BOOK
McRae's Orthopaedic Trauma and Emergency Fracture Management
Timothy O White | Samuel P Mackenzie | Alasdair J Gray
(2015)
Additional Information
Book Details
Abstract
This book is derived from Ronald McRae’s Pocketbook of Orthopaedics and Fractures, a highly successful ‘survival guide’ for the trainee working in accident and emergency or orthopaedic departments. Retaining the underlying principles of the original editions this comprehensive rewrite and re-presentation provides complete coverage of orthopaedic trauma surgery as relevant to contemporary practice.
- McRae's Orthopaedic Trauma and Emergency Fracture Management
- This book is a fully rewritten text based on a classic textbook by Mr Ronald McRae.
- Now in a larger page size the book contains over 500 illustrations all drawn in two colours for this new edition.
- Over 250 x-rays accompany the text, many of which are connected with the line drawings to ease interpretation.
Table of Contents
Section Title | Page | Action | Price |
---|---|---|---|
Front Cover | cover | ||
Inside Front Cover | ifc1 | ||
Half title page | i | ||
Ronald McRae (1926–2012) | ii | ||
McRae's Orthopaedic Trauma and Emergency Fracture Management | iii | ||
Copyright Page | iv | ||
Table Of Contents | v | ||
Preface | ix | ||
Dedications and acknowledgements | x | ||
Contributors | xi | ||
1 General Principles | 1 | ||
1 Fractures and fracture management | 2 | ||
Orthopaedic terminology | 2 | ||
Fracture types and patterns | 2 | ||
Aetiology | 2 | ||
Traumatic fractures | 2 | ||
Pathological fractures (Fig. 1.1) | 2 | ||
Insufficiency fractures (Fig. 1.2) | 2 | ||
Fatigue (or stress) fractures (Fig. 1.3) | 3 | ||
Morphology | 3 | ||
Transverse and oblique fractures (Fig. 1.4) | 3 | ||
Spiral fractures (Fig. 1.5) | 3 | ||
Avulsion fractures (Fig. 1.6) | 3 | ||
Impaction fractures (Fig. 1.7) | 4 | ||
Paediatric fractures (Fig. 1.8) | 4 | ||
Severity | 5 | ||
Open fractures (see Fig. 3.1) | 5 | ||
Intra-articular fractures (Fig. 1.9) | 5 | ||
Comminution (Fig. 1.10) | 5 | ||
Joint dislocation (Fig. 1.11) | 5 | ||
Fracture-dislocation (Fig. 1.12) | 6 | ||
Sprains (Fig. 1.13) | 6 | ||
Location (Fig. 1.14) | 6 | ||
Displacement | 7 | ||
Displacement in length (Fig. 1.16) | 7 | ||
Displacement by angulation (Figs 1.17, 1.18) | 7 | ||
Displacement by rotation (Fig. 1.19) | 8 | ||
Displacement by translation (Fig. 1.20) | 8 | ||
Classification systems | 10 | ||
AO comprehensive classification system | 10 | ||
AO classification of shaft fractures (Fig. 1.22) | 11 | ||
AO classification of metaphyseal fractures (Fig. 1.23) | 11 | ||
Assessment of a fracture | 12 | ||
History | 12 | ||
History of injury | 12 | ||
Medical and drug history | 12 | ||
Social history | 12 | ||
Examination | 12 | ||
Look | 12 | ||
Feel (Fig. 1.24) | 13 | ||
Move | 13 | ||
Neurovascular assessment | 13 | ||
Radiological assessment | 13 | ||
Radiographs | 13 | ||
Ultrasound | 14 | ||
Computed tomography (CT) | 14 | ||
Magnetic resonance imaging (MRI) | 14 | ||
Aspiration | 14 | ||
Blood tests | 14 | ||
Principles of fracture management | 15 | ||
Reduce | 15 | ||
Direct reduction | 15 | ||
Indirect reduction | 15 | ||
Hold | 15 | ||
Stable fractures | 15 | ||
Unstable fractures | 16 | ||
Move | 16 | ||
Bone structure and healing | 16 | ||
