Transfer.
  • Postoperative Care Specific to Contralateral C7 Nerve Transfer.
  • Complications.
  • Expected Outcomes.
  • Authors' Preferred Technique
  • Other Nerve Transfers
  • Intraplexal Nerve Transfers
  • Ipsilateral C7 Nerve Transfer.
  • Medial Pectoral Nerve Transfer.
  • Thoracodorsal Nerve Transfer.
  • Extraplexal Nerve Transfers
  • Phrenic Nerve Transfer.
  • Hypoglossal Nerve Transfer.
  • Platysma Motor Branch Transfer.
  • Transfer of Cervical Plexus Nerves.
  • Postoperative Care for Nerve Grafts and Nerve Transfers
  • Functioning Free Muscle Transfer
  • Prerequisites for Functioning Free Muscle Transfer
  • Shoulder and Elbow
  • Selection of a Donor Muscle
  • Operative Procedures
  • Gracilis Harvest
  • Free Muscle Transfer for Reconstruction of Grasp After Complete Avulsion of the Brachial Plexus
  • Rationale.
  • Prerequisites for Grasp Surgery.
  • Operative Technique
  • Double Free Muscle Transfer.
  • Postoperative Protocol.
  • Subsequent Surgery.
  • Complications.
  • Expected Outcome.
  • Single-Stage Functioning Free Muscle Transfer for Prehension
  • Nerve Reimplantation
  • Secondary Reconstruction
  • Shoulder Reconstruction in Adult Patients With Brachial Plexus Injury
  • Basic Biomechanics and Relevant Anatomy of the Shoulder
  • Principles of Tendon Transfer
  • Tendon Transfer for Reconstruction of Shoulder Function
  • Upper Trapezius Transfer
  • Latissimus Dorsi Transfer
  • Pectoralis Muscle Transfer.
  • Lower Trapezius Transfer
  • Contralateral Lower Trapezius Origin Transfer
  • Authors' Preferred Procedure
  • Shoulder Arthrodesis
  • Authors' Preferred Method: Glenohumeral Arthrodesis
  • Postoperative Protocol.
  • Expected Outcome.
  • Late Reconstruction of Elbow Function
  • Authors' Preferred Methods
  • Modified Steindler Procedure.
  • Operative Procedure.
  • Postoperative Protocol.
  • Complications.
  • Expected Outcomes.
  • Triceps-to-Biceps Transfer.
  • Operative Procedure.
  • Postoperative Protocol.
  • Complications.
  • Expected Outcomes.
  • Latissimus Dorsi Transfer.
  • Operative Procedure.
  • Bipolar transplantation.
  • Postoperative Protocol.
  • Complications.
  • Expected Outcomes.
  • Pectoralis Major Muscle Transfer.
  • Operative Procedure.
  • Complete bipolar transplantation of the pectoralis major.
  • Postoperative Protocol.
  • Expected Outcomes.
  • Complications.
  • Free Muscle Transfer for Elbow Flexion in Delayed Cases
  • Indications.
  • Donor Nerve Selection.
  • Donor Muscle Selection.
  • Operative Procedure.
  • Expected Outcomes.
  • Wrist Arthrodesis.
  • Neuropathic Pain Management
  • References
  • VI Pediatric Hand
  • 35 Embryology of the Upper Extremity
  • Embryogenesis
  • Spatial Axes of Limb Development and Their Signaling Centers
  • Proximodistal Limb Development
  • Anteroposterior Limb Development
  • Dorsoventral Limb Development
  • Musculoskeletal System Development
  • Genes and Molecular Abnormalities
  • Systemic Considerations
  • References
  • 36 Deformities of the Hand and Fingers
  • Syndactyly
  • General Considerations
  • Epidemiologic Findings
  • Pathologic Findings and Classification
  • Preoperative Evaluation
  • Management Considerations
  • Timing of Surgery
  • Commissure Reconstruction
  • Separation and Resurfacing of the Digits
  • Paronychial Fold Formation
  • Outcome
  • Complications
  • Authors' Preferred Method of Treatment
  • Special Cases of Syndactyly
  • Acrosyndactyly
  • Apert Syndrome
  • Symbrachydactyly
  • Poland Syndrome
  • Dystrophic Epidermolysis Bullosa
  • Expected Outcomes
  • Polydactyly
  • Ulnar Polydactyly
  • Epidemiologic Findings
  • Classification and Treatment
  • Surgical Technique
  • Central Polydactyly
  • Epidemiologic Findings
  • Treatment
  • Mirror Hand
  • Etiologic Findings
  • Treatment
  • Brachydactyly
  • Epidemiologic Findings
  • Pathologic Findings
  • Clinical Features
  • Management
  • Authors' Preferred Method of Treatment
  • Central Hand Deficiencies
  • Etiologic Findings
  • Clinical Features
  • Classification
  • Surgical Treatment
  • Indications for Surgery
  • Surgical Management of the Progressive Deformity
  • Removal of Transverse Bones.
  • Syndactyly Release.
  • Surgical Management of the Cleft Deformity
  • Release of the First Web Space and Closure of the Cleft.
  • Surgical Management of the Absent Thumb Deformity
  • Surgical Management of the Feet
  • Expected Outcomes
  • Absence of Fingers or Thumb
  • Constriction Ring Syndrome (Amniotic Disruption Sequence or Amniotic Band Syndrome)
  • Etiologic Findings
  • Clinical Features
  • Classification
  • Management
  • Treatment of the Digit or Limb Threatened at Birth.
  • Treatment of Nerve Palsies.
  • Treatment of the Constriction Ring.
  • Treatment of Acrosyndactyly.
  • Treatment of Skin Protuberances.
  • Treatment of Digital Absence.
  • Symbrachydactyly
  • Clinical Features
  • Anatomy
  • Management
  • Treatment of Short Finger Types (Types 1, 2, and 3).
  • Treatment of the Oligodactylic (Few Fingers) Type (Type 4).
  • Treatment of Monodactylic (Single-Finger) Type (Type 5).
  • Treatment of Peromelic (Short-Limb) Types (Types 6 and 7).
  • Acquired Transverse Absence of Fingers in Children
  • Construction or Reconstruction of Fingers
  • Free Phalangeal Transfer.
  • Authors' Preferred Method of Treatment for Free Phalangeal Transfer
  • Preparation of the hand.
  • Harvesting the graft.
  • Placement of the graft.
  • Complications.
  • Distraction of Digits.
  • Transposition of Rays.
  • Microvascular Toe Transfer for Hypoplastic Digits.
  • Choice of Technique.
  • Indications.
  • Reconstruction of the Thumb.
  • Reconstruction of the Fingers.
  • The Hand With No Digits.
  • Contraindications.
  • Presurgical Assessment.
  • Surgical Technique.
  • Hand preparation.
  • Retrieving the second toe (points relative to children).
  • Osteosynthesis.
  • Tendon repairs.
  • Nerve repairs.
  • Vessel repairs.
  • Skin repair.
  • Postoperative care.
  • Additional indications and technical alternatives.
  • Transfers from the great toe.
  • The metacarpal hand.
  • Results.
  • Secondary surgery.
  • Expected Outcomes
  • Clinodactyly
  • Epidemiologic Findings
  • Anatomy
  • Management
  • Authors' Preferred Method of Treatment
  • Expected Outcomes
  • Kirner Deformity
  • Epidemiologic Findings
  • Anatomy
  • Management
  • Authors' Preferred Method of Treatment
  • Macrodactyly
  • Anatomy
  • Management
  • Limiting Digital Growth
  • Reducing the Digit
  • Amputation
  • Hyperostotic Macrodactyly
  • Hemihypertrophic Macrodactyly
  • Authors' Preferred Method of Treatment
  • Expected Outcomes
  • References
  • 37 Deformities of the Thumb
  • Acknowledgment:
  • Thumb Hypoplasia
  • General Considerations in Thumb Hypoplasia
  • Diagnosis
  • Classification
  • Treatment for Thumb Hypoplasia
  • Thumb Reconstruction
  • Flexor Digitorum Superficialis Opponensplasty With Ulnar Collateral Ligament Reconstruction.
