Additional Information
Book Details
Abstract
Hand and Wrist Surgery, edited by Dr. Kevin Chung, shows you how to perform all the latest procedures and get the best results. This medical reference book in the Operative Techniques series uses step-by-step descriptions, illustrations, and videos to provide all the guidance you need to succeed.
- Search the complete contents online and watch all the videos with expertconsult.com.
- Improve your technique and optimize outcomes with pearls and pitfalls from the authors.
- Get just the information you need thanks to a new, more concise format and a user-friendly presentation.
- Watch and learn: 72 video clips show you how Dr. Chung performs key techniques.
- Know what to look for, how to proceed, and what results to expect with even more photos and illustrations demonstrating each technique and radiographs showing presenting problems and post-surgical outcomes.
- Stay up to date on the latest advances, including a greater focus on tissue-transplantation topics, four new procedures on skin flaps, and additional chapters on tendon transfers.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front cover | cover | ||
| Operative Techniques: Hand and Wrist Surgery | i | ||
| Copyright page | iv | ||
| Dedication | v | ||
| Contributors | vii | ||
| Preface | xi | ||
| Foreword | xiii | ||
| Table of Contents | xv | ||
| Video Contents | xxi | ||
| I Examination and Emergency Procedures | 1 | ||
| Procedure 1 Examination of the Hand and Wrist | 2 | ||
| Examination/Imaging | 5 | ||
| Position | 5 | ||
| Procedure | 5 | ||
| Primary Survey | 6 | ||
| Look | 6 | ||
| Feel | 8 | ||
| Move | 10 | ||
| Secondary Survey | 1.e1 | ||
| Assessment of Tendon and Muscle Function | 1.e1 | ||
| Assessment of Nerve Function | 1.e15 | ||
| Assessment of Vascular Function | 1.e27 | ||
| Assessment of Bone and Joint Function | 1.e29 | ||
| Procedure 2 Fasciotomy of the Upper Limb | 13 | ||
| Indications | 13 | ||
| Examination/Imaging | 14 | ||
| Clinical Examination | 14 | ||
| Investigations | 15 | ||
| Surgical Anatomy | 15 | ||
| Positioning | 16 | ||
| Exposures | 17 | ||
| Hand | 17 | ||
| Forearm | 18 | ||
| Arm | 19 | ||
| Procedure | 20 | ||
| Fasciotomy of the Hand | 20 | ||
| Step 1: Carpal Tunnel Release | 20 | ||
| Step 2: Thenar Decompression | 20 | ||
| Step 3: Hypothenar Decompression | 20 | ||
| Step 4: Decompression of the Dorsal Compartment | 20 | ||
| Step 5 | 21 | ||
| Procedure | 21 | ||
| Fasciotomy of the Forearm | 21 | ||
| Step 1: Volar Forearm Release | 21 | ||
| Step 2: Dorsal Forearm Release | 21 | ||
| Step 3: Two-Incision Release of Forearm | 21 | ||
| Step 4 | 21 | ||
| Procedure | 23 | ||
| Fasciotomy of the Arm | 23 | ||
| Step 1: Arm Decompression | 23 | ||
| Step 2 | 23 | ||
| Postoperative Care and Expected Outcomes | 23 | ||
| Evidence | 23 | ||
| Procedure 3 Nail Bed Repair | 24 | ||
| Indications | 24 | ||
| Examination/Imaging | 24 | ||
| Clinical Examination | 24 | ||
| Imaging | 25 | ||
| Surgical Anatomy | 25 | ||
| Positioning | 26 | ||
| Exposures | 26 | ||
| Procedure | 27 | ||
| Step 1 | 27 | ||
| Step 2 | 27 | ||
| Step 3 | 27 | ||
| Procedure | 29 | ||
| Germinal Matrix Avulsion | 29 | ||
| Step 1 | 29 | ||
| Step 2 | 29 | ||
| Step 3 | 30 | ||
| Step 4 | 30 | ||
| Management of Associated Distal Phalangeal Fracture | 30 | ||
| Postoperative Care and Expected Outcomes | 31 | ||
| Evidence | 33 | ||
| Procedure 4 Drainage of Purulent Flexor Tenosynovitis | 34 | ||
| Indications | 34 | ||
| Examination/Imaging | 34 | ||
| Clinical Examination | 34 | ||
| Imaging | 35 | ||
| Surgical Anatomy | 36 | ||
| Positioning | 36 | ||
| Exposures | 36 | ||
| Procedure | 37 | ||
| Step 1: Distal Exposure of the Fibrous Flexor Sheath | 37 | ||
| Step 2: Proximal Exposure of Fibrous Flexor Sheath | 37 | ||
| Step 3: Closed Tendon Sheath Irrigation | 38 | ||
| Postoperative Care and Expected Outcomes | 38 | ||
| Evidence | 38 | ||
| II Tendon Conditions | 39 | ||
| Procedure 5 Surgical Treatment of Trigger Digits | 40 | ||
| Indications | 40 | ||
| Examination/Imaging | 40 | ||
| Clinical Examination | 40 | ||
| Imaging | 41 | ||
| Surgical Anatomy | 42 | ||
| Positioning | 42 | ||
| Exposures | 42 | ||
| Procedure | 43 | ||
| Primary Trigger Finger Release | 43 | ||
| Step 1 | 43 | ||
| Step 2 | 44 | ||
| Procedure | 44 | ||
| Congenital Trigger Thumb | 44 | ||
| Step 1 | 44 | ||
| Step 2 | 45 | ||
| Procedure | 45 | ||
| Congenital Trigger Finger | 45 | ||
| Step 1 | 45 | ||
| Step 2 | 46 | ||
| Step 3 | 46 | ||
| Evidence | 47 | ||
| Procedure 6 Surgical Treatment of de Quervain Tendovaginitis | 48 | ||
| Indications | 48 | ||
| Examination/Imaging | 48 | ||
| Clinical Examination | 48 | ||
| Imaging | 49 | ||
| Surgical Anatomy | 50 | ||
| Positioning | 51 | ||
| Exposures | 51 | ||
| Procedure | 52 | ||
| Step 1 | 52 | ||
| Step 2 | 52 | ||
| Postoperative Care and Expected Outcomes | 53 | ||
| Evidence | 54 | ||
| Procedure 7 Acute Repair of Zone 1 Flexor Digitorum Profundus Avulsion | 55 | ||
| Indications | 55 | ||
| Examination/Imaging | 55 | ||
| Clinical Examination | 55 | ||
| Imaging | 55 | ||
| Surgical Anatomy | 56 | ||
| Positioning | 58 | ||
| Exposures | 58 | ||
| Procedure | 59 | ||
| Step 1 | 59 | ||
| Step 2 | 62 | ||
| Postoperative Care and Expected Outcomes | 63 | ||
| Evidence | 63 | ||
| Procedure 8 Acute Repair of Zone 2 Flexor Tendon Injury | 64 | ||
| Indications | 64 | ||
| Examination/Imaging | 64 | ||
| Clinical Examination | 64 | ||
| Imaging | 66 | ||
| Surgical Anatomy | 67 | ||
| Positioning | 67 | ||
| Exposures | 68 | ||
| Procedure | 68 | ||
| Step 1: Exposure of Divided Tendons | 68 | ||
| Step 2: Retrieval of Proximal Tendon End | 68 | ||
| Step 3: Tendon Repair | 70 | ||
| Step 4: Closure | 72 | ||
| Postoperative Care and Expected Outcomes | 72 | ||
| Evidence | 74 | ||
| Procedure 9 Staged Flexor Tendon Reconstruction | 75 | ||
| Indications | 75 | ||
| Examination/Imaging | 76 | ||
| Clinical Examination | 76 | ||
| Imaging | 77 | ||
| Surgical Anatomy | 78 | ||
| Positioning | 78 | ||
| Stage I: Exploration, Pulley Reconstruction, and Placement of Silicone Rod | 78 | ||
| Exposures | 78 | ||
| Procedure | 79 | ||
| Step 1: Assessment of Pulleys | 79 | ||
| Step 2: Débridement of Scar Sheath and Tendons | 79 | ||
| Step 3: Pulley Reconstruction | 79 | ||
| Step 4: Silicone Rod Placement | 80 | ||
| Step 5 | 81 | ||
| Postoperative Care and Expected Outcomes | 81 | ||
| Stage II: Removal of Silicone Rod and Placement of Tendon Graft | 83 | ||
| Exposures | 83 | ||
| Procedure | 83 | ||
| Step 1: Harvest of Tendon Graft | 83 | ||
| Step 2: Passing the Tendon Graft through the Flexor Tendon Sheath | 86 | ||
