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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_708_Библиотеки_им_академика_М_И_Перельмана
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SURGICAL EXPOSURES IN
Foot and Ankle Surgery
The Anatomic Approach
SECOND EDITION
Piet deBoer, MA, FRCS
Visiting Lecturer
Department of Anatomy
University of Rijeka Medical
Rijeka, Croatia
CEO
Medical Education Consultants GmbH
Zurich, Switzerland
Richard Buckley, MD, FRCSC
Professor of Orthopaedic Traumatology
University of Calgary Cumming School of
Medicine
Former Head, Orthopaedic Trauma
Department of Surgery, Section of Orthopaedics
Foothills Hospital
Calgary, Alberta, Canada
Stanley Hoppenfeld, MD
(1934–2020)
Clinical Professor of Orthopaedic Surgery
Albert Einstein College of Medicine
Attending Physician
Jack D. Weiler Hospital of the Albert
Einstein College of Medicine
Montefiore Hospital and Medical Center
Bronx, New York
Illustrations by Bernie Kida and Hugh A.
Thomas
Acquisitions Editor: Tulie McKay
Senior Development Editor: Stacey Sebring
Senior Production Manager: Alicia Jackson
Marketing Manager: Kirsten Watrud
Manager, Graphic Arts & Design: Steve Druding
Senior Manufacturing Manager: Beth Welsh
Prepress Vendor: Aptara, Inc.
Second Edition
Copyright © 2023 by Wolters Kluwer
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins. All rights reserved. This
book is protected by copyright. No part of this book may be reproduced or transmitted in any form or
by any means, including as photocopies or scanned-in or other electronic copies, or utilized by any
information storage and retrieval system without written permission from the copyright owner,
except for brief quotations embodied in critical articles and reviews. Materials appearing in this book
prepared by individuals as part of their official duties as U.S. government employees are not covered
by the above-mentioned copyright. To request permission, please contact Wolters Kluwer at Two
Commerce Square, 2001 Market Street, Philadelphia, PA 19103, via email at permissions@lww.com,
or via our website at shop.lww.com (products and services).
9 8 7 6 5 4 3 2 1
Printed in Singapore
Library of Congress Cataloging-in-Publication Data available upon request.
978-1-9751-9205-1
This work is provided “as is,” and the publisher disclaims any and all warranties, express or implied,
including any warranties as to accuracy, comprehensiveness, or currency of the content of this work.
This work is no substitute for individual patient assessment based upon healthcare professionals’
examination of each patient and consideration of, among other things, age, weight, gender, current or
prior medical conditions, medication history, laboratory data and other factors unique to the patient.
The publisher does not provide medical advice or guidance and this work is merely a reference tool.
Healthcare professionals, and not the publisher, are solely responsible for the use of this work
including all medical judgments and for any resulting diagnosis and treatments.
Given continuous, rapid advances in medical science and health information, independent
professional verification of medical diagnoses, indications, appropriate pharmaceutical selections and
dosages, and treatment options should be made and healthcare professionals should consult a variety
of sources. When prescribing medication, healthcare professionals are advised to consult the product
information sheet (the manufacturer’s package insert) accompanying each drug to verify, among
other things, conditions of use, warnings and side effects and identify any changes in dosage
schedule or contraindications, particularly if the medication to be administered is new, infrequently
used or has a narrow therapeutic range. To the maximum extent permitted under applicable law, no
responsibility is assumed by the publisher for any injury and/or damage to persons or property, as a
matter of products liability, negligence law or otherwise, or from any reference to or use by any
person of this work.
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Dedication
To my wife Suzi, my three children James, Kate, Jan and my two
grandchildren Rowan and Finn
PdeB
To my wife Lois,
who organizes my “whole”
life and makes it manageable,
who I respect greatly,
and my two children,
Shannon and Andrew.
RB
To my wife Norma,
my sons Jon-David,
Robert, and Stephen,
and my parents Agatha and David, all in their own special way have
made my life full
and made this book possible.
SH
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Stanley Hoppenfeld—A Personal
Recollection
2020 saw the death of Stanley Hoppenfeld, the senior author of this
textbook. For those of us who knew him as a friend, his passing has brought
about much sadness and reawakened many memories. These are my
recollections of Stan.
In 1980, I was approached by Stan to write this book. Stan had a thriving
clinical practice largely based on the treatment of scoliosis, and I was the
visiting UK fellow from St Thomas’ Hospital in London. Both of us worked
at Jacobi Hospital in the Bronx which had a training program based at the
Albert Einstein School of Medicine. For many years, Stan had taught
courses on topographical anatomy at the Yeshiva University, and at that
time, he had become interested in the work of AK Henry, an Irish
anatomist, who worked for many years as Professor of Anatomy in Cairo.
