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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_574_Библиотеки_им_академика_М_И_Перельмана.pdf
Cannulated screw placement, 32
guidelines for,32
Cannulated screws, 29–35
Acutrak cannulated screw (Acumed), 30
alternatives to, 34
biomechanical evaluation of, 30–31
CAD design diagram, 30
clinical applications, 31–34
carpal injuries, 33
distal radius fractures, 34
intercarpal arthrodesis, 33
interphalangeal arthrodesis, 32
metacarpal joint arthrodesis, 32
scaphoid fracture fixation, 32–33
configuration of, 29
Herbert/Whiplle cannualted screw,31
mechanical properties of, 29–30
Mini-Acutrak (Acumed), 31
Osteomed cannulated screw,30–31
potential complications, 34–35
Universal compression screw (Howmedica), 30
Capsular electrodermal shrinkage techniques, 217–222.
See also Arthroscopic treatment, wrist.
Carpal injuries, cannulated screws and, 33
Carpal instability,220. See also Arthroscopic
treatment, wrist.
Carpal instability,Geissler arthroscopic classification, 224
Carpal tunnel release, anatomy of, 3
Carpal tunnel release, Agee technique, 305–309
indications, 305
outcomes, 308, 309
preoperative planning, 306
surgical technique, 306–307
Carpal tunnel release, with Indiana tome, 293–297
complications, 295
indications, 293
outcomes, 295–296
preoperative planning, 293
surgical technique, 293–295
Carpal tunnel release, with Security clipe ,299–303
complications, 301–302
indications, 299
outcomes, 303
preoperative planning, 299
rehabilitation, 301
surgical technique, 299–301
Cements, calcium phosphate, 11–12
Ceramic bone graft substitutes
distal radius fracture, 12
indications, 12–13
overview of, 11
physical properties of, 11
surgical techniques, 13
Chow technique, 281–290
complications, 288–289
conversion to open procedure, 290
evolution of, 281
guidelines to avoid complications, 288
indications, 281–282
preoperative planning, 282
surgical technique, 282–290
anesthesia, 283–284
arthroscopicequipment needs, 283
cannula placement, 285
endoscopic examination, 285–286
entry portal positioning, 284
[Chow technique]
[surgical technique]
exit portal positioning, 285
instrumentation of ECTRAe System kit (Smith &
Nephew), 283, 284
operating room setup, 282–283
portals creation, 285, 286
transverse carpal ligament release, 287–288
Closed catheter irrigation (CCI) technique. See Pyogenic flexor
tensosynovitis, closed catheter irrigation.
Condylar fracture of middle phalanx, mini screw fixation, 51
Condylar fractureofproximal phalanx, mini screw fixation, 47
Cystic scaphoid nonunion image, 108
Delayed union, external fixation of metacarpals and
phalanges, 74
DeQuervain’s release, endoscopic, 317–319
indications/contraindications, 317
outcomes, 318
postoperative management, 318
surgical technique, 317–318
Digit, cross-section of, 4
Displaced fractures, percutaneous scaphoid fixation, 89
Distal radial malunion
established, 192
intramedullary nail. See Intramedullary nail repair,distal
radial malunions.
volar plating. Vo lar plating, distal radial malunions.
Distal radial osteotomies, non-bridging external fixation,
145–146
Distal radius bridge plate, 154–155
Distal radius fractures
AO/AISF,classification, 176, 183
augmented external fixation. See Augmented external
fixation, distal radius fractures.
balloon reduction and grafting. See Balloon reduction and
grafting, distal radius fractures.
bone graft substitutes and, 13–14
cannulated screws and, 34
dorsal nail plate fixation. See Dorsal nail plate fixation, distal
radius fractures.
limited approach open reduction. See Limited approach
open reduction/internal fixation, distal radius
fractures.
MICRONAIL. See MICRONAIL, distal radius fractures.
spanning plating. See Spanning plating, distal radius
fractures.
Distal radius, Rikli and Gregazzoni’s division, 182
Distal scaphoid excision, 250
complications, 250
indications/contraindication, 250
outcomes, 250
preoperativeplanning, 250
surgical technique, 250
Dorsal malunion, intramedullary nail repair,194–195
Dorsal nail plate fixation, distal radius fractures, 167–172
closure, 171
complications, 171–172
contraindications, 167
equipment, 168
fracture reduction, 168–170
implant description, 168
indications, 167
nail insertion, 168–170
vs. open techniques, 167
334&Index
[Dorsal nail plate fixation, distal radius fractures]
operating room setup, 168
postoperative management, 171
preoperative imaging, 168
preoperative planning, 168
specific dianosis, 167
surgical technique, 168–170
Dorsal percutaneous approach to scaphoid nonunions, 107
Dupuytren’s contracture,327–331
complications, 329
indications, 328
outcomes, 329–330
preoperative planning, 328
studies, 327
surgical technique, 328–329
Eastwood technique, forpercutaneoustrigger fingerrelease,312
ECTRAe System kit (Smith &Nephew), 283, 284
Endoscopic carpal tunnel release. See Chow technique;
Single-portal Mirza technique.
