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The Nonsurgical Treatment of Fractures in Contemporary Orthopedics
Augusto Sarmiento, Loren L Latta
SECTION 1: INTRODUCTION
1:
Pertinent Basic Science of Fracture Healing and Biomechanics
INTRODUCTION
MOTION AT THE FRACTURE SITE
HEALING WITH RIGID FIXATION OR MICROSCOPIC ELASTIC MOTION
HEALING WITH COMPLIANT FORMS OF FIXATION, OR MACROSCOPIC ELASTIC MOTION
THE ROLE OF VASCULARITY IN FRACTURE HEALING
THE STRUCTURAL MECHANICAL STAGES OF PERIPHERAL CALLUS
THE STRENGTH OF HEALING FRACTURES
Fracture Stability without Internal Fixation
SOFT TISSUE COMPRESSION
CONTROLLING ANGULATION
The Soft Tissue “Hinge”
Gravity Alignment
Angulation and Osteoarthritis
Rotational Control
SHORTENING
SECTION 2: THE TIBIAL FRACTURES
2:
The Closed Tibial Fracture: Introduction
3:
Overall Management Protocol
4:
Acute Care: Compartment Syndrome
5:
The Initial Above-the-Knee Cast
6:
The Below-the-Knee Functional Cast
7:
The Pre-fabricated Functional Brace
BRACE APPLICATION
8:
The Custom-made Brace
BRACE APPLICATION
9:
The Role of the Fibula
10:
Overall Clinical Experiences
METHODS AND ANALYSIS RESULTS
FACTORS INFLUENCING HEALING TIME
Factors Influencing Nonunion
Factors Influencing Final Shortening > 20 mm
Factors Influencing Brace Discontinuance
Factors Influencing Final Coronal Angulation (Varus/Valgus)
Factors Influencing Sagittal Angulattion (Anterior/Posterior)
DISCUSSION
11:
Fractures in the Proximal-third and Representative Examples
PATIENT AND FRACTURE VARIABLES
FRACTURE OUTCOMES
CLINICAL RESULTS
Healing Time
Final Shortening
Final Angulation
Final Displacement
DISCUSSION
REPRESENTATIVE EXAMPLES
12:
Fractures in the Middle-Third, Clinical Results and Representative Examples
MATERIAL
METHODS
CLINICAL RESULTS
Healing Time
Shortening
Angulation
Anatomical Alignment
Joint Motion and Length of Follow-Up
Comparison to Proximal and Distal-Third Fractures
REPRESENTATIVE EXAMPLES
13:
Fractures in the Distal-Third, Clinical Results and Representative Examples
INITIAL CARE
CLINICAL RESULTS
Healing Time
Shortening
ANGULATION
Anatomic Alignment
Joint Motion
DISCUSSION
REPRESENTATIVE EXAMPLES
14:
The Segmental Fracture, Results and Representative Examples
REPRESENTATIVE EXAMPLES
15:
The Open Fracture
16:
Pathological Fractures
17:
Delayed Unions and Nonunions
CLINICAL EXPERIENCES
Material and Methods
Results
DISCUSSION
REPRESENTATIVE EXAMPLES
18:
Tibial Condylar Fractures and Intra-articular Extensions
INCONGRUITY
19:
Notes on other Treatment Modalities
EXTERNAL FIXATORS
20:
Plate Fixation
21:
Interlocking Intramedullary Nailing
SECTION 3: THE FEMORAL SHAFT FRACTURES
22:
Rationale, Technique and Representative Examples
TECHNIQUE FOR TREATMENT OF FEMORAL SHAFT FRACTURE
REPRESENTATIVE EXAMPLE
DATA
SECTION 4: THE HUMERAL SHAFT FRACTURES
23:
Rationale of Functional Bracing
24:
Indications and Contraindications
INDICATIONS
CONTRAINDICATIONS
25:
Initial Management
26:
The Application of the Functional Brace
27:
Post-bracing Management
28:
Cautions and Pitfalls
AXIAL DISTRACTION
29:
Shoulder Subluxation
30:
Associated Nerve Palsy
NERVE PALSY
31:
Obesity
32:
Malrotation
33:
Angular Deformities
MALALIGNMENT
34:
Skin Problems
35:
The Polytraumatized Patient
36:
The Open Fracture
37:
The Proximal-third Fractures and Representative Examples
38:
The Middle-third Fractures and Representative Examples
39:
The Distal-third Fracture
40:
The Segmental Fracture and Representative Examples
41:
Bilateral Shaft Fractures
42:
Delayed Unions and Nonunions
43:
Clinical and Radiological Results
RESULTS
44:
Other Treatment Modalities: The Role of Plating
EXTERNAL FIXATORS
INTRAMEDULLARY NAILING
SECTION 5: THE ISOLATED ULNAR FRACTURE
45:
Rationale of Functional Treatment
46:
Indications and Contraindications
47:
Acute Management: Closed Fractures
48:
Open Fractures
49:
The Pre-fabricated Brace:Instructions and Expectations
CLINICAL EXPERIENCE
RESULTS
DISCUSSION
BRACE REMOVAL AND FOLLOW-UP
EXPECTED OUTCOMES
MANAGING COMPLICATIONS
SYNOSTOSIS
DELAYED UNIONS AND NONUNIONS
SKIN PROBLEMS
REPRESENTATIVE EXAMPLES
REFRACTURE
RANGE OF MOTION
POST-BRACING MANAGEMENT
DATA
SECTION 6: THE COLLES' FRACTURE
50:
Rationale of Functional Treatment
51:
Classification of Colles' Fracture
52:
The Etiology of Recurrent Deformity
53:
The Distal Radio-ulnar Joint
54:
The Long-oblique Fracture
55:
Late Arthritic Changes
56:
Immobilization: Pronation versus Supination
IMMOBILIZATION: PRONATION VERSUS SUPINATION
RESULTS
TECHNIQUE
REPRESENTATIVE EXAMPLES
CONCLUSIONS
SECTION 7: FRACTURES OF BOTH BONES OF THE FOREARM
57:
Rationale and Indications
58:
Technique and Representative Example
TECHNIQUE
REPRESENTATIVE EXAMPLES
SECTION 8: ISOLATED RADIAL SHAFT FRACTURES
59:
Rationale, Indications, Technique and Representative Examples
TECHNIQUE
REPRESENTATIVE EXAMPLES
INDEX
TOC
Index
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