| Step 3: Distal Tendon Repair | 87 | ||
| Step 4: Proximal Tendon Repair | 88 | ||
| Step 5: Wound Closure | 88 | ||
| Postoperative Care and Expected Outcomes | 89 | ||
| Evidence | 90 | ||
| Procedure 10 Extensor Tendon Repair in Zones 1 to 5 | 91 | ||
| Indications | 91 | ||
| Examination/Imaging | 91 | ||
| Imaging | 91 | ||
| Surgical Anatomy | 92 | ||
| Positioning | 93 | ||
| Exposures | 93 | ||
| Zone 1 Injury | 94 | ||
| Clinical Examination | 94 | ||
| Procedure | 95 | ||
| Step 1 | 95 | ||
| Step 2 | 95 | ||
| Step 3 | 95 | ||
| Step 4 | 95 | ||
| III Nerve Injury and Nerve Palsy | 105 | ||
| Procedure 11 Endoscopic Carpal Tunnel Release | 106 | ||
| Indications | 106 | ||
| Examination/Imaging | 106 | ||
| Clinical Examination | 106 | ||
| Imaging | 106 | ||
| Surgical Anatomy | 106 | ||
| Positioning | 110 | ||
| Exposures | 111 | ||
| Procedure | 113 | ||
| Step 1: Release the Forearm Fascia | 113 | ||
| Step 2: Dilate the Carpal Tunnel | 113 | ||
| Step 3: Clear the Synovium | 114 | ||
| Step 4: Introducing the Blade Assembly into the Carpal Tunnel | 114 | ||
| Step 5: Identifying the Distal End of the TCL | 115 | ||
| Step 6: Incise the TCL | 116 | ||
| Step 7: Closure | 118 | ||
| Postoperative Care and Expected Outcomes | 118 | ||
| Evidence | 118 | ||
| Procedure 12 Open Carpal Tunnel Release | 119 | ||
| Indications | 119 | ||
| Examination/Imaging | 119 | ||
| Clinical Examination | 119 | ||
| Imaging/Diagnostic Studies | 120 | ||
| Surgical Anatomy | 120 | ||
| Exposures | 121 | ||
| Procedure | 122 | ||
| Step 1 | 122 | ||
| Step 2 | 123 | ||
| Step 3 | 123 | ||
| Step 4 | 124 | ||
| Step 5 | 124 | ||
| Step 6 | 125 | ||
| Postoperative Care and Expected Outcomes | 125 | ||
| Evidence | 126 | ||
| Procedure 13 In Situ Cubital Tunnel Decompression | 127 | ||
| Indications | 127 | ||
| Examination/Imaging | 127 | ||
| Clinical Examination | 127 | ||
| Imaging | 127 | ||
| Surgical Anatomy | 128 | ||
| Positioning | 129 | ||
| Exposures | 130 | ||
| Procedure | 130 | ||
| Step 1 | 130 | ||
| Step 2 | 131 | ||
| Step 3 | 131 | ||
| Step 4 | 131 | ||
| Postoperative Care and Expected Outcomes | 132 | ||
| Evidence | 132 | ||
| Procedure 14 Distal Anterior Interosseous Nerve Transfer to Motor Branch of Ulnar Nerve | 133 | ||
| Indications | 133 | ||
| Examination/Imaging | 133 | ||
| Clinical Examination | 133 | ||
| Imaging | 133 | ||
| Surgical Anatomy | 134 | ||
| Positioning | 134 | ||
| Exposures | 135 | ||
| Procedure | 135 | ||
| Step 1 | 135 | ||
| Step 2 | 136 | ||
| Step 3 | 136 | ||
| Step 4 | 137 | ||
| Step 5 | 137 | ||
| Step 6 | 137 | ||
| Postoperative Care and Expected Outcomes | 138 | ||
| Evidence | 138 | ||
| Procedure 15 Nerve Transfer Techniques for Elbow Flexion in Brachial Plexus Palsy | 139 | ||
| Indications | 139 | ||
| Examination/Imaging | 139 | ||
| Clinical Examination | 139 | ||
| Surgical Anatomy | 139 | ||
| Positioning | 139 | ||
| Exposures | 140 | ||
| Procedure | 141 | ||
| Step 1 | 141 | ||
| Step 2 | 141 | ||
| Step 3 | 142 | ||
| Postoperative Care and Expected Outcomes | 142 | ||
| Evidence | 143 | ||
| Procedure 16 Treatment of a Nerve Gap in the Hand | 144 | ||
| Indications | 144 | ||
| Examination/Imaging | 145 | ||
| Clinical Examination | 145 | ||
| Imaging | 145 | ||
| Surgical Anatomy | 146 | ||
| Positioning | 148 | ||
| Exposures | 149 | ||
| Procedure | 150 | ||
| Step 1: Preparation of Nerve Ends | 150 | ||
| Step 2: Assessment of Nerve Gap and Possibility of Primary Repair | 151 | ||
| Step 3: Selection of Nerve Graft | 151 | ||
| Step 4: Harvest of Nerve Graft | 154 | ||
| Step 5: Suture of Nerve Graft | 154 | ||
| Step 6: Wound Closure | 154 | ||
| Postoperative Care and Expected Outcomes | 154 | ||
| Evidence | 155 | ||
| PROCEDURE 17 Surgical Treatment of Neuromas in the Hand | 156 | ||
| Indications | 156 | ||
| Examination/Imaging | 156 | ||
| Clinical Examination | 156 | ||
| Imaging | 156 | ||
| Surgical Anatomy | 157 | ||
| Positioning | 159 | ||
| Procedure | 160 | ||
| Available Distal Nerve | 160 | ||
| Step 1 | 160 | ||
| Step 2 | 161 | ||
| Step 3 | 161 | ||
| Step 4 | 161 | ||
| Procedure | 162 | ||
| No Distal Nerve Available | 162 | ||
| Step 1 | 162 | ||
| Step 2 | 163 | ||
| Step 3 | 163 | ||
| Step 4 | 163 | ||
| Procedure | 164 | ||
| Centro-Centralization of a Digital Nerve | 164 | ||
| Step 1 | 164 | ||
| Step 2 | 164 | ||
| Step 3 | 164 | ||
| Postoperative Care and Expected Outcomes | 165 | ||
| Evidence | 165 | ||
| Procedure 18 Tendon Transfers for Carpal Tunnel Syndrome | 166 | ||
| Indications | 166 | ||
| Examination/Imaging | 166 | ||
| Clinical Examination | 166 | ||
| Imaging | 167 | ||
| Surgical Anatomy | 167 | ||
| Positioning | 168 | ||
| Exposures | 169 | ||
| Procedure | 170 | ||
| Step 1 | 170 | ||
| Step 2 | 170 | ||
| Step 3 | 171 | ||
| Step 4 | 171 | ||
| Step 5 | 171 | ||
| Step 6 | 171 | ||
| Step 7 | 172 | ||
| Step 8 | 172 | ||
| Postoperative Care and Expected Outcomes | 172 | ||
| Evidence | 173 | ||
| Procedure 19 Tendon Transfers for Ulnar Nerve Palsy | 174 | ||
| Indications | 174 | ||
| Examination/Imaging | 174 | ||
| Clinical Examination | 174 | ||
| Imaging | 180 | ||
| Surgical Anatomy | 181 | ||
| Positioning | 181 | ||
| Procedure 1—Static Correction of Claw Deformity with an MCP Joint Volar Plate Advancement | 181 | ||
| Exposures | 181 | ||
| Procedure | 183 | ||
| Step 1 | 183 | ||
| Step 2 | 183 | ||
| Step 3 | 183 | ||
| Step 4 | 185 | ||
| Step 5 | 185 | ||
| Step 6 | 186 | ||
| Postoperative Care and Expected Outcomes | 186 | ||
| Procedure 2—Dynamic Correction of Claw Deformity with Transfer of Ring Finger FDS | 187 | ||
| Exposures | 187 | ||
| Step 1 | 188 | ||
| Step 2 | 188 | ||
| Step 3 | 189 | ||
| Step 4 | 190 | ||
| Step 5 | 190 | ||
| Step 6 | 190 | ||
| Postoperative Care and Expected Outcomes | 191 | ||
| Procedure 3—Restoration of Thumb Adduction with an ECRB Tendon Transfer | 191 | ||
| Exposures | 191 | ||
| Step 1 | 191 | ||
| Step 2 | 192 | ||
| Step 3 | 192 | ||
| Step 4 | 193 | ||
| Step 5 | 193 | ||
| Step 6 | 193 | ||
| Step 7 | 193 | ||
| Step 8 | 193 | ||
| Postoperative Care and Expected Outcomes | 194 | ||
| Procedure 4—Correction of Abduction Deformity (Wartenberg Sign) of Small Finger | 195 | ||
| Exposures | 195 | ||
| Step 1 | 195 | ||
| Step 2 | 196 | ||
| Step 3 | 196 | ||
| Postoperative Care and Expected Outcomes | 197 | ||
| Procedure 5—Side-to-Side FDP Transfer for Restoration of Ring and Small Finger DIP Joint Flexion Strength (High Ulnar Palsy) | 197 | ||
| Exposures | 197 | ||
| Step 1 | 198 | ||
| Step 2 | 198 | ||
| Postoperative Care and Expected Outcomes | 199 | ||
| Evidence | 199 | ||