  • Pollicization
  • Pollicization Procedure.
  • Outcome
  • Thumb Reconstruction.
  • Pollicization.
  • Complications
  • Thumb Duplication
  • General Considerations in Thumb Duplication
  • Epidemiologic Findings
  • Classification
  • Clinical Features
  • Treatment of Thumb Duplication
  • Type I or II Split Thumbs
  • Type III or IV Split Thumbs
  • Type V or VI Split Thumbs
  • Type VII Split Thumb
  • Outcomes
  • Complications
  • Triphalangeal Thumb
  • Management Considerations
  • Treatment of Triphalangeal Thumb
  • Length and Angulation
  • Extra Interphalangeal Joint
  • Thumb/Index Finger Web Space
  • Absence of Thumb Opposition
  • Concomitant Anomalies
  • Trigger Thumb
  • General Considerations in Trigger Thumb
  • Incidence and Etiologic Findings
  • Treatment
  • Natural History
  • Nonoperative Treatment
  • Surgical Treatment
  • Surgical Technique.
  • Outcome
  • Trigger Fingers
  • Clasped Thumb
  • Clinical Features
  • Treatment of Clasped Thumb
  • References
  • 38 Malformations and Deformities of the Wrist and Forearm
  • Acknowledgments:
  • Radial Longitudinal Deficiency (Case Study 38.1)
  • Preoperative Evaluation
  • Pertinent Anatomy
  • Types of Operations
  • Preliminary Soft Tissue Distraction
  • Centralization
  • Soft Tissue Release and Balancing
  • Ulnar Lengthening
  • Authors' Preferred Method of Treatment
  • Expected Outcomes
  • Postoperative Management and Expectations
  • Ulnar Deficiency
  • Preoperative Evaluation
  • Pertinent Anatomy
  • Types of Operations
  • Thumb Reconstruction (Deepening of the First Web, Opponensplasty, Pollicization)
  • Release of Syndactyly
  • Excision of the Ulnar Anlage
  • Rotational Osteotomy of the Humerus
  • Forearm Lengthening
  • Creation of a One-Bone Forearm
  • Authors' Preferred Method of Treatment
  • Expected Outcomes
  • Madelung Deformity
  • Preoperative Evaluation
  • Types of Operations
  • Physiolysis
  • Physiolysis and Dome Osteotomy
  • Dorsal Closing Wedge Osteotomy of the Distal Radius and Ulnar Shortening
  • Multiple Osteotomies Using Three-Dimensional Modeling
  • Radial Opening Wedge Osteotomy
  • Distal Radial Osteotomy and Distal Ulnar Resection
  • Distal Radial Osteotomy and the Sauvé-Kapandji Procedure
  • Authors' Preferred Technique
  • Expected Outcomes
  • Transverse Deficiency
  • Evaluation
  • Pertinent Anatomy
  • Types of Operations
  • Authors' Preferred Technique
  • Expected Outcomes
  • Congenital Dislocation of the Radial Head
  • Preoperative Evaluation
  • Types of Operations
  • Radial Head Resection
  • Authors' Preferred Method of Treatment
  • Expected Outcomes
  • Proximal Radioulnar Synostosis
  • Preoperative Evaluation
  • Pertinent Anatomy
  • Types of Operations
  • Resection of Synostosis
  • Derotation Osteotomy
  • Radial Head Excision
  • Authors' Preferred Method of Treatment
  • Postoperative Management and Expectations
  • Expected Outcomes
  • Congenital Pseudarthrosis of the Ulna or Radius
  • Preoperative Evaluation
  • Types of Operations
  • Authors' Preferred Method of Treatment
  • Postoperative Management and Expectations
  • Elbow and Forearm Deformity Caused by Multiple Hereditary Exostoses
  • Preoperative Evaluation
  • Pertinent Anatomy
  • Types of Operations
  • Removal of Osteochondroma
  • Distal Radial Hemiepiphyseal Stapling
  • Radial Head Excision (Posterolateral Dislocation)
  • Ulnar Distraction Lengthening
  • Differential Forearm Lengthening
  • Ulnar Detethering
  • Postoperative Management and Expectations
  • Authors' Preferred Technique
  • References
  • 39 Arthrogryposis
  • Preoperative Evaluation
  • History
  • Physical Examination
  • Diagnostic Imaging
  • Pertinent Anatomy
  • Historical Review
  • Surgical Procedures
  • Humeral External Rotation Osteotomy
  • Indications
  • Contraindications
  • Preoperative Planning
  • Technique
  • Author's Preferred Method of Treatment
  • Postoperative Management and Expectations
  • Expected Outcomes.
  • Complications.
  • Elbow Extension Contracture Release
  • Indications
  • Contraindications
  • Preoperative Planning
  • Technique
  • Author's Preferred Method of Treatment
  • Postoperative Management and Expectations
  • Expected Outcomes.
  • Complications.
  • Bipolar Latissimus Dorsi Transfer
  • Indications
  • Contraindications
  • Preoperative Planning
  • Technique
  • Author's Preferred Method of Treatment
  • Postoperative Management and Expectations
  • Expected Outcomes.
  • Complications.
  • Radial Osteotomy With and Without Ulnar Osteotomy
  • Indications
  • Contraindications
  • Preoperative Planning
  • Technique
  • Author's Preferred Method of Treatment
  • Postoperative Management and Expectations
  • Expected Outcomes.
  • Complications.
  • Carpal Wedge Osteotomy
  • Indications
  • Contraindications
  • Preoperative Planning
  • Technique
  • Author's Preferred Method of Treatment
  • Postoperative Management and Expectations
  • Expected Outcomes.
  • Complications.
  • Thumb Reorientation Osteotomy and/or Metacarpophalangeal Chondrodesis
  • Indications
  • Contraindications
  • Preoperative Planning
  • Technique
  • Author's Preferred Method of Treatment
  • Postoperative Management and Expectations
  • Expected Outcomes.
  • Complications.
  • Camptodactyly Release
  • Indications
  • Contraindications
  • Preoperative Planning
  • Technique
  • Author's Preferred Method of Treatment
  • Postoperative Management and Expectations
  • Expected Outcomes.
  • Complications.
  • Summary
  • References
  • 40 Pediatric Brachial Plexus Palsy
  • Acknowledgments:
  • Pertinent Anatomy
  • Preoperative Evaluation
  • Natural History
  • Nerve Surgery
  • Surgical Technique: Nerve Grafting
  • Surgical Technique: Nerve Transfers
  • Authors' Preferred Treatment: Nerve Surgery
  • Postoperative Management: Nerve Surgery
  • Secondary Musculoskeletal Problems
  • Preoperative Evaluation: Shoulder
  • Historical Review: Shoulder
  • Operations: Shoulder
  • Authors' Preferred Treatment
  • Postoperative Management
  • Elbow
  • Forearm
  • Wrist and Hand
  • References
  • 41 Hand, Wrist, and Forearm Fractures in Children
  • Hand Fractures
  • Epidemiology
  • Preoperative Evaluation
  • Pertinent Anatomy
  • Historical Review
  • Types of Operations
  • Distal Phalangeal Fractures
  • Shaft and Tuft Fractures.
  • Author's Preferred Method of Treatment
  • Physeal Fractures.
  • Author's Preferred Method of Treatment
  • Middle and Proximal Phalangeal Fractures
  • Articular Fractures of the Phalangeal Head.
  • Author's Preferred Method of Treatment
  • Phalangeal Neck Fractures.