Bone anatomy (Fig. 1.28) | 16 | ||
Fracture healing | 17 | ||
Secondary bone healing (healing with callus) (Fig. 1.29) | 17 | ||
Primary bone healing (Fig. 1.30) | 18 | ||
Assessment of healing | 18 | ||
How to present a radiograph | 18 | ||
Description of a distal radial fracture | 19 | ||
Description of an ankle fracture | 19 | ||
Description of a hip fracture | 20 | ||
2 Management of the injured patient | 21 | ||
Major trauma | 21 | ||
The anatomy of the trauma system and team | 21 | ||
The trauma system | 21 | ||
The trauma team | 21 | ||
Primary survey | 21 | ||
A – airway with cervical spine control | 21 | ||
B – breathing with 100% oxygen | 21 | ||
C – circulation with haemorrhage control | 21 | ||
Hypovolaemic shock | 22 | ||
D – disability | 23 | ||
E – exposure | 23 | ||
Secondary survey | 23 | ||
Tertiary survey | 24 | ||
Imaging in trauma | 24 | ||
Radiographs | 24 | ||
CT | 24 | ||
Intravascular fluid replacement in major trauma | 25 | ||
Blood | 25 | ||
Blood products | 25 | ||
Antifibrinolytic drugs | 26 | ||
Major haemorrhage protocols and packs | 26 | ||
Decision-making in trauma | 26 | ||
Response to resuscitation | 26 | ||
The lethal triad | 26 | ||
Disposition from the resuscitation room | 27 | ||
Orthopaedic decision-making: early total care and damage control orthopaedics | 28 | ||
Early total care | 28 | ||
Damage limitation surgery | 28 | ||
Early appropriate care | 28 | ||
The stress response to trauma | 28 | ||
The ‘second hit’ | 29 | ||
Management of the stress response, MODS and ARDS | 29 | ||
Anaesthesia and analgesia | 30 | ||
Types of anaesthesia | 30 | ||
Local anaesthetic agents | 30 | ||
Preparation for local anaesthesia | 31 | ||
Haematoma block | 31 | ||
Technique (Fig. 2.7) | 31 | ||
Regional nerve blockade | 32 | ||
Sensory nerve supply to the hand | 32 | ||
Ring block (digital nerve block) | 32 | ||
Technique (Fig. 2.8) | 32 | ||
Metacarpal block | 33 | ||
Technique (Fig. 2.9) | 33 | ||
Ulnar nerve block | 33 | ||
Technique (Fig. 2.10) | 33 | ||
Median nerve block | 34 | ||
Technique (Fig. 2.11) | 34 | ||
Fascia iliaca block | 34 | ||
Technique (Fig. 2.12) | 34 | ||
Regional intravenous anaesthesia | 35 | ||
Analgesia | 35 | ||
Trauma in the elderly | 35 | ||
History of the presenting complaint | 35 | ||
Past medical history | 36 | ||
Cognitive assessment | 36 | ||
Social history | 37 | ||
Drug history | 37 | ||
Examination | 38 | ||
Investigations | 38 | ||
Common medical problems | 38 | ||
Delirium | 38 | ||
Dehydration and electrolyte imbalance | 38 | ||
Cardiac dysrhythmias | 38 | ||
Myocardial infarction | 39 | ||
Infection | 39 | ||
Pathological fractures | 39 | ||
Postoperative management | 39 | ||
Analgesia | 39 | ||
Falls and fracture prevention | 39 | ||
3 Limb-threatening injuries | 40 | ||
Closed soft tissue injuries | 40 | ||
Contusion | 40 | ||
Haematoma | 40 | ||
Swelling | 40 | ||
Tenting | 40 | ||
Blisters | 40 | ||
Degloving | 40 | ||
Open fractures | 41 | ||
Classification | 41 | ||
Emergency Department management | 41 | ||
History | 41 | ||
Examination | 41 | ||
Treatment | 42 | ||
Orthopaedic management | 42 | ||
Emergency surgery indications | 42 | ||
Urgent surgery (<24 hours) indications | 42 | ||
Principles of surgery in open fractures | 43 | ||
1. Set-up | 43 | ||
2. Wound debridement | 43 | ||