| Procedure 20 Tendon Transfers for Radial Nerve Palsy | 200 | ||
| Indications | 200 | ||
| Examination/Imaging | 200 | ||
| Clinical Examination | 200 | ||
| Imaging | 202 | ||
| Surgical Anatomy | 202 | ||
| Positioning | 203 | ||
| Exposures | 203 | ||
| Procedure | 204 | ||
| Step 1 | 204 | ||
| Step 2 | 204 | ||
| Step 3 | 204 | ||
| Step 4 | 204 | ||
| Step 5 | 204 | ||
| Step 6 | 205 | ||
| Step 7 | 205 | ||
| Step 8 | 206 | ||
| Step 9 | 206 | ||
| Step 10 | 206 | ||
| Step 11 | 206 | ||
| Postoperative Care and Expected Outcomes | 207 | ||
| Evidence | 208 | ||
| Procedure 21 Steindler Flexorplasty | 209 | ||
| Indications | 209 | ||
| Examination/Imaging | 209 | ||
| Clinical Examination | 209 | ||
| Imaging | 209 | ||
| Surgical Anatomy | 209 | ||
| Positioning | 211 | ||
| Exposures | 211 | ||
| Procedure | 213 | ||
| Step 1 | 213 | ||
| Step 2 | 213 | ||
| Step 3 | 213 | ||
| Step 4 | 214 | ||
| Step 5 | 214 | ||
| Postoperative Care and Expected Outcomes | 215 | ||
| Evidence | 215 | ||
| IV Musculotendinous Unit Lengthening and Tendon Transfers for Spastic Conditions | 217 | ||
| Procedure 22 Intrinsic Muscle Release for Thumb-in-Palm Deformity | 218 | ||
| Indications | 218 | ||
| Examination/Imaging | 218 | ||
| Clinical Examination | 218 | ||
| Surgical Anatomy | 218 | ||
| Positioning | 218 | ||
| Exposures | 220 | ||
| Procedure | 221 | ||
| Step 1 | 221 | ||
| Step 2 | 221 | ||
| Postoperative Care and Expected Outcomes | 222 | ||
| Acknowledgment | 222 | ||
| Evidence | 222 | ||
| Procedure 23 Fractional Lengthening of the Flexor Tendons | 223 | ||
| Indications | 223 | ||
| Examination/Imaging | 223 | ||
| Clinical Examination | 223 | ||
| Surgical Anatomy | 223 | ||
| Positioning | 224 | ||
| Exposures | 224 | ||
| Procedure | 224 | ||
| Step 1 | 224 | ||
| Step 2 | 225 | ||
| Step 3 | 226 | ||
| Step 4 | 227 | ||
| Postoperative Care and Expected Outcomes | 227 | ||
| Evidence | 227 | ||
| Procedure 24 Superficialis-to-Profundus Tendon Transfer | 228 | ||
| Indications | 228 | ||
| Examination/Imaging | 228 | ||
| Clinical Examination | 228 | ||
| Surgical Anatomy | 228 | ||
| Positioning | 228 | ||
| Exposures | 229 | ||
| Procedure | 230 | ||
| Step 1 | 230 | ||
| Step 2 | 231 | ||
| Step 3 | 232 | ||
| Postoperative Care and Expected Outcomes | 232 | ||
| Evidence | 232 | ||
| Procedure 25 Flexor Pronator Slide | 233 | ||
| Indications | 233 | ||
| Examination/Imaging | 233 | ||
| Clinical Examination | 233 | ||
| Surgical Anatomy | 233 | ||
| Positioning | 233 | ||
| Exposures | 234 | ||
| Procedure | 234 | ||
| Step 1 | 234 | ||
| Step 2 | 234 | ||
| Postoperative Care and Expected Outcomes | 236 | ||
| Acknowledgment | 236 | ||
| Evidence | 236 | ||
| Procedure 26 Reconstruction of Key Pinch in Tetraplegia Patients | 237 | ||
| Indications | 237 | ||
| Examination/Imaging | 237 | ||
| Clinical Examination | 237 | ||
| Surgical Anatomy | 239 | ||
| Positioning | 241 | ||
| Exposures | 241 | ||
| Procedure | 242 | ||
| Step 1: Split FPL-to-EPL Transfer | 242 | ||
| Step 2: APL Tenodesis | 243 | ||
| Step 3: EPL Tenodesis | 244 | ||
| Step 4: Tenodesis of FPL | 245 | ||
| Step 5: BR-to-ECRB Transfer | 245 | ||
| Step 6: BR-to-FPL Transfer | 245 | ||
| Step 7: Index Finger MCP Joint Flexion Using an FDS Lasso | 247 | ||
| Postoperative Care and Expected Outcomes | 248 | ||
| Evidence | 248 | ||
| Procedure 27 Flexor Carpi Ulnaris–to–Extensor Carpi Radialis Brevis Transfer | 249 | ||
| Indications | 249 | ||
| Examination/Imaging | 249 | ||
| Clinical Examination | 249 | ||
| Surgical Anatomy | 250 | ||
| Positioning | 251 | ||
| Exposures | 251 | ||
| Procedure | 252 | ||
| Step 1 | 252 | ||
| Step 2 | 252 | ||
| Step 3 | 253 | ||
| Step 4 | 254 | ||
| Postoperative Care and Expected Outcomes | 254 | ||
| Evidence | 254 | ||
| Procedure 28 Pronator Teres Rerouting | 255 | ||
| Indications | 255 | ||
| Examination/Imaging | 255 | ||
| Clinical Examination | 255 | ||
| Surgical Anatomy | 256 | ||
| Positioning | 256 | ||
| Exposures | 256 | ||
| Procedure | 259 | ||
| Step 1 | 259 | ||
| Step 2 | 259 | ||
| Step 3 | 260 | ||
| Step 4 | 260 | ||
| Step 5 | 260 | ||
| Step 6 | 261 | ||
| Step 7 | 262 | ||
| Step 8 | 262 | ||
| Postoperative Care and Expected Outcomes | 263 | ||
| Evidence | 263 | ||
| Procedure 29 Release of a Spastic Elbow Flexion Contracture | 264 | ||
| Indications | 264 | ||
| Examination/Imaging | 264 | ||
| Clinical Examination | 264 | ||
| Imaging | 265 | ||
| Surgical Anatomy | 265 | ||
| Positioning | 265 | ||
| Exposures | 266 | ||
| Procedure | 266 | ||
| Step 1 | 266 | ||
| Step 2 | 266 | ||
| Step 3 | 268 | ||
| Step 4 | 269 | ||
| Step 5 | 269 | ||
| Step 6 | 270 | ||
| Step 7 | 270 | ||
| Postoperative Care and Expected Outcomes | 270 | ||
| Evidence | 270 | ||
| V Reconstruction of Rheumatoid Hand Deformities | 271 | ||
| Procedure 30 Synovectomy | 272 | ||
| Indications | 272 | ||
| Examination/Imaging | 272 | ||
| Clinical Examination | 272 | ||
| Imaging | 272 | ||
| Surgical Anatomy | 273 | ||
| Tenosynovectomy | 274 | ||
| 1. Digital Flexor Synovectomy | 274 | ||
| Exposures | 274 | ||
| Procedure | 275 | ||
| Step 1: Synovectomy | 275 | ||
| Step 2: Checking Passive Range of Motion | 275 | ||
| Step 3: Checking for Intrinsic Tightness | 276 | ||
| Step 4: Skin Closure | 276 | ||
| VI Congenital Conditions | 331 | ||
| Procedure 36 Syndactyly Release | 332 | ||
| Indications | 332 | ||
| Examination/Imaging | 332 | ||
| Clinical Examination | 332 | ||
| Imaging | 334 | ||
| Surgical Anatomy | 334 | ||
| Positioning | 335 | ||
| Positioning Equipment | 335 | ||
| General Principles | 335 | ||
| Procedure | 335 | ||
| Release of Simple Complete Syndactyly | 335 | ||
| Exposures | 335 | ||
| Step 1: Flap Elevation | 337 | ||
| Step 2: Separation of Digits | 337 | ||
| Step 3: Inset of Skin Flaps | 339 | ||
| Step 4: Harvest of Full-Thickness Skin Graft from the Groin | 340 | ||
| Procedure | 341 | ||
| Release of Simple Complete Syndactyly and Use of Dorsal Pentagonal Flap | 341 | ||
| Exposures | 341 | ||
| Step 1: Flap Elevation | 343 | ||
| Step 2: Separation of Digits | 343 | ||
| Step 3: Inset of Skin Flaps | 344 | ||
| Postoperative Care and Expected Outcomes | 344 | ||
| Evidence | 345 | ||
| Procedure 37 Duplicated Thumb Reconstruction | 346 | ||
| Indications | 346 | ||
| Examination/Imaging | 346 | ||
| Clinical Examination | 346 | ||
| Imaging | 348 | ||
| Surgical Anatomy | 348 | ||
| Positioning | 349 | ||
| Exposures | 349 | ||
| Procedure | 350 | ||
| Reconstruction of a Type III Thumb Duplication | 350 | ||
| Step 1 | 350 | ||
| Step 2 | 351 | ||
| Step 3 | 351 | ||
| Step 4 | 352 | ||
| Step 5 | 352 | ||
| Step 6 | 352 | ||
| Step 7 | 352 | ||