  • Author's Preferred Method of Treatment
  • Phalangeal Shaft Fractures.
  • Author's Preferred Method of Treatment
  • Physeal Fractures.
  • Author's Preferred Method of Treatment
  • Articular Fractures of the Phalangeal Base and Epiphyseal Fractures.
  • Author's Preferred Method of Treatment
  • Metacarpal Fractures
  • Epiphyseal Fractures.
  • Author's Preferred Method of Treatment
  • Metacarpal Neck Fractures.
  • Author's Preferred Method of Treatment
  • Metacarpal Shaft Fractures.
  • Author's Preferred Method of Treatment
  • Metacarpal Base Fractures.
  • Author's Preferred Method of Treatment
  • Thumb Fractures
  • Phalangeal Fractures.
  • Author's Preferred Method of Treatment
  • Metacarpal Diaphyseal Fractures.
  • Base of Thumb Metacarpal Fractures.
  • Author's Preferred Method of Treatment
  • Wrist Fractures
  • Epidemiology
  • Preoperative Evaluation
  • Pertinent Anatomy
  • Ossification Centers
  • Growth
  • Soft Tissue Structures
  • Types of Operations for Wrist Fractures
  • Scaphoid Fractures
  • Author's Preferred Method of Treatment
  • Capitate Fractures
  • Triquetrum Fractures
  • Hamate Fractures
  • Pisiform Fractures
  • Distal Radial Fractures
  • Torus Fractures.
  • Author's Preferred Method of Treatment
  • Bicortical Metaphyseal Fractures.
  • Author's Preferred Method of Treatment
  • Physeal Fractures of the Distal Radius.
  • Author's Preferred Method of Treatment
  • Postoperative Expectations and Management
  • Forearm Diaphyseal Fractures
  • Epidemiology
  • Preoperative Evaluation
  • Pertinent Anatomy
  • Historical Review
  • Types of Operations for Wrist Fractures
  • Plastic Deformation
  • Greenstick Fractures
  • Complete Fractures
  • Author's Preferred Method of Treatment
  • Single-Bone Fractures
  • Open Fractures
  • Monteggia Fracture-Dislocations
  • Galeazzi Fractures
  • Postoperative Expectations and Management
  • References
  • VII Bone and Soft Tissue Reconstruction
  • 42 Replantation
  • General Considerations in Replantation
  • Epidemiology
  • Emergency Management
  • Patient Selection
  • Technical Considerations in Preparing for Replantation
  • Intraoperative Technique
  • Preparation of the Amputated Part
  • Preparation of the Hand
  • Replantation
  • Osseous Fixation
  • Extensor Tendon Repairs
  • Flexor Tendon Repairs
  • Digital Nerve Repairs
  • Digital Vein Repairs
  • Arterial Repairs
  • Reperfusion
  • Skin Closure
  • Postoperative Protocol
  • Expected Outcomes
  • Future Directions: Vascularized Composite Tissue Allotransplantation
  • References
  • 43 Mangled Upper Extremity
  • Acknowledgment:
  • Principles
  • Classification
  • Mechanisms and Pathophysiology of Injury
  • Initial Evaluation
  • History
  • Examination
  • Goals of Treatment: Biomechanics of the Injured Hand
  • Amputation/Skeletal Contribution
  • Joints
  • Tendons
  • Soft Tissue Coverage and Nerves
  • Evolution in the Treatment of Mangling Injuries
  • Recommended Approach to Treatment
  • Emergency Treatment
  • Operative Treatment
  • Debridement/Wound Excision
  • Skeletal/Joint Reconstruction
  • Tendon Repair/Reconstruction
  • Vascular Repair/Reconstruction
  • Nerve Repair/Reconstruction
  • Soft Tissue Coverage
  • Fingers, Hand, and Wrist.
  • Forearm.
  • Elbow and Arm.
  • Postoperative Management/Rehabilitation
  • Secondary Procedures
  • Complications
  • Expected Outcomes
  • Conclusion
  • References
  • 44 Nonmicrosurgical Coverage of the Upper Extremity
  • Acknowledgment:
  • Skin Grafting
  • General Considerations in Skin Grafting
  • Histologic Findings of Skin
  • Substitution by Skin Grafts
  • Response to Injury
  • Effect of Infection on Wound Healing
  • Vascularity of the Wound
  • Timing of Grafting
  • Bacterial Content Determination.
  • Temporary Storage of Skin Grafts.
  • Types of Grafts
  • Skin Substitutes
  • Skin Thickness
  • Split-Thickness Grafting
  • Choice of Donor Sites
  • Harvesting Skin Grafts
  • Dermatomes
  • Padgett Dermatome.
  • Zimmer Air Dermatome.
  • Meshed Grafting
  • Preparation of a Meshed Graft.
  • Full-Thickness Grafts
  • Technique of Obtaining a Full-Thickness Graft
  • Choice of Graft
  • Negative Pressure Wound Therapy
  • Filling the Defect With the Graft
  • Postoperative Care
  • Care of the Donor Site
  • Outpatient Surgery
  • Acknowledgment:
  • Local and Regional Flap Coverage of the Hand
  • Types of Flaps
  • Random-Pattern Flaps
  • Axial-Pattern Flaps
  • Staging of Flaps
  • Preparation of the Wound for Flap Transfer
  • Raising a Flap
  • Local Flaps
  • Transposition Flaps
  • Random-Pattern Flaps
  • "Z"-Plasty.
  • Four-Flap "Z"-Plasty.
  • Rhomboid Flap.
  • Axial-Pattern Flaps.
  • Axial Flag Flap.
  • Kite Flap (First Dorsal Metacarpal Artery Flap).
  • Second Dorsal Metacarpal Artery Flap.
  • Digital Artery Island Flaps.
  • Advancement Flaps
  • "V-Y" Advancement Flap.
  • Regional Flaps
  • Random-Pattern Regional Flaps
  • Cross-Finger Flap.
  • Reversed Cross-Finger Flap.
  • Division of Random Regional Flaps.
  • Axial-Pattern Regional Flaps
  • Neurovascular Island Flap.
  • Fillet Flap.
  • Axial Cutaneous Flap
  • Fasciocutaneous Flap
  • Radial Artery Forearm Flap
  • Ulnar Artery Forearm Flap
  • Reversed Posterior Interosseous Artery Flap
  • Musculocutaneous Flap
  • Latissimus Dorsi Flap.
  • Distant Flaps
  • Random-Pattern Distant Flaps
  • Axial-Pattern Distant Flaps
  • Groin Flap.
  • Author's Preferred Method of Treatment: Defects of the Hand and Forearm
  • Chemotherapeutic Extravasation Skin Loss
  • Postoperative Care
  • Flap Failure
  • Salvage of a Failing Flap
  • References
  • 45 Free Flaps to the Hand and Upper Extremity
  • Indications
  • Contraindications
  • Inadequate Débridement
  • Poor Limb Function
  • Classification of Free Flaps
  • Cutaneous Flaps
  • Fasciocutaneous Flaps
  • Muscle and Musculocutaneous Flaps
  • Perforator Flaps
  • Composite Flaps
  • Venous Flaps
  • Preoperative Assessment and Preparation
  • Tissue Defect
  • Radiographs and Computed Tomography, Magnetic Resonance Imaging, and Bone Scans
  • Angiography
  • Preparation of the Patient for the Operating Room
  • Operative Technique
  • Wound Débridement
  • Skeletal Stabilization
  • Skin Pattern
  • Recipient Vessels
  • Avoiding the Zone of Injury
  • Pedicle Length and Accessibility
  • Harvesting the Flap
  • Dissection of the Pedicle
  • Flap Insetting
  • Dressings
  • Postoperative Care and Monitoring
  • Patient Care
  • Flap Monitoring
  • Color
  • Capillary Refill
  • Bleeding
  • Other Monitoring Techniques
  • Saving the Failing Free Flap
  • Exploration in the Operating Room
  • Other Salvage Techniques
  • Leeches
  • Thrombolytic Agents
  • Infection
  • Specific Free Flaps
  • Lateral Arm Flap
  • Anatomy
  • Operative Technique
  • Radial Forearm Flap
  • Anatomy
  • Operative Technique
  • Scapular Flap
  • Anatomy
  • Operative Technique
  • Groin Flap
  • Anatomy
  • Operative Technique.