Henry’s concept of surgeons utilizing internervous planes to allow safe
access to bones and joints fascinated Stan. He conceived an idea of a
textbook of surgical approaches based on the concepts of Henry.
While teaching anatomy, Stan had always been accompanied by Hugh
Thomas. Hugh took these opportunities to learn topographical anatomy and
develop his incredible demonstrative medical artistic skills. Hugh and Stan
had already worked on two other textbooks—(1) Orthopaedic Neurology
and (2) Physical Examination of the Spine and Extremities by the time the
Surgical Approaches book was written. These two books had been edited by
Rick Hutton, an English major from Columbia University, and for a while
Stan, Hugh, and Rick Hutton shared a bachelor apartment in New York.
Stan knew that he did not have the time to write the Surgical Approaches
book and he realized that the visiting English fellows who had the extensive
knowledge necessary and required to pass the British Primary fellowship
exam. I know that I was not the first fellow to be approached to contribute
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to the book, but I was the one who accepted his offer. My first effort was to
try to describe and write the anterior approach to the radius. This was and
still is my favorite anatomically based approach. The text was returned to
me at a meeting with Rick Hutton and Stan. In my mind’s eye, none of the
original text remained intact as all the pages were covered in red ink. Rick
politely told me that I was writing in Latin and I then learned the use of the
imperative when describing surgical approaches.
It took almost 6 months to agree to the final structure of the book. Every
approach was to be described in the same way—landmarks, incision, etc.
Stan was the perfect sounding board. A great educationalist, he knew what
worked and what did not work. His ability to know what needed to be
written to be educational was unique. Writing the final text took a further
year. A routine was started—dictating texts in the evening, passing them to
Stan the next day for his typists to produce hard copy the following day.
Hours sitting with Stan in Hugh’s office on Broadway listening to Don
Giovani working hard to develop medical drawings that showed the
approaches from the surgeon’s viewpoint.
Then on a freezing cold day in Manhattan, we had a breakfast meeting
with Stuart Freeman to sell the book to Lippincott. Hugh brought original
drawings in folio size. The meeting lasted a short time and I found myself
as a soon to be published coauthor.
Although I wrote all the original text, apart from the spine chapter, the
idea behind the book was entirely Stan’s. He brought together a team, all of
whom were just at the right stage of their careers to produce the book.
Stan’s ability to constructively criticize our efforts made the book what it is.
It must not be forgotten that Stan put in a lot of his own money to produce
the first edition. Stan’s contributions diminished after the publication of the
third edition in 2003. but he insisted on visiting with Rick Buckley before
agreeing to allow him to join the editorial team in 2009. Our last meeting
was in 2017 at his home in Scarsdale. He was at this time suffering from
Parkinsonism but was intellectually intact and took great pride in showing
my youngest son his home cinema which allowed him to demonstrate his
collection of over 1,000 glass covered slides.
Although I regarded his book on Orthopaedic Neurology as his finest
published work, Stan’s main legacy is this Surgical Approaches book. The
Approaches book has helped surgeons all around the world to safely treat
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millions of patients. He will be missed by his family and friends, but they
should take comfort that his ideas will continue to influence orthopedic
surgical care for many years to come.
Piet deBoer
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Preface
The publication of Surgical Exposures in Foot and Ankle Surgery—The
Anatomic Approach reflects the great advances seen in this field in the last
decade. Improved imaging techniques, the availability of new specialized
implants, and an improved understanding of the biomechanics of the foot
and ankle have resulted in a substantial increase in the number of foot and
ankle procedures performed, associated with improved and expanded
indications and more successful patient outcomes.
This book is derived in part from Surgical Exposures in Orthopaedics—
The Anatomic Approach, first published in 1984. The standard surgical
approach textbooks at that time were out of date, and the principle of
linking surgical anatomy to surgical approaches accompanied by incisive
text and dramatically clear diagrams was greeted favorably by orthopaedists
and trauma surgeons around the world. Throughout its 27-year history, this
book has remained the number one bestseller in its field. It has been
translated into six languages and is extensively used on all five continents.
Safety in surgery has always depended on knowledge of anatomy and
technical skills; one is useless without the other. Surgical skill can be
learned only by practical experience under expert supervision. But the
knowledge that underlies it must come from books, reliable sources on the
Internet, and actual dissection.
Structurally, this book is divided into four areas: the ankle, hindfoot,
midfoot, forefoot, and toes. Only the most commonly performed
approaches are described—we have omitted those designed for a specific
procedure, which are best understood in the original papers of those who
first presented them.
The key to Surgical Exposures in Foot and Ankle Surgery is a consistent
organization throughout. Each approach is explained, followed by a
discussion of the relevant surgical anatomy of the area. When one or more
approaches share anatomy, they are grouped together, with the relevant
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