| Procedure | 353 | ||
| Reconstruction of Type IV Thumb Duplication | 353 | ||
| Step 1 | 353 | ||
| Step 2 | 354 | ||
| Step 3 | 354 | ||
| Step 4 | 355 | ||
| Step 5 | 355 | ||
| Step 6 | 356 | ||
| Step 7 | 356 | ||
| Postoperative Care and Expected Outcomes | 357 | ||
| Evidence | 357 | ||
| Procedure 38 Reconstruction for Congenital Thumb Hypoplasia | 358 | ||
| Indications | 358 | ||
| Examination/Imaging | 359 | ||
| Clinical Examination | 359 | ||
| Imaging | 360 | ||
| Surgical Anatomy | 360 | ||
| Positioning | 360 | ||
| Exposures | 362 | ||
| Procedure | 364 | ||
| Step 1: Elevation of Four-Flap Z-Plasty Flaps | 364 | ||
| Step 2: Exposure of the Ulnar Collateral Ligament | 364 | ||
| Step 3: Pinning of Thumb MCP Joint | 365 | ||
| Step 4: Strengthening of the UCL | 365 | ||
| Step 5: Transposition of Four-Flap Z-Plasty Flaps | 365 | ||
| Step 6: Exposure of the APB Tendon on the Radial Aspect of the Thumb MCP Joint | 365 | ||
| Step 7: Exposure of the ADM | 366 | ||
| Step 8: Division of the Insertion of the ADM | 366 | ||
| Step 9: Elevation of the ADM | 366 | ||
| Step 10: Creation of a Subcutaneous Tunnel | 368 | ||
| Step 11: Transfer of the ADM | 368 | ||
| Step 12: Wound Closure | 369 | ||
| Postoperative Care and Expected Outcomes | 369 | ||
| Evidence | 370 | ||
| Procedure 39 Pollicization for Congenital Thumb Hypoplasia | 371 | ||
| Indications | 371 | ||
| Examination/Imaging | 371 | ||
| Clinical Examination | 371 | ||
| Imaging | 372 | ||
| Surgical Anatomy | 373 | ||
| Positioning | 373 | ||
| Exposures | 374 | ||
| Procedure | 375 | ||
| Step 1 | 375 | ||
| Step 2 | 376 | ||
| Step 3 | 377 | ||
| Step 4 | 378 | ||
| Step 5 | 378 | ||
| Step 6 | 379 | ||
| Step 7 | 380 | ||
| Step 8 | 380 | ||
| Step 9 | 380 | ||
| Step 10 | 382 | ||
| Postoperative Care and Expected Outcomes | 382 | ||
| Evidence | 382 | ||
| Procedure 40 Correction of Constriction Ring | 384 | ||
| Indications | 384 | ||
| Examination/Imaging | 384 | ||
| Clinical Examination | 384 | ||
| Imaging | 384 | ||
| Surgical Anatomy | 384 | ||
| Positioning | 385 | ||
| Exposures | 385 | ||
| Procedure | 386 | ||
| Correction of Finger Constriction Rings | 386 | ||
| Step 1: Design of Skin Flaps | 386 | ||
| Step 2: Excision of Constriction Ring and Elevation of Skin Flaps | 386 | ||
| Step 3: Excision of Excess Subcutaneous Fat | 387 | ||
| Step 4: Transposition and Suture of Z-Plasty Skin Flaps | 388 | ||
| Procedure | 388 | ||
| Correction of Proximal Limb Constriction Rings | 388 | ||
| Step 1: Design of Skin Flaps | 388 | ||
| Step 2: Excision of Constriction Ring and Elevation of Skin Flaps | 388 | ||
| Step 3: Transposition and Suture of Z-Plasty Skin Flaps | 388 | ||
| Postoperative Care and Expected Outcomes | 389 | ||
| Evidence | 389 | ||
| Procedure 41 Centralization for Radial Longitudinal Deficiency | 390 | ||
| Indications | 390 | ||
| Examination/Imaging | 390 | ||
| Clinical Examination | 390 | ||
| Imaging | 390 | ||
| Surgical Anatomy | 391 | ||
| Positioning | 391 | ||
| Exposures | 392 | ||
| Procedure | 393 | ||
| Step 1: Preliminary Soft Tissue Distraction | 393 | ||
| Step 2: Elevation of Bilobed Flap | 394 | ||
| Step 3: Dissection of Nerve and Tendons | 394 | ||
| Step 4: Ulnocarpal Joint Reduction and Centralization | 394 | ||
| Step 5: Fixation | 395 | ||
| Step 6: Wrist Stabilization | 395 | ||
| Postoperative Care and Expected Outcomes | 396 | ||
| Evidence | 396 | ||
| Procedure 42 Cleft Hand Reconstruction | 397 | ||
| Indications | 397 | ||
| Examination/Imaging | 397 | ||
| Clinical Examination | 397 | ||
| Imaging | 398 | ||
| Positioning | 398 | ||
| Exposures | 398 | ||
| Procedure | 400 | ||
| Cleft Hand Reconstruction | 400 | ||
| Step 1: Elevation of Palmar-Based Cleft Flap | 400 | ||
| Step 2: Release of Thumb and Index Finger Web Space | 402 | ||
| Step 3: Closure of Cleft | 402 | ||
| Step 4: Transfer of Cleft Flap to Resurface Thumb and Index Finger Web | 402 | ||
| Step 5: Creation of New Web Space in Cleft | 404 | ||
| Step 6 | 404 | ||
| Postoperative Care and Expected Outcomes | 405 | ||
| Evidence | 405 | ||
| Procedure 43 Carpal Wedge Osteotomy for Congenital Wrist Flexion Contracture (Arthrogryposis) | 406 | ||
| Indications | 406 | ||
| Examination/Imaging | 406 | ||
| Clinical Examination | 406 | ||
| Imaging | 407 | ||
| Surgical Anatomy | 407 | ||
| Positioning | 407 | ||
| Exposures | 408 | ||
| Procedure | 408 | ||
| Step 1 | 408 | ||
| Step 2 | 408 | ||
| Step 3 | 408 | ||
| Step 4 | 410 | ||
| Step 5 | 410 | ||
| Postoperative Care and Expected Outcomes | 410 | ||
| Evidence | 410 | ||
| VII Soft Tissue Coverage | 411 | ||
| Procedure 44 Dorsal Metacarpal Artery Perforator Flap | 412 | ||
| Indications | 412 | ||
| Examination/Imaging | 412 | ||
| Clinical Examination | 412 | ||
| Imaging | 412 | ||
| Surgical Anatomy | 413 | ||
| Positioning | 414 | ||
| Exposures | 414 | ||
| Procedure | 416 | ||
| Step 1 | 416 | ||
| Step 2 | 417 | ||
| Step 3 | 417 | ||
| Step 4 | 418 | ||
| Step 5 | 418 | ||
| Step 6 | 419 | ||
| Step 7 | 419 | ||
| Step 8 | 419 | ||
| Postoperative Care and Expected Outcomes | 419 | ||
| Evidence | 420 | ||
| Procedure 45 Dorsal Ulnar Artery Perforator Flap | 421 | ||
| Indications | 421 | ||
| Examination/Imaging | 422 | ||
| Clinical Examination | 422 | ||
| Imaging | 422 | ||
| Surgical Anatomy | 423 | ||
| Positioning | 424 | ||
| Exposures | 424 | ||
| Procedure | 425 | ||
| Step 1 | 425 | ||
| Step 2 | 426 | ||
| Step 3 | 427 | ||
| Step 4 | 427 | ||
| Step 5 | 427 | ||
| Step 6 | 428 | ||
| Step 8 | 429 | ||
| Postoperative Care and Expected Outcomes | 429 | ||
| Evidence | 430 | ||
| Procedure 46 Pedicled Groin Flap | 431 | ||
| Indications | 431 | ||
| Examination/Imaging | 432 | ||
| Clinical Examination | 432 | ||
| Surgical Anatomy | 432 | ||
| Positioning | 434 | ||
| Exposures | 434 | ||
| Procedure | 434 | ||
| Step 1: Elevation of Random Portion of Flap | 434 | ||
| Step 2 | 434 | ||
| Step 3 | 434 | ||
| Step 4: Elevation of Axial Portion of Flap | 436 | ||
| Step 5 | 436 | ||
| Step 6 | 436 | ||
| Step 7: Closure of Flap Donor Site | 437 | ||
| Step 8: Thinning of Flap | 437 | ||
| Step 9: Inset of Flap | 437 | ||
| Step 10: Immobilization of the Limb | 438 | ||
| Step 11: Flap Division | 438 | ||
| Postoperative Care and Expected Outcomes | 438 | ||
| Evidence | 439 | ||
| Procedure 47 Lateral Arm Flap for Upper Limb Coverage | 440 | ||
| Indications | 440 | ||
| Examination/Imaging | 440 | ||
| Clinical Examination | 440 | ||
| Imaging | 441 | ||
| Surgical Anatomy | 442 | ||
| Positioning | 443 | ||
| Preparation of the Recipient Site | 443 | ||
| Design of Free Lateral Arm Flap | 444 | ||