  • Anterolateral Thigh Flap
  • Anatomy
  • Operative Technique
  • Latissimus Dorsi Muscle and Musculocutaneous Flaps
  • Anatomy
  • Operative Technique
  • "Tailored" Latissimus Dorsi Musculocutaneous Flap and Thoracodorsal Artery Perforator Flap
  • Serratus Anterior Muscle Flap
  • Anatomy
  • Operative Technique
  • Rectus Abdominis Muscle Flap
  • Anatomy
  • Operative Technique
  • Temporoparietal Fascial Flap
  • Anatomy
  • Operative Technique
  • Sensory Flaps From the First Web Space of the Foot
  • Anatomy
  • Operative Technique
  • Authors' Preferred Method: Flap Selection
  • Soft Tissue Defects Alone
  • Composite Defects
  • Bone
  • Tendon
  • Artery
  • Sensation
  • Conclusion
  • References
  • 46 Vascularized Bone Grafting
  • General Considerations in Vascularized Bone Grafting
  • Pedicle Flap Versus Free Flap
  • Biology of Conventional Bone Grafts
  • Biology of Vascularized Bone Grafts
  • Other Advantages of Vascularized Bone Grafts
  • Indications for Vascularized Bone Grafting
  • Segmental Bone Loss
  • Biologic Failure
  • Avascular Necrosis of Bone
  • Complex Tissue Loss
  • Physeal Arrest
  • Osteomyelitis
  • Carpal Defects or Disorders
  • Vascularized Bone Graft Selection
  • Preoperative Planning
  • Recipient Site
  • Donor Site
  • Postoperative Monitoring
  • Buoy Flap
  • Implanted Laser or Ultrasonic Probes
  • Arteriogram
  • Bone Scan
  • Complications of Vascularized Bone Grafts
  • Impaired Vascularity
  • Delayed Union: Need for Secondary Bone Graft
  • Stress Fracture
  • Specific Vascularized Grafts: Long Bone Reconstruction
  • Vascularized Fibular Grafts
  • Anatomy
  • Technique
  • Osseous Fibular Flap.
  • Fibula With Skin Flap.
  • Fibula With Physis.
  • Fibula With Muscle.
  • Double-Barrel Flap.
  • Fibular Graft Complications
  • Iliac Crest Flap
  • Anatomy
  • Technique
  • Iliac Crest Complications
  • Results: Large Segmental Bone Loss
  • Fibula Donor Results
  • Iliac Crest Donor Results
  • Fibular and Iliac Crest Grafts in the Upper Extremity
  • Results by Diagnosis
  • Grafting for Defects Caused by Tumor Excision.
  • Grafting in Cases of Infection.
  • Grafting Following Trauma.
  • Grafting for Congenital Pseudarthrosis of the Forearm.
  • Grafting for Epiphyseal Transfer and Growth.
  • Vascularized Grafts: Small Bone and Periosteal Flaps
  • Indications for Grafting in the Carpus
  • Grafting for Fracture of the Scaphoid
  • Grafting for Kienböck Disease
  • Medial Femoral Condyle Grafts
  • Anatomy of the Medial Femoral Condyle
  • Surgical Technique
  • Flap Exposure and Pedicle Dissection.
  • Medial Femoral Condyle Corticoperiosteal Flap Harvest.
  • Medial Femoral Condyle Vascularized Bone Graft Harvest.
  • Medial Femoral Condyle Osteochondral Graft Harvest.
  • Medial Femoral Condyle Graft Aftercare
  • Donor Site Complications
  • Radius Pedicle Grafts
  • Dorsal Radius Grafts
  • Dorsal Radius Anatomy
  • 1,2 Intercompartmental Supraretinacular Artery.
  • 2,3 Intercompartmental Supraretinacular Artery.
  • Fourth Extensor Compartment Artery.
  • Fifth Extensor Compartment Artery.
  • Specific Dorsal Radius Pedicle Grafts.
  • 1,2 Intercompartmental Supraretinacular Artery Graft.
  • Harvest technique.
  • Scaphoid preparation.
  • Placement of the dorsal inlay graft.
  • 5 plus 4 Extensor Compartment Artery Graft.
  • Harvest technique for the 5 plus 4 extensor compartment artery graft.
  • Graft Insetting for the Lunate.
  • Palmar Radius Pedicle Grafts
  • Anatomy
  • Harvest of Palmar Radius Bone Grafts to Reach Either the Scaphoid or the Lunate.
  • Technique.
  • Results.
  • Other Vascularized Grafts
  • Rib
  • Scapula
  • Humerus
  • Pisiform
  • Second Metacarpal
  • Manufactured Bone Grafts
  • Allogeneic Bone Grafts
  • Recipient Site
  • Clavicle
  • Shoulder and Humerus
  • Forearm
  • Wrist and Hand
  • Results
  • Scaphoid
  • Role of Internal Fixation.
  • 1,2 Intercompartmental Supraretinacular Artery Inlay Graft.
  • Medial Femoral Condyle Bone Flap.
  • Medial Femoral Condyle Osteochondral Flap.
  • Lunate Graft in Kienböck Disease
  • Summary
  • References
  • 47 Toe-to-Hand Transplantation
  • General Considerations
  • Initial Care and Preoperative Evaluation
  • Bone and Joint
  • Tendons
  • Vessels
  • Nerves
  • Skin
  • Primary Versus Secondary Toe-to-Hand Transplantation
  • Reconstructive Options
  • Thumb Amputation
  • Reconstruction of Single-Finger Amputation
  • Reconstruction of Distal Digit Amputation
  • Reconstruction of Proximal Digit Amputation
  • Reconstruction of Multiple-Digit Amputation in the Nonmetacarpal Hand
  • Reconstruction of Multiple Digits in Distal Amputation
  • Reconstruction of Multiple Digits in Proximal Amputation
  • Reconstruction of Multiple Digits at Various Amputation Levels
  • Reconstruction of the Metacarpal Hand
  • Congenital and Traumatic Loss of Digits in a Pediatric Hand
  • Anatomy for Toe Dissection
  • Surgical Techniques
  • Total or Trimmed Transplantation of the Great Toe
  • Indications
  • Authors' Preferred Method of Treatment
  • Partial or Total Transplantation of the Second Toe
  • Indications
  • Flap Design and Elevation
  • Authors' Preferred Method of Treatment
  • Wraparound Flap of the Second Toe
  • Indications
  • Flap Design
  • Pulp and Web Space Neurosensory Flaps
  • Indications
  • Flap Design and Elevation
  • Pulp Flap.
  • First Web Space Neurocutaneous Flap.
