Additional Information
Book Details
Abstract
An excellent book covering the biomechanical and clinical aspects of each ‘element’ of fracture fixation and informs on different effective methods of use in a very concise and lucid manner.
Exceedingly valuable for postgraduate students, orthopaedic surgeons and teaching faculties as the book provides the basics and biomechanics of both new and old elements of fracture fixation. The simple sketches and descriptions will help the students and trainees to easily understand the basic and scientific rationales of modern operative fracture treatment.
- Techniques and implants involved in the management of fracture have been discussed in detail.
- Provides current knowledge on structure, design, material properties and functions of screws, plates, nails, wires and external fixators.
- Contains the relevant facts about commonly used implants in a simple and precise language.
- Essentially deals with metals used in fracture fixation and with the elements in some details.
- Deals with the structuring of the wreckage of the old bones.
- Highlights the different instruments used in fracture fixation along with the methods.
New to this Edition
- New chapter on osteoporosis and fracture fixation.
- New topics included in this edition are: totally novel concepts of screw design and effective plate fixation, methods in osteoporotic bone stabilization, biomechanics of elastic stable intramedullary nail, innovative methods and devices to prevent cutout of sliding hip screw, fresh information on cable fixation and utilization of Kirschner wire, elements of ring fixator, latest materials in fracture treatment and contemporary norms of metal removal.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover\r | Front Cover | ||
| Front Matter\r | i | ||
| Copyright\r | iv | ||
| Dedication\r | v | ||
| Foreword to the second edition\r | vii | ||
| Foreword to the first edition | ix | ||
| Preface to the second edition\r | xi | ||
| Preface to the first edition\r | xiii | ||
| Contents | xv | ||
| Chapter 1 - Lexicon of fracture fixation | 1 | ||
| Force | 1 | ||
| Types and effects of loading | 3 | ||
| Loading modes and fracture patterns | 6 | ||
| Bending and axial compression | 8 | ||
| Torsion | 8 | ||
| Useful definitions | 10 | ||
| Stress risers | 10 | ||
| Fracture fixation construct | 13 | ||
| Compression | 13 | ||
| Stiffness | 13 | ||
| Near and far cortex | 13 | ||
| Stable and rigid fixation | 13 | ||
| Elasticity | 14 | ||
| Plasticity | 14 | ||
| Ductility | 14 | ||
| Toughness | 14 | ||
| Brittleness | 14 | ||
| Spiral | 14 | ||
| Helix | 14 | ||
| Working length | 14 | ||
| Chapter 2 - Metals and materials for fracture fixation | 17 | ||
| Introduction | 17 | ||
| Metal working methods and their effects on implants | 19 | ||
| Forging | 19 | ||
| Casting | 19 | ||
| Rolling and drawing | 19 | ||
| Milling | 19 | ||
| Cold working | 19 | ||
| Annealing | 19 | ||
| Case hardening | 20 | ||
| Machining | 20 | ||
| Broaching | 20 | ||
| Surface treatment | 20 | ||
| Polishing and passivation | 20 | ||
| Nitriding | 20 | ||
| Fabrication of implants | 21 | ||
| Corrosion and its varities | 22 | ||
| Galvanic corrosion | 22 | ||
| Crevice corrosion | 23 | ||
| Pitting corrosion | 23 | ||
| Fretting corrosion | 23 | ||
| Stress corrosion | 23 | ||
| Intergranular corrosion | 23 | ||
| Ion release | 24 | ||
| Standard organizations | 24 | ||
| Metals in orthopaedic use | 24 | ||
| Stainless steel | 24 | ||
| Cobalt-chromium alloys | 26 | ||
| Titanium alloys | 26 | ||
| Bioabsorbable polymers | 28 | ||
| Mechanical properties | 30 | ||
| Fracture fixation | 31 | ||
| Clinical relevance | 32 | ||
| Metal failure | 32 | ||
| Metal removal | 33 | ||
| Mixing of implants | 35 | ||
| Chapter 3 - Bone Screws | 37 | ||
| Anatomy of a screw | 37 | ||
| The head | 38 | ||
| Recess | 38 | ||
| Countersink | 40 | ||
| Function | 41 | ||
| The shaft | 41 | ||
| Run out | 42 | ||