| Harvesting of the Free Lateral Arm Flap | 444 | ||
| Procedure | 445 | ||
| Step 1: Posterior Dissection | 445 | ||
| Step 2: Distal Dissection | 446 | ||
| Step 3: Anterior Dissection | 447 | ||
| Step 4: Proximal Dissection | 447 | ||
| Step 5: Division of the Vascular Pedicle | 448 | ||
| Step 6: Closure of the Donor Wound | 448 | ||
| Step 7: Flap Insertion at Recipient Site | 448 | ||
| Step 8: Design of the Pedicled Flap | 448 | ||
| Step 9: Harvesting the Pedicled Flap | 448 | ||
| Postoperative Care and Expected Outcomes | 450 | ||
| Evidence | 451 | ||
| VIII Hand Fractures, Dislocations, and Arthritis | 453 | ||
| Procedure 48 Open Reduction and Internal Fixation of Phalangeal Unicondylar Fractures | 455 | ||
| Indications | 455 | ||
| Examination/Imaging | 455 | ||
| Clinical Examination | 455 | ||
| Imaging | 455 | ||
| Surgical Anatomy | 455 | ||
| Positioning | 457 | ||
| Exposures | 457 | ||
| Procedure | 458 | ||
| Step 1 | 458 | ||
| Step 2 | 458 | ||
| Step 3 | 460 | ||
| Postoperative Care and Expected Outcomes | 460 | ||
| Evidence | 460 | ||
| Procedure 49 Open Reduction and Internal Fixation of Phalangeal Shaft Spiral or Long Oblique Fractures | 461 | ||
| Indications | 461 | ||
| Examination/Imaging | 461 | ||
| Clinical Examination | 461 | ||
| Imaging | 462 | ||
| Surgical Anatomy | 462 | ||
| Positioning | 462 | ||
| Exposures | 463 | ||
| Procedure | 463 | ||
| Step 1 | 463 | ||
| Step 2 | 463 | ||
| Step 3 | 464 | ||
| Step 4 | 464 | ||
| Step 5 | 465 | ||
| Step 6 | 465 | ||
| Postoperative Care and Expected Outcomes | 466 | ||
| Evidence | 466 | ||
| Procedure 50 Open Reduction and Internal Fixation of Phalangeal Shaft Comminuted Fractures | 467 | ||
| Indications | 467 | ||
| Examination/Imaging | 467 | ||
| Clinical Examination | 467 | ||
| Imaging | 468 | ||
| Surgical Anatomy | 468 | ||
| Positioning | 468 | ||
| Exposures | 468 | ||
| Procedure | 468 | ||
| Cerclage Wiring–Assisted Plate Fixation Technique | 470 | ||
| Step 1 | 470 | ||
| Step 2 | 470 | ||
| Step 3 | 470 | ||
| Step 4 | 472 | ||
| Step 5 | 472 | ||
| Interfragmentary Screws and Neutralization Plate Fixation Technique | 473 | ||
| Step 1 | 473 | ||
| Step 2 | 473 | ||
| Step 3 | 474 | ||
| Step 4 | 474 | ||
| Step 5 | 475 | ||
| Step 6 | 475 | ||
| Postoperative Care and Expected Outcomes | 476 | ||
| Evidence | 476 | ||
| Procedure 51 Volar Plate Arthroplasty for Dorsal Fracture-Dislocations of the Proximal Interphalangeal Joint | 477 | ||
| Indications | 477 | ||
| Examination/Imaging | 477 | ||
| Clinical Examination | 477 | ||
| Imaging | 477 | ||
| Surgical Anatomy | 478 | ||
| Positioning | 478 | ||
| Exposures | 479 | ||
| Procedure | 480 | ||
| Step 1: Incision of the Volar Plate and Joint Exposure | 480 | ||
| Step 2: Preparation of the Joint and the Volar Plate | 480 | ||
| Step 3: Reduction and Fixation | 481 | ||
| Step 4: Extension Block Pinning (Optional) | 482 | ||
| Postoperative Care and Expected Outcomes | 482 | ||
| Evidence | 483 | ||
| Procedure 52 Hemi-Hamate Arthroplasty | 484 | ||
| Indications | 484 | ||
| Examination/Imaging | 484 | ||
| Clinical Examination | 484 | ||
| Imaging | 484 | ||
| Surgical Anatomy | 484 | ||
| Positioning | 485 | ||
| Exposures | 485 | ||
| Procedure | 487 | ||
| Step 1: Preparing the Articular Surface of the Middle Phalanx | 487 | ||
| Step 2: Harvesting the Hamate Osteochondral Graft | 488 | ||
| Step 3: Graft Fixation | 489 | ||
| Step 4: Closure | 490 | ||
| Postoperative Care and Expected Outcomes | 490 | ||
| Evidence | 491 | ||
| Procedure 53 Metacarpophalangeal and Proximal Interphalangeal Joint Collateral Ligament Avulsion Fractures | 492 | ||
| Indications | 492 | ||
| Examination/Imaging | 492 | ||
| Clinical Examination | 492 | ||
| Imaging | 493 | ||
| Surgical Anatomy | 494 | ||
| Positioning | 494 | ||
| Exposures | 494 | ||
| Metacarpophalangeal Joint | 494 | ||
| Proximal Interphalangeal Joint | 495 | ||
| Procedure | 495 | ||
| Step 1: Principles and Methods of Fixation | 495 | ||
| Step 2 | 496 | ||
| Step 3 | 498 | ||
| Postoperative Care and Expected Outcomes | 499 | ||
| Evidence | 499 | ||
| Procedure 54 Metacarpal Neck Fractures | 500 | ||
| Indications | 500 | ||
| Examination/Imaging | 500 | ||
| Clinical Examination | 500 | ||
| Imaging | 501 | ||
| Surgical Anatomy | 502 | ||
| Positioning | 502 | ||
| Exposures | 503 | ||
| Procedure | 503 | ||
| Step 1: Preparation of Plate and Insertion of Blade | 503 | ||
| Step 2: Alignment of Plate with Shaft | 505 | ||
| Step 3: Compression of the Fracture | 506 | ||
| Step 4: Completion of Fixation | 508 | ||
| Step 5: Wound Closure | 509 | ||
| Additional Steps | 509 | ||
| Postoperative Care and Expected Outcomes | 511 | ||
| Evidence | 511 | ||
| Procedure 55 Metacarpal Shaft Fractures | 513 | ||
| Indications | 513 | ||
| Examination/Imaging | 513 | ||
| Clinical Examination | 513 | ||
| Imaging | 513 | ||
| Surgical Anatomy | 514 | ||
| Positioning | 514 | ||
| Exposures | 514 | ||
| Procedure | 516 | ||
| Step 1: Principles and Methods of Fixation | 516 | ||
| Step 2: Dynamic Compression Plate | 516 | ||
| Step 3: Neutralization Plate | 518 | ||
| Step 4: Completion of Fixation | 518 | ||
| Step 5: Wound Closure | 518 | ||
| Additional Steps | 518 | ||
| Postoperative Care and Expected Outcomes | 519 | ||
| Evidence | 520 | ||
| Procedure 56 Percutaneous Pinning of Bennett Fracture and Open Reduction and Internal Fixation of Rolando Fracture | 521 | ||
| Indications | 521 | ||
| Examination/Imaging | 521 | ||
| Clinical Examination | 521 | ||
| Imaging | 521 | ||
| Surgical Anatomy | 521 | ||
| Positioning | 522 | ||
| Exposures | 522 | ||
| Procedures | 524 | ||
| Closed Reduction Percutaneous Pinning of Bennett Fracture | 524 | ||
| Step 1 | 524 | ||
| Step 2 | 524 | ||
| Alternative 1 | 524 | ||
| Alternative 2 | 526 | ||
| IX Thumb Carpometacarpal Joint Instability and Arthritis | 575 | ||
| Procedure 61 Trapeziometacarpal Ligament Reconstruction | 576 | ||
| Indications | 576 | ||
| Examination/Imaging | 576 | ||
| Clinical Examination | 576 | ||
| Imaging | 576 | ||
| Surgical Anatomy | 576 | ||
| Positioning | 578 | ||
| Exposures | 578 | ||
| Procedure | 578 | ||
| Step 1 | 578 | ||
| Step 2 | 579 | ||
| Step 3 | 580 | ||
| Step 4 | 580 | ||
| Postoperative Care and Expected Outcomes | 580 | ||
| Evidence | 581 | ||
| Procedure 62 Trapeziectomy and Abductor Pollicis Longus Suspensionplasty | 582 | ||
| Indications | 582 | ||
| Examination/Imaging | 582 | ||
| Clinical Examination | 582 | ||
| Imaging | 583 | ||
| Surgical Anatomy | 584 | ||
| Positioning | 584 | ||
| Exposures | 584 | ||
| Procedure | 585 | ||
| Step 1 | 585 | ||
| Step 2 | 585 | ||
| Step 3 | 585 | ||
| Step 4 | 587 | ||