  • Vascularized Nail Graft
  • Indications
  • Flap Design and Elevation
  • Transplantation of the Third Toe
  • Indications
  • Authors' Preferred Method of Treatment
  • Combined Transplantation of the Second and Third Toes
  • Indications
  • Authors' Preferred Method of Treatment
  • Combined Third and Fourth Transplantation
  • Indications
  • Authors' Preferred Method of Treatment
  • Combined Triple-Toe Transplantations
  • Recipient Site Preparation
  • Skin Incisions
  • Bone and Joint Preparation
  • Tendon and Pulley Preparation
  • Nerve Preparation
  • Vessel (Artery and Vein) Preparation
  • Toe Fixation Technique
  • Skeletal Fixation
  • Tendon Repair
  • Nerve Repair
  • Skin Closure
  • Vascular Anastomoses
  • Postoperative Management
  • Complications
  • Vascular Complications
  • Other Complications
  • Secondary Procedures
  • Donor Site Morbidity and Gait Analysis
  • Rehabilitation
  • Motor Rehabilitation
  • Sensory Rehabilitation
  • Donor Site Rehabilitation
  • Outcome
  • Conclusion
  • References
  • 48 Thumb Reconstruction
  • Acknowledgments:
  • Historical Review
  • General Considerations
  • Thumb Reconstruction after Partial or Complete Traumatic Loss
  • Acceptable Length With Poor Soft Tissue Coverage
  • Palmar Advancement Flap
  • Palmar Advancement Flap Without Proximal Releasing Incision
  • Palmar Advancement Flap With Proximal Releasing Incision
  • Heterodigital Flap Reconstruction
  • Cross-Finger Flap to the Thumb
  • Innervated Cross-Finger Flap
  • Radial-Innervated Cross-Finger Flap.
  • Dual Innervated Cross-Finger Flap.
  • First Dorsal Metacarpal Artery Island Flap
  • Neurovascular Island Pedicle Flap
  • Summary: Reconstruction of Soft Tissue Defects of the Thumb
  • Subtotal Amputation With Questionable Remaining Length
  • "Z"-Plasty Procedures
  • Simple "Z"-Plasty of the Thumb Web.
  • Four-Flap "Z"-Plasty of the Thumb Web.
  • Dorsal Rotational Flap
  • Phalangization of the First Metacarpal With Dorsal Rotational Flap Coverage.
  • Regional and Distant Flaps
  • First Web Space Deepening With Cross-Arm Flap Coverage.
  • Total Amputation With Preservation of the Basal Joint
  • Osteoplastic Reconstruction
  • Two-Stage Osteoplastic Reconstruction of the Thumb
  • Stage 1.
  • Stage 2.
  • Composite Radial Forearm Island Flap
  • Pollicization of an Injured Digit
  • Pollicization of an Index or Long Finger Stump.
  • Total Loss With Destruction of the Basal Joint
  • Conclusion
  • References
  • VIII Other Disorders of the Upper Extremity
  • 49 Digital Amputations
  • Acknowledgment:
  • Digital Tip Amputations
  • Digital Tip Amputations With Skin or Pulp Loss Only
  • Nonmicrosurgical Reattachment or Composite Graft
  • Dressing Changes and Healing by Secondary Intention
  • Primary Closure
  • Split-Thickness Grafting
  • Digital Tip Amputations With Exposed Bone
  • Semiocclusive Dressings
  • Bilayer Matrix Wound Dressing
  • Atasoy-Kleinert Volar "V-Y" Flap
  • Kutler Lateral "V-Y" Flaps
  • Volar Flap Advancement
  • Cross-Finger Pedicle Flap
  • Thenar Flap
  • Thenar "H"-Flap.
  • Island Flaps
  • Free Flaps
  • Author's Preferred Method of Treatment: Digital Tip Amputation
  • Amputations from the Distal Interphalangeal to the Metacarpophalangeal Joint (Excluding the Thumb)
  • Distal Interphalangeal Joint Disarticulation
  • Complications of Digital Amputation: The Lumbrical-Plus Finger
  • Amputation Through the Middle Phalanx
  • Amputations Through the Proximal Interphalangeal Joint
  • Amputation Through the Proximal Phalanx
  • Ray Amputations
  • Index Finger Ray Amputation
  • Author's Preferred Method of Treatment: Index Finger Ray Amputation
  • Long Finger Ray Amputation
  • Long Finger Ray Amputation Without Transposition
  • Author's Preferred Method of Treatment: Long Finger Ray Amputation Without Ray Transposition
  • Long Finger Ray Amputation With Transposition
  • Author's Preferred Method of Treatment: Long Finger Ray Amputation With Ray Transposition
  • Ring Finger Ray Amputation
  • Ring Finger Ray Amputation Without Transposition
  • Author's Preferred Method of Treatment: Ring Finger Ray Amputation Without Transposition
  • Ring Finger Ray Amputation With Transposition of the Fifth Metacarpal
  • Author's Preferred Method of Treatment: Ring Finger Ray Amputation With Small Finger Ray Transposition
  • Small Finger Ray Amputation
  • Author's Preferred Method of Treatment: Small Finger Ray Amputation
  • Multiple-Digit Amputations
  • Amputations Through the Carpus
  • Wrist Disarticulation
  • Author's Preferred Method of Treatment: Wrist Disarticulation
  • Hand Prosthetics
  • Types of Prostheses
  • Rehabilitation Process of the Hand Amputee
  • Pain Management after Amputations
  • Neuromas
  • References
  • 50 Major Limb Amputations and Prosthetics
  • Major Limb Amputations
  • Indications
  • Wrist Disarticulation and Transradial Amputation
  • Authors' Preferred Method of Treatment: Transradial Amputation
  • Elbow Disarticulation and Transhumeral Amputation
  • Authors' Preferred Method of Treatment: Transhumeral Amputation
  • Interscapulothoracic Amputation
  • Authors' Preferred Method of Treatment: Forequarter Amputation
  • Current Prosthetic Rehabilitation
  • Rehabilitation After Upper Extremity Amputation
  • Prosthetic Components and Options
  • Prosthetic Designs
  • Sockets and Suspension Systems
  • Frontiers in Prosthetic Rehabilitation
  • Improved Prosthetic Control
  • Improved Prosthetic Design
  • Summary
  • References
  • 51 Compartment Syndrome and Volkmann Ischemic Contracture
  • Acknowledgment:
  • Compartment Syndrome
  • Types of Compartment Syndromes
  • Acute Compartment Syndrome
  • Impending Compartment Syndrome
  • Exercise-Induced or Exertional Compartment Syndrome
  • Crush Injury or Crush Syndrome
  • Neonatal Compartment Syndrome and Neonatal Volkmann Contracture
  • Volkmann Ischemic Contracture
  • Etiologic Findings and Incidence
  • Pathophysiologic Findings
  • Diagnosis
  • Diagnosis of Acute Compartment Syndrome
  • Diagnosis of Exertional Compartment Syndrome
  • Pertinent Anatomy
  • Treatment
  • Surgical Procedure
  • Indications.
  • Contraindications.
  • Author's Preferred Method of Treatment
  • Release of the Compartments of the Arm.
  • Release of the Compartments of the Forearm.
  • Release of the Compartments of the Hand.
  • Volar Release.
  • Dorsal Release.
  • Release of the Fingers.
  • Postoperative Management
  • Outcomes and Expectations
  • Volkmann Contracture
  • Classification
  • Treatment
  • Operative Treatment
  • Bone Procedures.
  • Soft Tissue Procedures.
  • Authors' Preferred Methods of Treatment
  • Mild (Localized) Type (Deep Flexor Compartment Without Neurologic Deficit).
  • Moderate Type (Deep and Superficial Flexor Compartment With Neurologic Deficit).
  • Reconstruction of Thumb Function.
  • Reconstruction of Finger Flexion.
  • Nerve Reconstruction.
  • Severe Type (Superficial and Deep Flexor Compartments, Extensor Compartment, and Severe Neurologic Deficits).
  • Surgical Techniques
  • Flexor Pronator Slide.
  • Restoration of Extrinsic Flexor Function.
  • Restoration of Extrinsic Flexor Function: Free Functional Muscle Transfer.
  • Transfer of Gracilis Muscle.
  • Outcomes
  • Outcomes of Flexor Origin Slide.
  • Outcomes of Free Functional Muscle Transfer.
  • Restoration of Intrinsic Function After Volkmann Contracture of the Forearm
  • Nerve Dysfunction Associated With Forearm Compartment Syndrome.
