32 Extremity trauma

Achilles tendon rupture Complete rupture of the Achilles tendon is a common injury; 20% of acute...

Ankle fractures Ankle fractures are very common. As with all intra-articular fractures one should...

Bony injury Description Describing the bony injury depends on several characteristics and include...

COMPARTMENT SYNDROME Compartment syndrome is raised pressure in a fascial compart - ment to a lev...

CONCLUSION The correct identification of extremity trauma, combined with timely and appropriate t...

Carpal instability The most commonly involved carpal bone is the lunate. A lunate dislocation is ...

Clavicle fractures Diaphyseal fractures of the middle third of the clavicle have traditionally ...

DESCRIPTION AND CLASSIFICATION OF THE INJURY Soft-tissue injury There are several classification s...

DESCRIPTION AND CLASSIFICATION OF THE INJURY Soft-tissue injury There are several classification s...

DIAGNOSIS The diagnosis of extremity trauma begins with the taking of a pertinent history follo...

Diaphyseal fractures Extra-articular fractures do not require an anatomical reduc - tion, but rat...

Distal femoral fractures Metaphyseal osteoporotic fractures of the distal femur are amenable to ...

Distal humerus (supracondylar fracture) Supracondylar humeral fractures are very common injuries ...

Distal radial fractures Extra-articular (type A) fractures of the distal radius may displace in a...

Examination An initial general examination, including vital signs and general assessment, should ...

FRACTURE HEALING It is useful to review fracture healing, as it relates to treatment and outcome....

FURTHER READING Blom A, Warwick D, Whitehouse M. Apley’s system of orthopaedics and fractures , ...

Femoral shaft fractures It is possible to treat diaphyseal fractures of the femoral shaft non-op...

Forearm fractures (radius and ulna) Fractures of the diaphyseal shaft of the radius and ulna ar...

Fractures of the proximal humerus In fractures of the proximal humerus consideration is given to ...

Heal Time to fracture healing depends on several factors: patient comorbidities, the age of the ...

History It is important to ascertain the mechanism of injury and the amount of force involved in...

Hold If the fracture fragments are in an acceptable position, or have been reduced into an accep...

Humeral fractures Fractures of the diaphyseal portion of the humeral shaft are extra-articular ...

Intra-articular fractures AO type B and type C fractures are intra-articular and as such the prin...

Intracapsular femoral neck fractures Intracapsular fractures are further broken down into whether...

INTRODUCTION In several chapters the importance of life-threatening trauma is emphasised, but nu...

Investigations The mainstay of extremity trauma investigation remains radi - ography of the a ...

Lateral condylar mass fracture of the elbow Lateral condylar mass fractures of the elbow are eas...

Learning objectives To gain an understanding of: How to identify whether an injury exists • The i...

Metaphyseal fractures In the AO classification metaphyseal fractures are classified into A type – e...

Olecranon fractures Olecranon fractures may be displaced or undisplaced. Undisplaced fractures wi...

Open fractures Any fracture with an overlying wound should be considered an open fracture. The t...

Osteoporotic fractures Osteoporosis is a condition characterised by low bone mineral density and ...

Patellar fractures Similar to olecranon fractures, undisplaced fractures in which the extensor ...

Pathological fractures When abnormal bone fails under normal load this is referred to as a pathol...

Peripheral nerve injury Seddon classified nerve injuries into neurapraxia, axonotmesis and neurotm...

Proximal femoral fractures The blood supply to the femoral head is a prime consideration in treat...

Reduce The first thing to consider is the degree of displacement of the fracture fragments. It is...

SPECIAL CONSIDERATIONS Special consideration needs to be given to osteoporotic and pathological f...

SPECIFIC PAEDIATRIC INJURIES Distal radial fractures Fractures of the distal radius are very com...

SPECIFIC PAEDIATRIC INJURIES Distal radial fractures Fractures of the distal radius are very com...

Slipped upper femoral epiphysis A slipped upper femoral epiphysis classically occurs in a child a...

TO TOE) Scaphoid fracture The blood supply to the scaphoid enters distally and supplies the scaph...

TREATMENT BY FRACTURE LOCATION In general, the principles of treatment described above are depen...

TREATMENT OF FRACTURES IN THE SKELETALL Y IMMATURE The treatment principles that were described f...

TREATMENT The main principle of extremity fracture management builds on the classical concept of...

Talus fracture The talus consists of a head, neck and body . The most common injury is a talar n...

Tarsometatarsal (Lisfranc) joint injuries Injuries to the midfoot are associated with significan...

Terminology of bone healing after fracture Union The fracture has healed su ffi ciently from a clin...

Thumb metacarpophalangeal ulnar collateral ligament Injury to the thumb metacarpal ulnar collater...

Thumb metacarpophalangeal ulnar collateral ligament Injury to the thumb metacarpal ulnar collater...

Tibial plateau fractures Intra-articular fractures of the tibial plateau are common. Injuries ma...

Tibial shaft fractures Tibial fractures in children are often very amenable to non-operative tr...