| Step 5 | 588 | ||
| Step 6 | 588 | ||
| Step 7 | 588 | ||
| Step 8 | 588 | ||
| Step 9 | 588 | ||
| Postoperative Care and Expected Outcomes | 591 | ||
| Evidence | 591 | ||
| Procedure 63 Trapeziometacarpal Fusion | 593 | ||
| Indications | 593 | ||
| Examination/Imaging | 593 | ||
| Clinical Examination | 593 | ||
| Imaging | 593 | ||
| Surgical Anatomy | 594 | ||
| Positioning | 594 | ||
| Exposures | 594 | ||
| Procedure | 595 | ||
| Step 1 | 595 | ||
| Step 2 | 595 | ||
| Step 3 | 595 | ||
| Step 4 | 595 | ||
| Step 5 | 596 | ||
| Postoperative Care and Expected Outcomes | 597 | ||
| Evidence | 597 | ||
| X Wrist Arthroscopy | 599 | ||
| Procedure 64 Diagnostic Wrist Arthroscopy | 600 | ||
| Indications | 600 | ||
| Examination/Imaging | 600 | ||
| Clinical Examination | 600 | ||
| Imaging | 601 | ||
| Surgical Anatomy | 601 | ||
| Exposures | 604 | ||
| Procedure | 606 | ||
| Step 1 | 606 | ||
| Step 2 | 606 | ||
| Step 3 | 606 | ||
| Step 4 | 608 | ||
| Step 5 | 608 | ||
| Postoperative Care and Expected Outcomes | 611 | ||
| Evidence | 611 | ||
| Procedure 65 Arthroscopic Treatment for Septic Arthritis | 612 | ||
| Indications | 612 | ||
| Examination/Imaging | 612 | ||
| Clinical Examination | 612 | ||
| Imaging | 612 | ||
| Surgical Anatomy | 612 | ||
| Positioning | 613 | ||
| Exposures | 613 | ||
| Procedure | 614 | ||
| Step 1 | 614 | ||
| Step 2 | 614 | ||
| Step 3: Radiocarpal Evaluation | 615 | ||
| Step 4: Midcarpal Evaluation | 616 | ||
| Postoperative Care and Expected Outcomes | 616 | ||
| Evidence | 616 | ||
| Procedure 66 Arthroscopic Ganglionectomy | 617 | ||
| Indications | 617 | ||
| Examination/Imaging | 617 | ||
| Clinical Examination | 617 | ||
| Imaging | 617 | ||
| Surgical Anatomy | 618 | ||
| Positioning | 618 | ||
| Exposures | 619 | ||
| Procedure | 620 | ||
| Step 1 | 620 | ||
| Step 2 | 620 | ||
| Step 3 | 622 | ||
| Step 4 | 622 | ||
| Postoperative Care and Expected Outcomes | 622 | ||
| Evidence | 622 | ||
| Procedure 67 Arthroscopic Triangular Fibrocartilage Complex Repair | 623 | ||
| Indications | 623 | ||
| Examination/Imaging | 623 | ||
| Clinical Examination | 623 | ||
| Imaging | 623 | ||
| Surgical Anatomy | 623 | ||
| Positioning | 624 | ||
| Exposures | 624 | ||
| Procedure | 625 | ||
| Step 1 | 625 | ||
| Step 2 | 626 | ||
| Step 3 | 627 | ||
| Step 4 | 628 | ||
| Step 5: Arthroscopic Knotless Technique | 628 | ||
| Step 6 | 629 | ||
| Step 7 | 630 | ||
| Postoperative Care and Expected Outcomes | 632 | ||
| Evidence | 632 | ||
| XI Carpal Fractures and Ligamentous Instability | 633 | ||
| Procedure 68 Percutaneous Screw Fixation of Scaphoid Fractures | 634 | ||
| Indications | 634 | ||
| Examination/Imaging | 634 | ||
| Clinical Examination | 634 | ||
| Imaging | 634 | ||
| Surgical Anatomy | 634 | ||
| Positioning | 637 | ||
| Exposures | 637 | ||
| Procedure | 637 | ||
| Step 1: Dorsal Approach—Finding the Starting Point | 637 | ||
| Step 2: Reducing the Fracture (if Necessary) | 638 | ||
| Step 3: Placing the Guidewire | 638 | ||
| Step 4: Reaming | 640 | ||
| Step 5: Screw Insertion | 641 | ||
| Postoperative Care and Expected Outcomes | 642 | ||
| Evidence | 642 | ||
| Procedure 69 Vascularized Bone Grafting for Scaphoid Nonunion | 643 | ||
| Indications | 643 | ||
| Examination/Imaging | 643 | ||
| Clinical Examination | 643 | ||
| Imaging | 643 | ||
| Surgical Anatomy | 645 | ||
| Positioning | 645 | ||
| Exposures | 646 | ||
| Procedure | 647 | ||
| Step 1: Cutting the Graft | 647 | ||
| Step 2: Elevate the Graft and Pedicle | 647 | ||
| Step 3: Scaphoid Preparation and Fixation | 648 | ||
| Step 4: Insetting the Graft | 648 | ||
| Step 5: Closure | 650 | ||
| Postoperative Care and Expected Outcomes | 650 | ||
| Evidence | 650 | ||
| Procedure 70 Medial Femoral Condyle Vascularized Bone Flap for Scaphoid Nonunion | 651 | ||
| Indications | 651 | ||
| Examination/Imaging | 651 | ||
| Clinical Examination | 651 | ||
| Imaging | 651 | ||
| Surgical Anatomy | 652 | ||
| Recipient Site: Vascular Anatomy of Scaphoid | 652 | ||
| Donor Site: Medial Femoral Condyle | 652 | ||
| Positioning | 652 | ||
| Exposures | 653 | ||
| Procedure | 653 | ||
| Team 1: Donor Site (Bone Graft Harvest) | 653 | ||
| Step 1 | 653 | ||
| Step 2 | 654 | ||
| Step 3 | 654 | ||
| Step 4 | 654 | ||
| Step 5 | 654 | ||
| Step 6 | 655 | ||
| Step 7 | 655 | ||
| Step 8 | 655 | ||
| Step 9 | 656 | ||
| Team 2: Recipient Site Preparation and Microanastomosis | 656 | ||
| Step 1 | 656 | ||
| Step 2 | 656 | ||
| Step 3 | 656 | ||
| Step 4 | 656 | ||
| Step 5 | 657 | ||
| Step 6 | 658 | ||
| Step 7 | 658 | ||
| Step 8 | 658 | ||
| Step 9 | 658 | ||
| Postoperative Care and Expected Outcomes | 659 | ||
| Evidence | 659 | ||
| Procedure 71 Open Reduction and Acute Repair of Perilunate Fracture-Dislocations | 660 | ||
| Indications | 660 | ||
| Examination/Imaging | 660 | ||
| Clinical Examination | 660 | ||
| Imaging | 660 | ||
| Surgical Anatomy | 662 | ||
| Positioning | 663 | ||
| Exposures | 663 | ||
| Procedure | 663 | ||
| Step 1: Volar Approach | 663 | ||
| Step 2: Dorsal Approach | 664 | ||
| Step 3 | 665 | ||
| Step 4 | 665 | ||
| Step 5 | 666 | ||
| Additional Steps | 666 | ||
| Postoperative Care and Expected Outcomes | 667 | ||
| Evidence | 667 | ||
| Procedure 72 Dorsal Capsulodesis for Scapholunate Instability Using Suture Anchors | 668 | ||
| Indications | 668 | ||
| Examination/Imaging | 669 | ||
| Clinical Examination | 669 | ||
| Imaging | 669 | ||
| Surgical Anatomy | 670 | ||
| Exposures | 670 | ||
| Procedure | 671 | ||
| Step 1: Reduction of Scaphoid and Lunate | 671 | ||
| Step 2: Maintenance of SL Reduction | 672 | ||
| Step 3: Make a Drill Hole in the Scaphoid, and Insert a Bone Anchor | 672 | ||
| Step 4: Secure the Dorsal Capsule to the Scaphoid | 672 | ||
| Step 5: Assess Final Fixation | 672 | ||
| Step 6: Dorsal Capsular Repair | 674 | ||
| Step 7: Closure | 674 | ||
| Postoperative Care and Expected Outcomes | 674 | ||
| Evidence | 675 | ||
| Procedure 73 Scapholunate Ligament Reconstruction Using a Flexor Carpi Radialis Tendon Graft | 676 | ||
| Indications | 676 | ||
| Examination/Imaging | 676 | ||
| Clinical Examination | 676 | ||
| Imaging | 676 | ||
| Surgical Anatomy | 679 | ||
| Exposures | 680 | ||
| Dorsal | 680 | ||
| Volar | 680 | ||
| Procedure | 682 | ||
| Step 1: Excise Scar Tissue between the Scaphoid and Lunate | 682 | ||
| Step 2: Reduction of Scaphoid and Lunate | 682 | ||
| Step 3: Create a Bone Tunnel within Scaphoid | 682 | ||
| Step 4: Harvest a Strip of Distally Based FCR | 683 | ||
| Step 5: Pass the FCR through the Scaphoid Tunnel | 684 | ||
| Step 6: Reduce SL Interval | 684 | ||
| Step 7: Secure the FCR to the Lunate | 684 | ||