  • Volkmann Contracture of the Hand
  • Complications
  • Complications of Tendon Transfer.
  • Complications of Flexor Origin Slide.
  • Complications of Functional Free Muscle Transfer.
  • References
  • 52 Management of Venomous Injuries
  • The Main Groups of Venomous Animals Associated with Hand Envenomation with Local Manifestations
  • Caterpillars
  • Spiders
  • Snakes
  • Authors' Preferred Method of Treatment of Snakebite
  • Cnidarians (Jellyfish, Portuguese Man o' War, Anemones, Corals)
  • Sea Urchins
  • Venomous Fish
  • References
  • 53 A Practical Guide for Complex Regional Pain Syndrome in the Acute Stage and Late Stage
  • General Considerations in Complex Regional Pain Syndrome
  • Clinical Definitions
  • Budapest Criteria
  • Historical Review
  • Physiology of Pain
  • Perception of Pain
  • Pain Mediators and Receptor Control
  • Gate Theory of Pain
  • Acute Versus Chronic Pain
  • Demographics of Complex Regional Pain Syndrome
  • Psychological Factors and Effects
  • Psychological Problems Mimicking Complex Regional Pain Syndrome
  • Symptoms and Signs
  • Autonomic Function
  • Physical Examination
  • Mechanical Nociceptive Focus
  • Diagnostic Testing
  • Pain Threshold Evaluation
  • Radiography
  • Functional Magnetic Resonance Imaging
  • Bone Scan (Scintigraphy)
  • Evaluation of Autonomic Control
  • Regulation of Microvascular Flow
  • Sudomotor Function
  • Diagnostic Regional and Sympathetic Blockade
  • Thermography
  • Endurance Testing
  • Staging
  • Treatment
  • Multidisciplinary Approach to Management
  • Pharmacologic Interventions
  • Vitamin C
  • Oral and Topical Medications
  • Antidepressants
  • Anticonvulsants
  • Membrane-Stabilizing Agents
  • Adrenergic Compounds
  • Calcium Channel Blockers
  • Corticosteroids
  • Neuromuscular Blocking Agents
  • Bisphosphonates
  • Calcitonin
  • Ketamine
  • Free Radical Scavengers
  • Other Treatments
  • Parenteral Medications
  • Intravenous Regional Infusion
  • Diagnostic Intravenous Infusion
  • Epidural Agents
  • Percutaneous Neural or Ganglionic Blockade
  • Continuous Autonomic Blockade
  • Biofeedback and Acupuncture
  • Implantable Devices
  • Peripheral Nerve Implants
  • Implantable Spinal Cord Stimulation
  • Central Nervous System Ablative Techniques
  • Level of Evidence for Treatment of Complex Regional Pain Syndrome
  • Authors' Preferred Method of Evaluation and Treatment
  • Diagnosis
  • Multidisciplinary Team Approach
  • Hand Therapy
  • Adaptive Modalities
  • Patient Expectations
  • Authors' Preferred Method of Treatment: Oral Medications
  • Treatment Expectations and Complications
  • Expected Outcomes of Drug Therapy
  • Authors' Preferred Method of Treatment: Parenteral Medications
  • Treatment Expectations and Complications
  • Expectations for Parenteral Treatment
  • Surgical and Ablative Therapies
  • Chemical Sympathectomy
  • Surgical Sympathectomy
  • Surgical Outcomes and Complications
  • Summary of the Role of Sympathectomy
  • Management of the Neural Dystrophic Focus
  • Diagnosis and Management of Structural Neural Problems
  • Surgical Management of Neural Injury in Complex Regional Pain Syndrome
  • Authors' Preferred Method of Treatment: Common Nerve-Related Complex Regional Pain Syndrome
  • Surgical Technique for the Management of Injury to the Superficial Branch of the Radial Nerve Complicated by Complex Regional Pain Syndrome
  • Authors' Preferred Method of Treatment: Revision of Carpal Tunnel Surgery
  • Authors' Preferred Method of Treatment: Metacarpophalangeal and Proximal Interphalangeal Joint Contractures (Late-Stage Treatment)
  • Operative Technique
  • Amputation
  • References
  • 54 Factitious Disorders
  • Recognizable Factitious Disorders
  • Factitious Lymphedema
  • Factitious Ulceration
  • Dysfunctional Postures
  • Differential Diagnosis of Factitious Disorders
  • Recognizing Factitious Illness and Avoiding Mistaken Diagnoses
  • Management of Patients With Factitious Disorders
  • References
  • 55 Rheumatoid Arthritis and Other Connective Tissue Diseases
  • Acknowledgments:
  • Surgical Considerations in the Arthritic Patient
  • Medical Considerations in the Rheumatoid Patient
  • Staging Hand Surgery
  • Other Connective Tissue Diseases (Rheumatoid Variants)
  • Psoriatic Arthritis
  • Digital Deformity
  • Thumb Deformity
  • Wrist Deformity
  • Systemic Lupus Erythematosus
  • Wrist Deformity
  • Digital Deformity
  • Authors' Preferred Method of Treatment
  • Proximal Interphalangeal Joint Deformity
  • Thumb Deformity
  • Authors' Preferred Method of Treatment
  • Scleroderma
  • Digital Deformity
  • Authors' Preferred Method of Treatment
  • Ulceration
  • Calcinosis
  • Deformity of Digital Joints
  • The Proximal Interphalangeal Joint
  • The Metacarpophalangeal Joint
  • First Web Contracture
  • Vascular Insufficiency
  • Rheumatoid Nodulosis
  • Rheumatoid Arthritis
  • Tenosynovitis
  • Anatomy of the Tendons ANd Tendon Sheath
  • Dorsal (Extensor) Tenosynovitis in the Wrist
  • Authors' Preferred Method of Treatment: Dorsal Tenosynovectomy
  • Postoperative Management.
  • Complications.
  • Flexor Tenosynovitis in the Wrist
  • Authors' Preferred Method of Treatment: Flexor Tenosynovectomy
  • Flexor Tenosynovitis in the Digits
  • Authors' Preferred Method of Treatment: Digital Tenosynovectomy
  • Tendon Ruptures
  • Diagnosis
  • Extensor Tendon Ruptures.
  • Flexor Tendon Ruptures.
  • Treatment of Extensor Tendon Ruptures
  • Rupture of the Extensor Pollicis Longus.
  • Authors' Preferred Method of Treatment
  • Rupture of the Finger Extensors
  • Single Tendon Ruptures
  • Operative Technique
  • Multiple Ruptures of the Extensor Tendons
  • Options and Techniques for Extensor Tendon Reconstruction
  • Ring and Little Finger Ruptures
  • Rupture of More Than Three Extensor Tendons
  • Tendon Transfers for Patients With Fused Wrists
  • Multiple Ruptures With Metacarpophalangeal Joint Disease
  • Treatment of Flexor Tendon Ruptures
  • Rupture of the Flexor Pollicis Longus.
  • Operative Technique.
  • Rupture of the Flexor Digitorum Profundus.
  • Rupture of the Flexor Digitorum Superficialis.
  • Rupture of Both Superficial and Deep Finger Flexor Tendons.
  • The Wrist
  • Natural History of Rheumatoid Wrist Involvement
  • Operative Treatment for Rheumatoid Radiocarpal and Radioulnar Joint Deformities
  • Synovectomy of the Radiocarpal and Radioulnar Joints
  • Indications.
  • Operative Technique: Dorsal Approach for Synovectomy.
  • Operative Technique: Volar Wrist Synovectomy.
  • Distal Ulnar Excision and DRUJ Complex Reconstruction
  • Operative Technique: Distal Ulnar Excision and DRUJ Reconstruction.
  • Complications of Ulnar Head Excision.