3. Fracture stabilization | 43 | ||
4. Wound closure | 44 | ||
5. Repeated inspection and debridement | 44 | ||
6. Soft tissue reconstruction | 44 | ||
7. Bone defect reconstruction | 45 | ||
Compartment syndrome | 45 | ||
Aetiology | 46 | ||
Emergency Department management | 46 | ||
History and examination | 46 | ||
Treatment | 46 | ||
Orthopaedic management | 46 | ||
Pressure monitoring | 47 | ||
Technique (Fig. 3.7) | 47 | ||
Fasciotomy of the leg (Fig. 3.8) | 47 | ||
Neglected compartment syndrome | 49 | ||
Crush injuries | 49 | ||
Emergency Department management | 49 | ||
History and examination | 49 | ||
Investigation | 50 | ||
Treatment | 50 | ||
Orthopaedic management | 50 | ||
Nerve injury | 50 | ||
Anatomy (Fig. 3.9) | 50 | ||
Classification | 50 | ||
Neurapraxia | 51 | ||
Axonotmesis | 52 | ||
Neurotmesis | 52 | ||
Emergency Department management | 52 | ||
History | 52 | ||
Examination | 52 | ||
Nerve root levels: upper limb (Fig. 3.14) | 52 | ||
Nerve root levels: lower limb (Fig. 3.15) | 54 | ||
Nerve root levels: perineum (Fig. 3.16) | 54 | ||
Peripheral nerve assessment | 55 | ||
Treatment | 55 | ||
Fracture displacement/joint dislocation | 55 | ||
Indications for urgent senior review | 56 | ||
Orthopaedic management | 57 | ||
Vascular injury | 58 | ||
Emergency Department management | 59 | ||
Examination | 59 | ||
Treatment | 59 | ||
Orthopaedic management | 60 | ||
Vascular repair | 60 | ||
The mangled limb | 60 | ||
Signpost injuries | 61 | ||
4 Closed management of fractures | 62 | ||
Reduce: closed reduction | 62 | ||
Urgent reduction | 62 | ||
Definitive reduction | 62 | ||
Reduction manœuvres | 62 | ||
Disimpaction with traction | 62 | ||
Unlocking the fragments by exaggeration of the deformity | 63 | ||
Reduction with the aid of the periosteal hinge | 64 | ||
Assessment | 64 | ||
Positioning for cast application | 64 | ||
Hold: principles of cast management | 64 | ||
2 Specific Injuries by Region | 127 | ||
8 Shoulder girdle | 128 | ||
General principles | 128 | ||
Anatomy | 128 | ||
The clavicle | 128 | ||
The scapula | 128 | ||
The superior shoulder suspensory complex | 129 | ||
The proximal humerus | 129 | ||
Clinical assessment of the painful shoulder | 129 | ||
History | 129 | ||
Examination | 130 | ||
Look | 130 | ||
Feel (Fig. 8.4) | 130 | ||
Move | 131 | ||
Neurovascular assessment | 132 | ||
Radiological assessment of the painful shoulder | 132 | ||
Radiographs | 132 | ||
Shoulder trauma series | 134 | ||
CT | 134 | ||
Clavicle | 134 | ||
Classification | 134 | ||
Robinson (Edinburgh) classification | 134 | ||
Emergency Department management | 134 | ||
Clinical features | 134 | ||
Radiological features | 136 | ||
Closed reduction | 136 | ||
Immobilization and reassessment | 136 | ||
Inpatient referral | 136 | ||
Outpatient follow-up | 137 | ||
Patient instructions | 137 | ||
Orthopaedic management | 137 | ||
Complications of surgery | 137 | ||
Indications for surgery | 137 | ||
Surgical techniques | 137 | ||
Outpatient management | 139 | ||
Acromioclavicular joint | 139 | ||
Classification | 139 | ||
Rockwood classification | 139 | ||
Emergency Department management | 141 | ||
Clinical features | 141 | ||
Radiological features | 141 | ||
Closed reduction | 141 | ||
Immobilization and reassessment | 141 | ||
Inpatient referral | 141 | ||