| Step 8: Repair of Dorsal Wrist Capsule | 686 | ||
| Step 9: Closure | 686 | ||
| Postoperative Care and Expected Outcomes | 686 | ||
| Evidence | 687 | ||
| Procedure 74 Lunotriquetral Ligament Reconstruction Using a Slip of the Extensor Carpi Ulnaris Tendon | 688 | ||
| Indications | 688 | ||
| Examination/Imaging | 688 | ||
| Clinical Examination | 688 | ||
| Imaging | 688 | ||
| Surgical Anatomy | 689 | ||
| Exposures | 691 | ||
| Dorsal | 691 | ||
| Procedure | 692 | ||
| Step 1: Excise Scar Tissue between the Lunate and Triquetrum | 692 | ||
| Step 2: Harvest a Strip of Distally Based ECU | 692 | ||
| Step 3: Reduction of Lunate and Triquetrum | 692 | ||
| Step 4: Create a Bone Tunnel within Triquetrum and Lunate | 694 | ||
| Step 5: Pass the ECU through the Lunate and Triquetrum Tunnel | 694 | ||
| Step 6: Secure the ECU Graft to Itself and over the Remnant of the LT Ligament | 694 | ||
| Step 7: Closure | 696 | ||
| Postoperative Care and Expected Outcomes | 696 | ||
| Evidence | 696 | ||
| Procedure 75 Scaphotrapeziotrapezoid Arthrodesis and Lunate Excision with Replacement by Palmaris Longus Tendon | 697 | ||
| Indications | 697 | ||
| Examination/Imaging | 697 | ||
| Clinical Examination | 697 | ||
| Imaging | 697 | ||
| Plain Radiographs | 697 | ||
| Computed Tomography | 699 | ||
| Magnetic Resonance Imaging | 700 | ||
| Bone Scan | 700 | ||
| Controversies | 700 | ||
| Positioning | 700 | ||
| Exposures | 701 | ||
| Procedure | 701 | ||
| Step 1 | 701 | ||
| Step 2 | 703 | ||
| Step 3 | 704 | ||
| Step 4 | 705 | ||
| Step 5 | 705 | ||
| Postoperative Care and Expected Outcomes | 705 | ||
| Evidence | 705 | ||
| XII Distal Radius Fractures and Distal Radioulnar Joint Repair and Reconstruction | 707 | ||
| Procedure 76 Percutaneous Pinning of Distal Radius Fractures | 708 | ||
| Indications | 708 | ||
| Examination/Imaging | 708 | ||
| Clinical Examination | 708 | ||
| Imaging | 708 | ||
| Surgical Anatomy | 708 | ||
| Positioning | 709 | ||
| Exposures | 709 | ||
| Procedure | 710 | ||
| Step 1 | 710 | ||
| Step 2 | 711 | ||
| Step 3 | 713 | ||
| Step 4 | 713 | ||
| Postoperative Care and Expected Outcomes | 714 | ||
| Evidence | 716 | ||
| Procedure 77 Volar Plating of Distal Radius Fractures | 717 | ||
| Indications | 717 | ||
| Examination/Imaging | 717 | ||
| Clinical Examination | 717 | ||
| Imaging | 717 | ||
| Surgical Anatomy | 718 | ||
| Positioning | 719 | ||
| Exposures | 719 | ||
| Procedure | 721 | ||
| Step 1 | 721 | ||
| Step 2 | 722 | ||
| Step 3 | 723 | ||
| Step 4 | 724 | ||
| Postoperative Care and Expected Outcomes | 725 | ||
| Evidence | 725 | ||
| Procedure 78 Dorsal Plate Fixation | 727 | ||
| Dorsal Plating of Distal Radius Fractures | 727 | ||
| Indications | 727 | ||
| Examination/Imaging | 727 | ||
| Clinical Examination | 727 | ||
| Imaging | 727 | ||
| Surgical Anatomy | 728 | ||
| Exposures | 730 | ||
| Procedure | 731 | ||
| Dorsal Plate Fixation for Distal Radius Fractures | 731 | ||
| Step 1: Reduction of Dorsally Angulated Fractures | 731 | ||
| Step 2: Fixation of Dorsally Angulated Fractures | 731 | ||
| Step 3: Reduction and Fixation of Dorsal Marginal Fractures | 732 | ||
| Step 4: Reduction and Fixation of Lunate Facet Fractures | 734 | ||
| Step 5: Assessment of DRUJ Stability and Wound Closure | 735 | ||
| Postoperative Care and Expected Outcomes | 735 | ||
| Dorsal Distraction (Bridge) Plating | 736 | ||
| Indications | 736 | ||
| Examination/Imaging | 736 | ||
| Clinical Examination | 736 | ||
| Imaging | 736 | ||
| Surgical Anatomy | 737 | ||
| Exposures | 737 | ||
| Procedure | 738 | ||
| Dorsal Distraction (Bridge) Plating | 738 | ||
| Step 1: Selection of an Appropriate-Length Plate | 738 | ||
| Step 2: Retrograde Passage of the Plate | 739 | ||
| Step 3: Initial Plate Fixation to the Index Metacarpal | 740 | ||
| Step 4: Plate Fixation to the Radial Shaft | 740 | ||
| Step 5: Fixation of the Articular Surface and Diaphyseal Fragments (if Necessary) | 741 | ||
| Postoperative Care and Expected Outcomes | 742 | ||
| Evidence | 742 | ||
| Procedure 79 External Fixation of Comminuted Intra-articular Distal Radius Fractures | 745 | ||
| Indications | 745 | ||
| Examination/Imaging | 745 | ||
| Clinical Examination | 745 | ||
| Imaging | 745 | ||
| Surgical Anatomy | 746 | ||
| Positioning | 747 | ||
| Exposures | 747 | ||
| Procedure | 748 | ||
| Step 1 | 748 | ||
| Step 2 | 748 | ||
| Step 3 | 750 | ||
| Postoperative Care and Expected Outcomes | 751 | ||
| Evidence | 753 | ||
| Procedure 80 Corrective Osteotomy of Malunited Distal Radius Fractures | 755 | ||
| Indications | 755 | ||
| Relative Indications for Osteotomy | 756 | ||
| Relative Contraindications for Osteotomy | 757 | ||
| Examination/Imaging | 757 | ||
| Clinical Examination | 757 | ||
| Imaging | 757 | ||
| Timing | 758 | ||
| Positioning | 759 | ||
| Exposures | 759 | ||
| Volar | 759 | ||
| Dorsal | 760 | ||
| Procedure | 761 | ||
| Volar Approach—Dorsal Malunion | 761 | ||
| Step 1 | 761 | ||
| Step 2 | 762 | ||
| Step 3 | 762 | ||
| Step 4 | 764 | ||
| Postoperative Care and Expected Outcomes | 764 | ||
| Procedure | 764 | ||
| Correction of Volar Malunions | 764 | ||
| Procedure | 766 | ||
| Dorsal Approach | 766 | ||
| Step 1 | 766 | ||
| Step 2 | 767 | ||
| Step 3 | 767 | ||
| Step 4 | 768 | ||
| Postoperative Care and Expected Outcomes | 768 | ||
| Evidence | 768 | ||
| Procedure 81 Ulnar Shortening Osteotomy | 769 | ||
| Indications | 769 | ||
| Examination/Imaging | 769 | ||
| Clinical Examination | 769 | ||
| Imaging | 770 | ||
| Surgical Anatomy | 772 | ||
| Positioning | 772 | ||
| Exposures | 773 | ||
| Procedure | 774 | ||
| Step 1: Preparation of Osteotomy Site | 774 | ||
| Step 2: Placement of Saw Guide | 774 | ||
| Step 3: Performing Oblique Osteotomy | 776 | ||
| Step 4: Application of Plate, Compression Device, and Compression of Osteotomy | 777 | ||
| Step 5: Placement of Interfragmentary Lag Screw | 778 | ||
| Step 6: Final Fixation of Plate | 778 | ||
| Step 7: Wound Closure | 779 | ||
| Postoperative Care and Expected Outcomes | 779 | ||
| Evidence | 780 | ||
| Procedure 82 Radioulnar Ligament Reconstruction for Chronic Distal Radioulnar Joint Instability | 781 | ||
| Indications | 781 | ||
| Examination/Imaging | 781 | ||
| Clinical Examination | 781 | ||
| Imaging | 783 | ||
| Surgical Anatomy | 785 | ||
| Positioning | 786 | ||
| Exposures | 787 | ||
| Procedure | 788 | ||
| Step 1: Development of Volar Plane | 788 | ||
| Step 2: Development of Dorsal Plane | 788 | ||
| Step 3: Harvest of Palmaris Longus Tendon Graft | 789 | ||
| Step 4: Creation of Bone Tunnel in the Radius | 789 | ||
| Step 5: Passage of Tendon Graft | 790 | ||