  • Tendon Transfers to Restore Wrist Balance
  • Operative Technique for ECRL Transfer
  • Extensor Carpi Ulnaris Tendon
  • Operative Technique for Repositioning.
  • Reconstruction of the Radiocarpal Joint
  • Choice of Operation for the Rheumatoid Wrist
  • Partial Wrist Fusion
  • Operative Technique for Partial Wrist Arthrodesis.
  • Operative Technique for Wrist Arthrodesis.
  • Feldon's Two-Pin Modification.
  • Combined Wrist Arthrodesis and MP Joint Arthroplasty
  • Complications of Wrist Fusion
  • The Metacarpophalangeal Joints
  • Etiology of Rheumatoid MP Joint Deformities
  • Indications for Operative Treatment of MPJoint
  • Synovectomy
  • Combined Synovectomy and Soft Tissue Reconstruction
  • Contraindications to MP Joint Surgery
  • Operative Techniques for MP Joint
  • Synovectomy
  • Intrinsic Release
  • Crossed Intrinsic Transfer
  • Extensor Tendon Relocation
  • Postoperative Management of Soft Tissue Procedures
  • MP Joint Arthroplasty in Rheumatoid Arthritis
  • Indications
  • Contraindications
  • Arthroplasty Options
  • Surgical Technique
  • Flexible Implant Arthroplasty.
  • Extensor Tendon Centralization.
  • Technical Points.
  • Rehabilitation
  • Complications
  • Outcomes
  • The Proximal Interphalangeal Joints
  • Synovectomy
  • Operative Technique
  • Finger Deformities
  • Swan Neck Deformity
  • Type I: PIP Joints Flexible in All Positions
  • DIP Joint Fusion.
  • Operative Technique for DIP Joint Fusion With a Screw.
  • Dermadesis.
  • Flexor Tendon Tenodesis ("Sublimis Sling").
  • Retinacular Ligament Reconstruction.
  • Type II: Limited PIP Joint Flexion in Certain Positions
  • Intrinsic Release.
  • Type III: Limited PIP Joint Flexion in All Positions
  • PIP Joint Manipulation.
  • Skin Release.
  • Lateral Band Mobilization.
  • Flexor Tenosynovitis and PIP Joint Stiffness
  • Type IV: Stiff PIP Joints With Poor Radiographic Appearance
  • PIP Joint Fusion for Swan Neck Deformity.
  • PIP Joint Arthroplasty.
  • Indications.
  • Contraindications.
  • Surgical Approaches.
  • Dorsal approach.
  • Volar approach.
  • Rehabilitation.
  • Outcomes.
  • Boutonnière Deformity
  • Stage I: Mild Boutonnière Deformity
  • Extensor Tenotomy.
  • Stage II: Moderate Boutonnière Deformity
  • Reconstruction of the Extensor Mechanism.
  • Stage III: Severe Boutonnière Deformity
  • PIP Joint Fusion.
  • PIP Joint Arthroplasty.
  • Thumb Deformities
  • Pathophysiology
  • Type I Thumb (Boutonnière) Deformity
  • Indications for Operative Treatment
  • Type II Thumb Deformity
  • Type III Thumb (Swan Neck) Deformity
  • Indications for Operative Treatment
  • Type IV Thumb (Gamekeeper's) Deformity
  • Indications for Operative Treatment
  • Type V Thumb Deformity
  • Thumb Deformities Secondary to Joint Destruction
  • Operative Treatment Indications for Severe Joint Destruction and Arthritis Mutilans
  • Operative Techniques for Thumb Reconstruction
  • Interphalangeal Joint.
  • Synovectomy.
  • IP Joint Release.
  • IP Joint Arthrodesis.
  • Metacarpophalangeal Joint.
  • Synovectomy.
  • MP Joint Synovectomy With Extensor Mechanism Reconstruction.
  • MP Joint Ligament Reconstruction for Type IV Deformity.
  • Procedures for Fixed MP Joint Contractures.
  • Arthrodesis of IP and MP joints without severe deformity or bone loss.
  • Athrodesis for arthritis mutilans.
  • Trapeziometacarpal joint anthroplasty.
  • References
  • 56 Tendinopathy
  • Acknowledgment:
  • Proliferative Tenosynovitis
  • Rheumatoid Arthritis
  • Crystalline Tendinopathy
  • Gout
  • Calcific Tendinitis
  • Other Crystalline Tendinopathies
  • Pseudogout.
  • Hydroxyapatite Deposition.
  • Amyloid Deposition
  • Ochronosis
  • Septic Tenosynovitis
  • Chronic Tenosynovitis
  • Sarcoid
  • Tendon Entrapment
  • Histologic Findings
  • Causative Factors
  • Trigger Digits
  • Pathologic Findings
  • Demographics
  • Classification
  • Treatment
  • Nonoperative Management.
  • Technique of Corticosteroid Injection.
  • Splinting.
  • Surgical Treatment
  • Pertinent Anatomy
  • Topographic Anatomy and Skin Incisions.
  • Operative Technique of Open Trigger Digit Release.
  • Percutaneous Trigger Finger Release (Video 56.1).
  • Author's Preferred Method of Treatment
  • Complications
  • Congenital Trigger Thumb
  • Treatment
  • Surgical Technique.
  • Trigger Digits in Childhood
  • De Quervain Disease
  • Treatment
  • Nonoperative Treatment.
  • Technique of Injection.
  • Surgical Treatment
  • Pertinent Anatomy
  • Author's Preferred Method
  • Complications
  • Other Stenotic Conditions of Tendons at the Wrist
  • Anatomy
  • Intersection Syndrome
  • Extensor Pollicis Longus Entrapment
  • Stenosis of the Fourth and Fifth Extensor Compartments
  • Extensor Carpi Ulnaris Tendinitis
  • Surgical Treatment
  • Flexor Carpi Radialis Tendinitis
  • Anatomy
  • Treatment
  • Nonoperative Treatment.
  • Operative Technique.
  • References
  • 57 Burned Hand
  • Epidemiologic Findings
  • Anatomy
  • Pathophysiology
  • Acute Hand Burns
  • Treatment Goals
  • Initial Evaluation and Management
  • Classification of Burns
  • Determination of Burn Depth
  • Control of Edema
  • Escharotomy
  • Splinting
  • Local Wound Care
  • Excision and Grafting
  • Complications
  • Secondary Infection
  • Graft Loss
  • Early Hypergranulation
  • Postburn Deformities
  • Prevention
  • Treatment
  • Nail Bed Deformities
  • Claw Deformities
  • Web Space Syndactyly and Interdigital Contractures
  • Contractures of the Thumb
  • Digital Flexion Contracture
  • Boutonnière Deformity
  • Contractures of the Dorsum of the Hand
  • Volume Deficiencies and Contour Irregularities
  • Amputation Deformity
  • Thumb Reconstruction.
  • Elbow Contractures
  • Heterotopic Ossification.