| The thread | 42 | ||
| Core diameter | 43 | ||
| Pitch | 43 | ||
| Lead | 44 | ||
| Outside diameter (thread diameter) | 44 | ||
| Thread design | 44 | ||
| The tip | 45 | ||
| Self-tapping tip | 45 | ||
| Non-self-tapping tip | 45 | ||
| Corkscrew tip | 46 | ||
| Trocar tip | 46 | ||
| Self-drilling self-tapping tip | 46 | ||
| Screw types | 47 | ||
| Machine and wood screws | 47 | ||
| Cortical and cancellous screws | 48 | ||
| Self-tapping screw | 48 | ||
| Non-self-tapping screw | 49 | ||
| Fully and partially threaded screws | 50 | ||
| Cannulated screw | 50 | ||
| The herbert screw | 52 | ||
| Screw insertion | 53 | ||
| Drill bit | 53 | ||
| Principles of cutting instruments | 54 | ||
| Drill size nomenclature | 55 | ||
| Heat generation in drilling | 55 | ||
| Effects of heat on the bone | 56 | ||
| Factors affecting heat production | 56 | ||
| Techniques to minimize heat production | 56 | ||
| Mechanics of drilling | 57 | ||
| Drill bit failure | 57 | ||
| The power drill | 58 | ||
| The drill sleeve | 59 | ||
| Drilling depth | 59 | ||
| Pilot hole | 59 | ||
| Importance of a pilot hole | 59 | ||
| Measurement of screw length | 60 | ||
| Tapping | 61 | ||
| Countersink | 62 | ||
| Washers | 62 | ||
| Insertion | 62 | ||
| Efficiency of screw insertion | 64 | ||
| Screw removal | 65 | ||
| Holding power of the screw | 65 | ||
| Definition | 65 | ||
| Modifying factors | 65 | ||
| Screw failure | 67 | ||
| Clinical considerations | 70 | ||
| The lag screw | 70 | ||
| Fixation of a spiral fracture | 74 | ||
| Chapter 4 - Bone plates | 77 | ||
| Introduction | 77 | ||
| Classification | 78 | ||
| NEUTRALIZATION PLATE | 78 | ||
| COMPRESSION PLATE | 79 | ||
| BUTTRESS PLATE | 82 | ||
| CONDYLAR PLATE | 83 | ||
| General principles of plate fixation | 84 | ||
| Screw related factors | 85 | ||
| Bone related factors | 86 | ||
| Construct related factors | 86 | ||
| Effect of compression | 87 | ||
| Additional principles of plate fixation | 90 | ||
| Tension band plate | 90 | ||
| Prebending of plate | 91 | ||
| Plate fixation of oblique long bone fractures | 93 | ||
| Minimizing stress concentration at the plate–bone junction | 94 | ||
| How many screws? | 95 | ||
| Locked internal fixator plate | 96 | ||
| Biomechanics of LIFP19 | 100 | ||
| Length of the LIFP | 108 | ||
| Plate removal | 109 | ||
| Removal of LIFP | 111 | ||
| Regional considerations | 112 | ||
| THE FEMUR | 113 | ||
| Shaft | 113 | ||
| Distal femur | 113 | ||
| The condylar buttress plate | 114 | ||
| Subtrochanteric fracture of the shaft of the femur | 115 | ||
| THE TIBIA | 115 | ||
| THE HUMERUS | 117 | ||
| Shaft | 117 | ||
| The distal humerus | 117 | ||
| The proximal humerus | 117 | ||
| THE RADIUS AND ULNA | 118 | ||
| THE HAND AND THE FOOT | 121 | ||
| Precontoured plates | 121 | ||
| Clavicle plate | 122 | ||
| Distal humerus plate | 123 | ||
| Radial head plate | 123 | ||
| Olecranon plates | 123 | ||
| Plates for joint dislocation | 124 | ||
| Chapter 5 - Intramedullary nailing | 127 | ||
| Introduction | 127 | ||
| Principle of splintage | 128 | ||
| Bone response to nailing | 128 | ||
| Effect on circulation | 128 | ||
| Side effects of reaming | 129 | ||
| Bone healing after nailing | 132 | ||
| Nail design | 132 | ||
| Cross-section | 132 | ||
| Diameter | 133 | ||
| Curves | 133 | ||
| Reamed and non-reamed nails | 140 | ||
| Slotted and non-slotted nails | 141 | ||
| Interlocking nail | 142 | ||
| Dynamic locking | 143 | ||
| Poller screw | 145 | ||
| Dynamization | 145 | ||
| Closed and open nailing | 146 | ||
| Reaming of the medullary canal | 147 | ||
| Nail removal | 148 | ||
| Regional considerations | 150 | ||
| THE FEMUR | 150 | ||
| THE TIBIA | 153 | ||
| THE HUMERUS | 155 | ||
| THE RADIUS AND ULNA | 156 | ||
| Elastic stable intramedullary nailing | 157 | ||
| Biomechanics | 158 | ||
| The femur | 161 | ||
| The humerus | 163 | ||
| The tibia | 164 | ||
| Chapter 6 - Hip fixation | 167 | ||