Endoscopic DeQuervain’s release. See DeQuervain’s release,
endoscopic.
Extensor tendon injuries, 2
External button, 5
External fixation of metacarpals and phalanges, 73–80
arthrodesis, 74–75
closed fracture, 74
complications, 79
delayed union, 74
distraction osteogenesis, 75
established nonunion, 74
indications, 73–75
joint and soft tissue stabilization, 75
malunion, 74
open fracture, 73
osteogenesis. See Osteogenesis.
osteomyelitis, 74
outcomes, 79–80
preoperative planning, 75
surgical technique, 75–78
operating room setup, 75
operative approach–fractures, 75–76
operative approach–distraction osteogenesis, 76–78
External fixation of the distal radius, non-bridging.
See Non-bridging external fixation of distal radius.
Extra-articular osteotomy,volar plating, 204–205
Fiber optic technology,1
Fifth metacarpal base fracture, 38
Jahss maneuver,39
methods of fixation, 30
Finger joint contracture, percutaneous release.
See Percutaneous release of posttraumatic finger
joint contracture.
Fingers, mid-axial approach, 3
Fixator placement, uniplanar external, 77
Flanged anchors, 6
Flexor tendon sheath anatomy,2,324
Four-part fractures, percutaneous and arthroscopic-assisted
reduction, 232
Fractures
displaced, percutaneous scaphoid fixation, 89
implants for fixation of, 21–23
nondisplaced, percutaneous scaphoid fixation, 89–91
Geissler arthroscopic classification, carpal instability,224
Geissler technique, percutaneous approach to scaphoid
nonunions, 107–110
HAKI knife (BK Meditech Inc.), 1
for percutaneous trigger finger release, 312–313
Herbert screw,30
Herbert/Whipple cannulated screw,31
Implants
evolution of, 19
processing and sterilization, 19–20
properties of, 19
Index finger,mid-axial line, 4
Indiana tome, carpal tunnel release, 293–297
Intercarpal arthrodesis, cannulated screws and, 33
Intermediate column fractures, 182–183
Intermedullary rodding
complications
excessive distraction, 59–60
inadequate reduction, 58
infection, 61
malunion, 60, 61
nonunion, 61
penetration of the nail, 59
PIP joint extensor lag, 61
poor fixation, 58–59
soft tissue injury,60
stiffness, 60–61
locking technique, 59
metacarpal fractures, 55–56
complications, 56
operative approach, 57–58
preoperative imaging, 57
preoperative planning, 57
outcomes, 61–62
Intermedullary rodding, phalangeal fractures
complications, 56
operative approach, 58
preoperative imaging, 57
preoperative planning, 57
Internal distraction plating. See Spanning plating, distal
radius fractures.
Interosseous ligament tear,220. See also Arthroscopic
treatment, wrist.
Interphalangeal arthrodesis, cannulated screws and, 32
Interphalangeal joint arthrodesis. See Arthrodesis.
Intra-articular distal radius fractures, percutaneous and
arthroscopic-assisted reduction.
relevant anatomy,223
See also Percutaneous and arthroscopic-assisted reduction,
intra-articular distal radius fractures.
Intra-articular osteotomy,distal radial malunions, 205
Intramedullary nail repair,distal radial malunions,
191–201
closure, 197
dorsal incision, 193
dorsal malunion, 194–195
indications, 191–192
MICRONAIL and, 194
nascent malunion, 197
operating room setup, 194
operative technique, 194–197
outcome, 198
postoperative emanagement, 197
Index&335
[Intramedullary nail repair,distal radial malunions]
preoperative evaluation, 192–193
preoperative imaging, 193
preoperative planning, 192
surgical technique, 194
volarly angulated malunion, 196–197
Jahss maneuver,39
Kaplan’s cardinal lines, 2
Kirschner wires
in augmented external fixation, 137
targeting guides, percutaneous scaphoid fixation, 90
Lateral radiographic angles, normal, 11 8
Limited approachopen reduction/internal fixation
distal radius fractures, 181–190
complications, 183
indications, 181
outcomes, 183–184
preoperative planning, 181
Rikli and Gregazzoni’s division of distal radius, 182
surgical technique, 181–183
volar ulnar approach, 185, 186
intermediate column fractures, 182–183
radial column fractures, 182
ulnar column fractures, 183, 185
Malunion
distal radial
volar plating and, 203–208
See Intramedullary nail repair,distal radial malunions.