  • Axillary Contractures
  • Reconstructive Tools
  • Random Abdominal Wall Flap
  • Groin Flap
  • Tensor Fasciae Latae Flap
  • Forearm Flaps
  • Anterolateral Thigh Flaps
  • Lateral Arm Flap
  • Free Serratus Fascial Flap
  • Electrical Injury
  • Epidemiologic Findings
  • Properties of Electricity and Pathophysiologic Conditions
  • Mechanism and Classification
  • Clinical Manifestations
  • Treatment
  • General Management
  • Surgical Management
  • Complications
  • Rehabilitation
  • Chemical Burns
  • Management
  • Phenol
  • Hydrofluoric Acid
  • Cement Burns
  • White Phosphorus
  • Frostbite Injuries
  • Pathophysiologic Findings
  • Diagnosis
  • Treatment
  • Rehabilitation
  • References
  • 58 Skin Tumors of the Hand and Upper Extremity
  • Anatomy and Clinical Examination
  • Diagnostic Procedures and Nonsurgical Treatment
  • Surgical Lesion Excision
  • Epidermal Lesions
  • Warts
  • Seborrheic Keratosis
  • Sweat Glands
  • Pigmented Epidermal Lesions
  • Pigmented Macules
  • Melanocytes
  • Moles
  • Benign Juvenile Melanoma
  • Blue Nevus
  • Dysplastic Nevus Syndrome
  • Longitudinal Melanonychia
  • Dermal Lesions
  • Nonhemangiomatous Vascular Lesions
  • Premalignant, Skin Cancer Associated, and Indeterminate Behavior Lesions
  • Cutaneous Horns
  • Porokeratosis
  • Keratoacanthoma
  • Distal Digital Keratoacanthoma
  • Actinic Keratosis
  • Arsenical Keratosis
  • Bowen Disease
  • Syndromal Conditions Associated With Skin Cancers
  • Gorlin Syndrome
  • Xeroderma Pigmentosum
  • Basal Cell Carcinoma
  • Classification of BCCs
  • Solid (Nodular) BCC
  • Adenoid BCC
  • Cystic BCC
  • Superficial BCC
  • Morpheaform (Sclerosing) BCC
  • Treatment of BCC
  • Squamous Cell Carcinoma
  • Melanoma
  • Prognosis and Staging
  • Local Surgical Excisional Treatment
  • Evaluation of Lymphatic Basins
  • Less Common Malignant Tumors
  • Merkel Cell (Neuroendocrine) Carcinoma
  • Lymphangiosarcoma (Stewart-Treves Syndrome)
  • Sweat Gland Tumors
  • Human Immunodeficiency Virus
  • Dermatofibrosarcoma Protuberans
  • Metastatic Tumors
  • References
  • 59 Bone and Soft Tissue Tumors
  • Acknowledgment:
  • Diagnosis and Management of Musculoskeletal Tumors
  • Classification and Staging of Tumors
  • Histologic Grade and Surgical Staging
  • Location (Site)
  • Metastases
  • Evaluation Protocol
  • Laboratory Studies
  • Diagnostic Imaging
  • Plain Radiographs
  • Computed Tomography
  • Scintigraphy
  • Magnetic Resonance Imaging
  • Sonography
  • Biopsy
  • Needle Biopsy
  • Open Biopsy
  • Incisional Biopsy
  • Excisional Biopsy
  • Primary Wide Excision
  • Definitive Treatment
  • General Plan of Tumor Excision
  • Benign Tumors
  • Malignant Tumors
  • Principles of Excision for Specific Sites
  • Distal Phalanx
  • Middle Phalanx
  • First Metacarpal
  • Finger Metacarpals
  • Wrist and Distal Forearm
  • Benign Soft Tissue Lesions
  • Ganglions and Mucous Cysts
  • Clinical Characteristics
  • Anatomy
  • Pathogenesis
  • Nonoperative Treatment
  • Operative Treatment
  • Dorsal Wrist Ganglion
  • Clinical Characteristics.
  • Author's Preferred Method of Treatment
  • Operative Technique.
  • Postoperative Care.
  • Complications.
  • Occult Dorsal Carpal Ganglion
  • Volar Wrist Ganglion
  • Clinical Characteristics.
  • Author's Preferred Method of Treatment
  • Operative Technique.
  • Postoperative Care.
  • Complications.
  • Volar Retinacular (Flexor Tendon Sheath) Ganglion
  • Clinical Characteristics.
  • Author's Preferred Method of Treatment
  • Operative Technique.
  • Mucous Cyst
  • Clinical Characteristics.
  • Author's Preferred Method of Treatment
  • Operative Technique.
  • Complications.
  • Carpometacarpal Boss
  • Clinical Characteristics.
  • Author's Preferred Method of Treatment
  • Operative Technique.
  • Postoperative Care.
  • Complications.
  • Ganglions of the Proximal Interphalangeal Joint
  • Clinical Characteristics.
  • Author's Preferred Method of Treatment
  • Operative Technique.
  • Postoperative Care.
  • Ganglions of Extensor Tendons
  • Clinical Characteristics.
  • Author's Preferred Method of Treatment
  • Operative Technique.
  • Miscellaneous Locations
  • First Extensor Compartment (Dorsal Retinacular) Ganglion.
  • Carpal Tunnel.
  • Guyon Canal/Distal Ulnar Nerve.
  • Intraosseous Ganglions
  • Epidermal Inclusion Cysts
  • Foreign Body Lesions
  • Lipomas
  • Lipofibromatous Hamartomas
  • Giant Cell Tumors of the Tendon Sheath (Pigmented Villonodular Tenosynovitis)
  • Schwannomas (Neurilemomas)
  • Neurofibromas
  • Granular Cell Tumors (Granular Cell Myoblastomas)
  • Fibromatoses
  • Digital Fibroma of Infancy
  • Juvenile Aponeurotic Fibroma
  • Nodular Fasciitis
  • Malignant Soft Tissue Lesions
  • Soft Tissue Sarcomas
  • Clinical Picture
  • Biopsy
  • Staging
  • Operative Treatment
  • Epithelioid Sarcoma
  • Synovial Sarcoma
  • Liposarcoma
  • Fibrosarcoma
  • Dermatofibrosarcoma Protuberans
  • Malignant Fibrous Histiocytoma
  • Malignant Peripheral Nerve Sheath Tumor (Neurofibrosarcoma/Malignant Schwannoma)
  • Rhabdomyosarcoma
  • Leiomyosarcoma
  • Clear Cell Sarcoma
  • Benign Bone Tumors
  • Enchondroma
  • Author's Preferred Method of Treatment
  • Multiple Enchondromatosis (Ollier Disease)
  • Maffucci Syndrome
  • Periosteal Chondroma
  • Osteochondroma
  • Bizarre Parosteal Osteochondromatous Proliferation
  • Subungual Exostosis (Subungual Osteochondroma)
  • Chondromyxoid Fibroma
  • Osteoid Osteoma
  • Osteoblastoma
  • Unicameral Bone Cyst
  • Author's Preferred Method of Treatment
  • Aneurysmal Bone Cyst
  • Author's Preferred Method of Treatment
  • Giant Cell Tumor of Bone
  • Author's Preferred Method of Treatment
  • Malignant Bone Tumors
  • Chondrosarcoma
  • Osteogenic Sarcoma
  • Author's Preferred Method of Treatment
  • Ewing's Sarcoma
  • Author's Preferred Method of Treatment
  • Metastatic Tumors
  • References
  • 60 Vascular Disorders of the Hand
  • Acknowledgment:
  • Anatomy
  • Etiology of Ischemia
  • Evaluation
  • Management
  • Open Arterial Trauma
  • Author's Preferred Method of Treatment: Arterial Vascular Repair
  • Postoperative Care After Vein Graft Repair.
  • Complications.
  • Closed Arterial Trauma
  • Author's Preferred Method of Treatment: Ulnar Artery Bypass
  • Complications.
  • Vascular Disease
  • Preoperative Evaluation
  • Author's Preferred Method of Treatment: In Situ Bypass of the Forearm
  • Complications.
  • Management of Vasospastic Disorders
  • Nonsurgical Management of Vasospastic Disorders
  • Operative Management of Vasospastic Disease
  • Postoperative Management and Anticoagulation.
  • Author's Preferred Method of Treatment: Periarterial Sympathectomy
  • Aneurysms
  • Venous Thrombosis
  • Vascular Malformations
  • Glomus Tumors
  • References
  • Index
  • A
  • B
  • C
  • D
  • E
  • F
  • G
  • H
  • I
  • J
  • K
  • L
  • M
  • N
  • O
  • P
  • Q
  • R
  • S
  • T
  • U
  • V
  • W
  • X
  • Y
  • Z

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