Outpatient follow-up | 141 | ||
Orthopaedic management | 141 | ||
Non-operative | 141 | ||
Operative | 141 | ||
Surgical techniques | 141 | ||
Acromion fixation | 141 | ||
Coracoid fixation | 142 | ||
Outpatient management | 142 | ||
Sternoclavicular joint | 142 | ||
Classification | 142 | ||
Emergency Department management | 143 | ||
Clinical features | 143 | ||
Radiological features | 143 | ||
Closed reduction | 143 | ||
Immobilization | 143 | ||
Outpatient follow-up | 143 | ||
Inpatient referral | 143 | ||
Orthopaedic management | 143 | ||
Non-operative | 143 | ||
Operative | 143 | ||
Scapula | 144 | ||
Classification | 144 | ||
Ideberg classification | 144 | ||
Emergency Department management | 145 | ||
Clinical features | 145 | ||
Radiological features | 145 | ||
Closed reduction | 145 | ||
Inpatient referral | 145 | ||
Outpatient follow-up | 145 | ||
Orthopaedic management | 145 | ||
Operative | 145 | ||
Surgical approach | 145 | ||
Scapulothoracic dissociation | 145 | ||
Emergency Department management | 146 | ||
Clinical features | 146 | ||
Radiological features | 146 | ||
Immobilization | 146 | ||
Inpatient referral | 146 | ||
Orthopaedic management | 146 | ||
Anterior shoulder (glenohumeral) dislocation | 146 | ||
Anatomy of shoulder stability | 146 | ||
Static stabilizers | 146 | ||
Dynamic stabilizers | 147 | ||
Pathoanatomy of shoulder instability | 147 | ||
Emergency Department management | 148 | ||
Clinical features | 148 | ||
Radiological features | 148 | ||
Closed reduction | 149 | ||
Kocher’s technique (Fig. 8.21) | 149 | ||
Hippocratic method (Fig. 8.22) | 150 | ||
Milch’s technique (Fig. 8.23) | 150 | ||
Stimpson’s technique (Fig. 8.24) | 150 | ||
Immobilization and reassessment | 150 | ||
Inpatient referral | 151 | ||
Outpatient follow-up | 151 | ||
Patient instructions | 151 | ||
Orthopaedic management | 151 | ||
Non-operative | 151 | ||
Operative | 151 | ||
Urgent surgery | 151 | ||
Planned surgery | 151 | ||
Late presentation | 152 | ||
Posterior shoulder dislocation | 152 | ||
Emergency Department management | 152 | ||
Clinical features | 152 | ||
Radiological features | 152 | ||
Closed reduction (Fig. 8.28) | 153 | ||
Immobilization and reassessment | 153 | ||
Inpatient referral | 154 | ||
Outpatient follow-up | 154 | ||
Patient instructions | 154 | ||
Orthopaedic management | 154 | ||
Non-operative | 154 | ||
Operative | 154 | ||
Urgent surgery | 154 | ||
Surgery within 48 hours | 154 | ||
Planned surgery | 154 | ||
Inferior shoulder dislocation (luxatio erecta) | 155 | ||
Emergency Department management | 155 | ||
Clinical features | 155 | ||
Radiological features | 155 | ||
Closed reduction (Fig. 8.30) | 155 | ||
Immobilization and reassessment | 155 | ||
Inpatient referral | 155 | ||
Outpatient follow-up | 155 | ||
Patient instructions | 155 | ||
Orthopaedic management | 156 | ||
Rotator cuff tears | 156 | ||
Emergency Department management | 156 | ||
Clinical features | 156 | ||
Index | 611 | ||
A | 611 | ||
B | 612 | ||
C | 613 | ||
D | 615 | ||
E | 617 | ||
F | 617 | ||
G | 620 | ||
H | 621 | ||
I | 622 | ||
J | 623 | ||
K | 623 | ||
L | 623 | ||
M | 624 | ||
N | 625 | ||
O | 626 | ||
P | 626 | ||
Q | 628 | ||
R | 629 | ||
S | 630 | ||
T | 632 | ||
U | 634 | ||
V | 634 | ||
W | 635 | ||
Y | 635 | ||
Back Cover | backcover |