external fixation of metacarpals and phalanges, 74
intermedullary rodding, 60, 61
Mandibular reconstruction plate, distal radius fractures,
154–155
Metacarpal fracture radiograph, 24
Metacarpal fractures
intramedullary rodding. See Intermedullary rodding,
metacarpal fractures.
percutaneous mini screw fixation. See Mini screw fixation,
phalangeal and metacarpal fractures.
percutaneous pinning
Bennett’s fracture, 38–39
Boxer ’s fracture, 38
fifth metacarpal base fracture (Baby Bennett’s), 38, 41
indications, 37
metacarpal shaft fractures, 38
second to fourth metacarpal base fractures, 38, 40, 41
surgical technique, 38
Metacarpal joint arthrodesis, cannulated screws and, 32
Metacarpal shaft fracture fixation, surgical technique,
21–22
Metacarpal shaft fractures, 38. See also Metacarpal fractures,
percutaneous pinning.
Metacarpophalangeal joint fractures in the hand,
arthroscopic treatment, 235–238
complications, 237–238
indications, 235
outcomes, 238
preoperative planning, 235
surgical technique, 235–236
Metal implants, problems fomr,21
Metallic suture anchors, 5–6
MicroMite sutureanchor,9
MICRONAIL, distal radius fractures, 161–166
complications, 164–165
fixation, 15
outcome, 166
preoperative planning, 161
surgical technique, 161–164
Midcarparl portals for wrist joint arthroscopy,211
Mini screw fixation, condylar fracture of proximal
phalanx, 47
Mini screw fixation, phalangeal and metacarpal fractures,
45–53
Bennett’s fracture, 46
complications, 51
intraoperative complications, 51–52
outcomes, 52–53
postoperative care, 50–51
rehabilitation, 50–51
surgical technique, 45–46
Mini-Acutrak cannulated screw,31
Mirza technique. See Single-portal Mirza technique.
Monobasic calcium phosphate, 11
MP joint arthroscopy,214
Necrotic proximal pole image, 126
Non-bridging external fixation of distal radius, 143–149
acute fractures, 144–145
complications, 146
fixator pin placement, 144, 145
future direction, 149
indications, 143
osteotomy,149
outcomes, 146, 148–149
preoperative planning, 143
surgical technique, 144
Non-bridging external fixation, distal radial osteotomies,
145–146
Nonunion
external fixation of metacarpals and phalanges, 74
intemedullary rodding, 61
scaphoid, arthroscopic views, 108–114
scaphoid, classification of, 106
See also Scaphoid nonunions, percutaneous and
arthroscopicmanagement.
Osteogenesis, distraction, external fixation of metacarpals and
phalanges, 75
outcome, 80
Osteomed cannulated screw,30–31
Osteomyelitis, external fixation of metacarpals and
phalanges, 74
Osteotomy,non-bridging external fixation of distal radius, 149
Palmer classification, triangular fibrocartilage tears, 240
Percutaneous acute scaphoid fracture fixation, 95–103
advanced imaging, 95–96
cannular screw placement, 100, 101
complications, 101
guide wire placement, 97–99
imaging, 95
indications, 95
operating room setup, 96
outcomes, 101–102
physical examination, 95
preoperative planning, 95–96
surgical technique, 96–101
336&Index
Percutaneous and arthroscopic-assisted reduction,
intra-articular distal radius fractures, 223–234
ARC traction tower,225
Geissler arthroscopic classification, 224
operating room setup, 224–226
outcomes, 233
surgical technique, 226–233
radial styloid fractures, 226–228
three-part fractures, 228
with extensive metaphyseal comminution,
230–232
four-part fractures, 232
ulnar styloid fractures, 233
Percutaneous approach to scaphoid
nonunions
arthroscopic views, 108–114
Geissler technique, 107–110
See also Scaphoid nonunions, percutaneous and
arthroscopicmanagement.
Percutaneous pinning. See Phalangeal fractures,
percutaneous pinning; Metacarpal fractures,
percutaneous pinning.