| Step 6: Creation of Bone Tunnel in Ulna | 790 | ||
| Step 7: Passage of Tendon Graft through Ulna | 791 | ||
| Step 8: Reduction and Pinning of DRU Joint | 791 | ||
| Step 9: Suture Fixation of Reconstructed Ligaments | 792 | ||
| Step 10: Closure | 792 | ||
| Postoperative Care and Expected Outcomes | 793 | ||
| Evidence | 794 | ||
| Procedure 83 Darrach Procedure | 795 | ||
| Indications | 795 | ||
| Examination/Imaging | 795 | ||
| Clinical Examination | 795 | ||
| Imaging | 796 | ||
| Surgical Anatomy | 796 | ||
| Positioning | 796 | ||
| Exposures | 796 | ||
| Procedure | 798 | ||
| Step 1 | 798 | ||
| Step 2 | 798 | ||
| Step 3 | 799 | ||
| Postoperative Care and Expected Outcomes | 799 | ||
| Evidence | 800 | ||
| Procedure 84 Sauve-Kapandji Arthrodesis for Distal Radioulnar Joint Arthritis | 801 | ||
| Indications | 801 | ||
| Examination/Imaging | 801 | ||
| Clinical Examination | 801 | ||
| Imaging | 801 | ||
| Surgical Anatomy | 802 | ||
| Positioning | 802 | ||
| Exposures | 802 | ||
| Procedure | 804 | ||
| Step 1 | 804 | ||
| Step 2 | 804 | ||
| Step 3 | 804 | ||
| Step 4 | 805 | ||
| Procedure | 805 | ||
| Modified Sauve-Kapandji Procedure | 805 | ||
| Step 1 | 805 | ||
| Step 2 | 806 | ||
| Step 3 | 806 | ||
| Step 4 | 806 | ||
| Postoperative Care and Expected Outcomes | 807 | ||
| Evidence | 808 | ||
| XIII Wrist Osteoarthritis | 809 | ||
| Procedure 85 Wrist Denervation | 810 | ||
| Indications | 810 | ||
| Examination/Imaging | 811 | ||
| Clinical Examination | 811 | ||
| Surgical Anatomy | 812 | ||
| Positioning | 812 | ||
| Exposures | 812 | ||
| Procedure | 813 | ||
| Step 1: Partial Denervation | 813 | ||
| Step 2: Full Denervation: Incision 2 | 815 | ||
| Step 3: Full Denervation: Incision 3 | 815 | ||
| Step 4: Full Denervation: Incision 4 | 816 | ||
| Postoperative Care and Expected Outcomes | 816 | ||
| Acknowledgment | 816 | ||
| Evidence | 816 | ||
| Procedure 86 Proximal Row Carpectomy | 817 | ||
| Indications | 817 | ||
| Examination/Imaging | 817 | ||
| Clinical Examination | 817 | ||
| Imaging | 817 | ||
| Surgical Anatomy | 818 | ||
| Positioning | 819 | ||
| Exposures | 819 | ||
| Procedure | 820 | ||
| Step 1 | 820 | ||
| Step 2 | 820 | ||
| Step 3 | 821 | ||
| Step 4 | 821 | ||
| Step 5 | 822 | ||
| Additional Steps | 822 | ||
| Postoperative Care and Expected Outcomes | 823 | ||
| Evidence | 823 | ||
| Procedure 87 Four-Corner Fusion | 824 | ||
| Indications | 824 | ||
| Examination/Imaging | 824 | ||
| Clinical Examination | 824 | ||
| Imaging | 824 | ||
| Surgical Anatomy | 824 | ||
| Positioning | 826 | ||
| Exposures | 826 | ||
| Procedure | 828 | ||
| Step 1 | 828 | ||
| Step 2 | 828 | ||
| Step 3 | 829 | ||
| Step 4 | 830 | ||
| Step 5 | 830 | ||
| Additional Steps | 831 | ||
| Postoperative Care and Expected Outcomes | 831 | ||
| Evidence | 832 | ||
| Procedure 88 Four-Corner Fusion Using a Circular Plate | 833 | ||
| Indications | 833 | ||
| Examination/Imaging | 833 | ||
| Clinical Examination | 833 | ||
| Imaging | 834 | ||
| Surgical Anatomy | 834 | ||
| Exposures | 835 | ||
| Procedure | 835 | ||
| Step 1: Scaphoidectomy | 835 | ||
| Step 2: The Lunate Is Stabilized in Neutral Position | 836 | ||
| Step 3: Stabilize the Carpal Bones with K-Wires | 837 | ||
| Step 4: Ream the Carpal Bones | 837 | ||
| Step 5: Denude the Cartilage between the Four Bones | 838 | ||
| Step 6: Fix the Circular Plate | 838 | ||
| Step 7: Pack Bone Graft | 838 | ||
| Step 8: Remove the Plate Post and Apply the Screw Cover | 839 | ||
| Step 9: Assess Final Fixation | 840 | ||
| Step 10: Closure | 840 | ||
| Postoperative Care and Expected Outcomes | 841 | ||
| Evidence | 841 | ||
| Procedure 89 Total Wrist Fusion | 843 | ||
| Indications | 843 | ||
| Examination/Imaging | 843 | ||
| Clinical Examination | 843 | ||
| Imaging | 843 | ||
| Surgical Anatomy | 843 | ||
| Positioning | 843 | ||
| Exposures | 844 | ||
| Procedure | 845 | ||
| Step 1 | 845 | ||
| Step 2 | 846 | ||
| Step 3 | 846 | ||
| Step 4 | 848 | ||
| Postoperative Care and Expected Outcomes | 848 | ||
| Evidence | 849 | ||
| Procedure 90 Total Wrist Arthroplasty | 850 | ||
| Indications | 850 | ||
| Examination/Imaging | 850 | ||
| Clinical Examination | 850 | ||
| Imaging | 850 | ||
| Surgical Anatomy | 851 | ||
| Positioning | 851 | ||
| Exposures | 851 | ||
| Procedure | 852 | ||
| Step 1 | 852 | ||
| Step 2 | 854 | ||
| Step 3 | 855 | ||
| Step 4 | 856 | ||
| Step 5 | 856 | ||
| Step 6 | 858 | ||
| Step 7 | 858 | ||
| Step 8 | 859 | ||
| Step 9 | 859 | ||
| Step 10 | 860 | ||
| Postoperative Care and Expected Outcomes | 861 | ||
| Evidence | 862 | ||
| XIV Tumors | 863 | ||
| Procedure 91 Treatment of Mucous Cysts of the Distal Interphalangeal Joint | 864 | ||
| Indications | 864 | ||
| Examination/Imaging | 864 | ||
| Clinical Examination | 864 | ||
| Imaging | 864 | ||
| Surgical Anatomy | 864 | ||
| Positioning | 865 | ||
| Exposures | 866 | ||
| Procedure | 866 | ||
| Step 1: Mobilization of Cyst | 866 | ||
| Step 2: Removal of the Cyst | 867 | ||
| Step 3: Removal of DIP Joint Osteophytes | 867 | ||
| Step 4: Flap Elevation | 867 | ||
| Step 5: Skin Closure | 868 | ||
| Postoperative Care and Expected Outcomes | 868 | ||
| Evidence | 868 | ||
| Procedure 92 Excision of a Dorsal Wrist Ganglion | 869 | ||
| Indications | 869 | ||
| Examination/Imaging | 869 | ||
| Clinical Examination | 869 | ||
| Imaging | 870 | ||
| Surgical Anatomy | 870 | ||
| Positioning | 870 | ||
| Exposures | 870 | ||
| Procedure | 870 | ||
| Step 1: Mobilization of Ganglion Cyst | 870 | ||
| Step 2: Excision of Ganglion Cyst | 871 | ||
| Step 3: Hemostasis | 872 | ||
| Step 4: Skin Closure | 872 | ||
| Postoperative Care and Expected Outcomes | 872 | ||
| Evidence | 872 | ||
| Procedure 93 Digital Ray Amputation | 873 | ||
| Indications | 873 | ||
| Examination/Imaging | 873 | ||
| Clinical Examination | 873 | ||
| Imaging | 873 | ||
| Surgical Anatomy | 874 | ||
| Positioning | 874 | ||
| Exposures | 874 | ||
| Procedure | 875 | ||
| Step 1 | 875 | ||
| Step 2 | 875 | ||
| Step 3 | 875 | ||
| Step 4 | 876 | ||
| Step 5 | 876 | ||
| Step 6 | 876 | ||
| Step 7 | 876 | ||
| Step 8 | 876 | ||
| Step 9 | 876 | ||
| Step 10 | 877 | ||
| Step 11 | 877 | ||
| Postoperative Care and Expected Outcomes | 878 | ||
| Evidence | 879 | ||
| Index | 881 | ||
| A | 881 | ||
| B | 881 | ||
| C | 882 | ||
| D | 883 | ||
| E | 884 | ||
| F | 885 | ||
| G | 886 | ||
| H | 887 | ||
| I | 887 | ||
| J | 887 | ||
| K | 887 | ||
| L | 887 | ||
| M | 888 | ||
| N | 888 | ||
| O | 889 | ||
| P | 889 | ||
| R | 890 | ||
| S | 891 | ||
| T | 893 | ||
| U | 895 | ||
| V | 896 | ||
| W | 896 | ||
| Z | 896 | ||
| Endsheet3 | bm_ii | ||
| Inside front cover | ifc1 |