Percutaneous release of posttraumatic finger joint
contracture, 83–88
cadaveric studies, 84
current treatment options, 84
etiology,83–84
indications, 84
surgical technique, 86–87
Percutaneous scaphoid fixation, dorsal technique,
89–94
arthroscopy,91–92
displaced fractures, 89
fixation, 92–93
implant selection, 89
indications, 89
nondisplaced fractures, 89–91
post-operative care, 93
scaphoid length, 92
targeting guide, 89
Percutaneous surgical technique, 86–87
Percutaneous trigger finger release, 311–316
complications, 315
Eastwood technique, 312
first annular pulley release, 313
HAKI knife, 312–313
outcomes, 315–316
preoperativeplanning, 312
primary type, 311
surface anatomy of the palm, 313
surgical technique, 312–315
Phalangeal fracture fixation
surgical technique, 23
transverse, 42
Phalangeal fractures, 23
intramedullary rodding. See Intermedullary
rodding, phalangeal fractures.
percutaneous mini screw fixation. See Mini screw
fixation, phalangeal and metacarpal fractures.
percutaneous pinning
indications, 38
outcomes, 41–42
surgical technique, 39–40
Phalangeal shaft, long oblique fractures, 48–49
Pilot hole, creation of, 6
PIP fracture dislocations, hipped fixation and dynamic
traction, 63–71
bent wire fixator,66–68, 69, 70
BioSymMetRic PIP fixator,64–65
“perfect circle” technique, 66
complications, 68–69
indications, 63–64
outcomes, 69–70
preoperative planning, 64
surgical techniques, 64–68
PIP joint
anatomy,83
percutaneous release of, 85
Prosthetic arthroplasty,proximal pole scaphoid nonunions,
125–130
arthroscopic views, 127–129
complications, 128–129
cosmetic appearance, 130
implant placement, 126–127
outcome, 129–130
preoperative imaging, 125
properative planning, 125
resection, 126
surgical technique, 125–127
Proximal phalanx, long oblique fractureof, 49, 52
Proximal pole scaphoid nonunions. See prosthetic
arthroplasty,proximal pole scaphoid nonunions.
Proximal row carpectomy,250–254
complications, 251
indications/contraindication, 250–251
open, 251–252
long term outcomes, 253
outcomes, 252
technique, 251–252
outcomes, 251
preoperativeplanning, 251
surgical technique, 251
Pulley anatomy,2–3
Pulley system of afinger,anatomy drawing, 324
Pyogenic flexor tensosynovitis, closed catheter irrigation,
321–324
clinical photo, 322, 324
complications, 323
indications, 321
outcomes, 323–324
preoperative planning, 321
surgical technique, 322–323
variations in technique, 323
Radial column fractures, 182
Radial styloid fracture
with cannulated screw repair,34
percutaneous and arthroscopic-assisted reduction, 226–228
Radial styloidectomy,247–250
complications, 249
indications/contraindication, 247
outcomes, 249
preoperativeplanning, 247–249
surgical technique, 249
Radiocarpal portals for wrist joint arthroscopy,211
Radiographic angles, normal lateral, 11 8
RASL reconstruction, 117–123
complications, 121
contraindications, 117
indications, 117–118
outcome, 122
Index&337
[RASL reconstruction]
preoperativeplanning, 118
surgical technique, 119–121
ReUnitee ,22
screw and smooth pin, 20
screw set, 20
Rikli and Gregazzoni’s division of distal radius, 182
Scaphoid and lunate reconstruction. See RASL
reconstruction.
Scaphoid fixation, percutaneous. See Percutaneous acute
scaphoid fracture fixation; Percutaneous scaphoid
fixation, dorsal technique.
Scaphoid fixation, volar technique, 33
Scaphoid fracture displacement radiograph, 25
Scaphoid fracture fixation, 23–24
available implants, 24
cannulated screwsand, 32–33
surgical technique, 23–24
Scaphoid length, in percutaneous scaphoid
fixation, 92
Scaphoid nonunions
arthroscopicviews, 108–114
classification of, 106
midcarpal space views, 106
percutaneous and arthroscopic management,
105–115
dorsal percutaneous approach, 107
Geissler technique, 107–110
indications, 105–106
preoperative evaluation, 106
surgical techniques, 106–110
volar percutaneous approach, 106–107
Scaphoid nonunions. See also Prosthetic arthroplasty,
proximal pole scaphoid nonunions.
Scaphoid waist fracture image, 96
Screws
cannulated. See Cannulated screws.
configuration, 29
mechanical properties of, 29–30
Second metacarpal shaft fracture radiograph, 21
Second to fourth metacarpal base fractures, 38, 40, 41
Secondary calcium phosphate, 11
Security clipe ,carpal tunnel release, 299–303
Self-absorbable implants, adverse reactions to, 26
Single-portal Mirza technique, 275–279
complications, 276, 277
indications, 275
outcomes, 276
preoperative planning, 275
surgical technique, 275–276, 277, 278
Small Bone Fixation System, 1
Small bone soft tissue fixation devices, list of, 7
Soft tissue fixation devices, small bone, list of, 7
Soft tissue fixation. See also Suture anchors.
Soft tissue repair to bone
using bone bridge, diagram of, 6
using pullout suture, diagram of, 6
Soft tissue surgery
assessment of tissue, 6
bony bed preparation, 6
complications, 8–9
pilot hole, 6
rehabilitation and outcome, 7
Soft tissue suture to bone bridge, 5
Soft tissue suturing techniques, 6
Spanning plating, distal radius fractures, 151–159
ASIF compression plate, 154
complications, 156
contraindications, 152–153
distal radius bridge plate, 154–155
indications, 152
mandibular reconstruction plate, 154–155
outcomes, 156–157
postoperative protocol, 155–156
preoperative evaluation, 153
rehabilitation, 155–156
surgical technique, 154–155
Stener lesion, 6
Sutureanchors
considerations for use, 5–6
development of, 5
flanged, 6
general surgical technique, 6
in hand surgery,5–9
indications for,5
Suturebreakage, 8
Tendon excursion, 1–2
Threaded anchor,8
Three part fractures
with metaphyseal comminution, 230
percutaneous and arthroscopic-assisted reduction, 228,
230–232
Thumb CMC joint arthroscopy,213–214
Thumb MP joint, ulnar collateral ligament repair,6–7
Toggle anchor,7
Toggling, 6
Transsaphoid perilunate fracture with cannulated screw
repair,33
Transverse phalangeal fracture fixation, 42
Trapeziometacarpal joint anatomy,212
Triangular fibrocartilage tears
arthroscopic wafer,243–244
arthroscopy for
anatomy,239–240
complications, 244
debridement, 241–242
indications, 239
operating room setup, 240–241
outcomes, 244
Palmer 1A repair,242
Palmer 1B repair,243
preoperative planning, 239
repair,242–243
surgical technique, 239
Palmer classification, 240
Tricalcium phosphate, 11
Trigger finger
in children, 31
clinical course, 311
See also Percutaneous trigger finger release.
Ulnar collateral ligament (UCL), 6
Ulnar collateral ligament tears
repair of, 25–26
surgical technique, 25–26
Ulnar styloid fractures, percutaneous and arthroscopic-
assisted reduction, 233
338&Index
Ulnocarpal impaction. See Triangular fibrocartilage tears,
arthroscopy for.
Unicondylar fracture,displaced, mini screw fixation, 47, 48
outcome, 52
Uniplanar external fixator placement, 77
Universal compression screw (Howmedica), 30
Volar percutaneous approach to scaphoid nonunions,
106–107
Volar plating, distal radial malunions, 203–208
complications, 205
extra-articular osteotomy,204–205
intra-articular osteotomy,205
outcomes, 208
preoperative planning, 203
schematic, 204
surgical technique, 203–205
Volarly angulated malunion, intramedually nail repair,
196–197
Wrist, arthroscopic treatment
complications, 221
indications, 217–218
outcome, 221–222
preoperative planning, 218–219
surgical technique, 220–221
Wrist and hand arthroscopy,traumatic
complications, 214–215
MP joints, 214
operative technique, 210–214
preoperative eplanning, 209
surgical setup, 209–210
surgical technique, 209–214
wrist joints, 210–213
Wrist and hand arthroscopy,traumatic. See also Thumb
CMC joint arthroscopy.
Wrist and hand arthroscopy,traumatic. See also Wr ist joint
arthroscopy.
Wrist and hand arthroscopy,triangular fibrocartilage tears.
See Tr iangular fibrocartilage tears.
Wrist arthroscopic views, 211–212
Wrist ganglion cysts, arthroscopy,257–261
complications, 259
indications, 257–258
outcomes, 260
preoperative planning, 258
surgical technique, 258–259
Wrist joint anatomy,dorsal perspective, 210
Wrist joint arthroscopy
operative technique, 210–213
standard midcarpal portals, 211
standard radiocarpal portals, 211
trapeziometacarpal joint anatomy,212
Index&339