| Introduction | 167 | ||
| Anatomy and forces acting on the hip joint | 168 | ||
| Causes of hip fracture and associated forces | 169 | ||
| Classification of hip fractures | 171 | ||
| Need for fracture fixation | 172 | ||
| Factors affecting fracture fixation | 173 | ||
| Fixation devices | 173 | ||
| FUNCTIONAL SEGMENTS OF A FIXATION DEVICE | 175 | ||
| FIXED ANGLE NAIL-PLATE | 176 | ||
| SLIDING HIP SCREW | 177 | ||
| Supplementary fixations for SHS | 182 | ||
| SHS LOCKING DEVICE | 182 | ||
| TROCHANTER SUPPORTING PLATE | 182 | ||
| BIAXIAL COMPRESSION PLATE | 183 | ||
| PERCUTANEOUS COMPRESSION PLATE | 185 | ||
| INTRAMEDULLARY DEVICE | 186 | ||
| MULTIPLE LAG SCREWS | 188 | ||
| COMPARATIVE FEATURES OF FIXATION DEVICES | 189 | ||
| GUIDE WIRE | 191 | ||
| Hip fracture and osteoporosis | 192 | ||
| Regional considerations | 192 | ||
| EXTRACAPSULAR FRACTURE | 193 | ||
| INTRACAPSULAR FRACTURE | 196 | ||
| IMPLANT REMOVAL | 199 | ||
| Chapter 7 - Wire, cable and pins | 203 | ||
| Introduction | 203 | ||
| Wire | 204 | ||
| MATERIAL | 204 | ||
| Size nomenclature | 204 | ||
| Classification of sutures | 205 | ||
| Factors affecting the strength of the wire | 205 | ||
| Effect of time | 205 | ||
| Twisted wire | 205 | ||
| Kinks and knots | 205 | ||
| Effect on blood supply of the bone | 206 | ||
| METHODS OF FASTENING | 206 | ||
| INSTRUMENTS TO HANDLE WIRE | 207 | ||
| USES OF WIRE | 208 | ||
| Tension band wiring | 208 | ||
| INTRODUCTION | 208 | ||
| GENERAL PRINCIPLES | 208 | ||
| REGIONAL CONSIDERATIONS | 210 | ||
| The patella | 212 | ||
| The greater trochanter of femur | 213 | ||
| The greater tuberosity of humerus | 214 | ||
| The medial malleolus | 214 | ||
| Lateral end of the clavicle | 214 | ||
| Unusual sites | 214 | ||
| Cerclage wiring | 215 | ||
| The tibia and femur | 216 | ||
| Patello-tibial cerclage | 217 | ||
| Parham bands | 217 | ||
| The Patridge band | 218 | ||
| The Mennen plate | 218 | ||
| Wire cables | 219 | ||
| Bilateral cable tension banding | 221 | ||
| PINS | 223 | ||
| USES OF KIRSCHNER WIRE | 224 | ||
| Provisional fixation | 225 | ||
| Definitive fixation | 225 | ||
| REGIONAL CONSIDERATIONS | 226 | ||
| The tibial plateau | 226 | ||
| Lower end of the humerus | 227 | ||
| Crossed pins | 228 | ||
| Two lateral pins | 228 | ||
| Forearm bones | 229 | ||
| The radial head | 229 | ||
| Intra-articular fracture | 234 | ||
| Arthrodesis | 234 | ||
| Traction | 234 | ||
| STEINMANN PIN | 234 | ||
| Chapter 8 - External fixators | 239 | ||
| Introduction | 240 | ||
| Classification | 240 | ||
| Pin fixator | 240 | ||
| Ring fixator | 241 | ||
| Instrumentation | 242 | ||
| The pin (schanz screw, half-pin are synonyms) | 242 | ||
| The tip | 243 | ||
| The thread | 244 | ||
| The core | 244 | ||
| The shaft | 245 | ||
| The Clamp | 245 | ||
| The central body | 245 | ||
| Compression-distraction system | 246 | ||
| Frames | 246 | ||
| Unilateral uniplanar frame | 247 | ||
| Unilateral biplanar frame | 248 | ||
| Bilateral uniplanar frame | 248 | ||
| Bilateral biplanar frame | 249 | ||
| Modular frame | 250 | ||
| Mechanical properties of external fixators | 251 | ||
| Number of pins | 252 | ||
| The pin diameter | 252 | ||
| Distance between bone and support column | 252 | ||
| Pin-clamp interface | 253 | ||
| Pin-bone interface | 253 | ||
| Preloading | 254 | ||
| Fracture healing with external fixation | 256 | ||
| Unilateral uniplanar versus bilateral biplanar frame | 257 | ||
| Unilateral uniplanar frame with varying rigidity | 257 | ||
| Effect of fracture type on its healing in external fixation | 257 | ||
| Use of minimal internal fixation | 258 | ||
| Compression versus no compression under external fixation | 258 | ||
| Constant rigid versus dynamic compression under external fixation | 258 | ||
| Plate fixation versus external fixation | 258 | ||
| Dynamization | 258 | ||
| Bone grafting in external fixation | 259 | ||
| Frame construction | 259 | ||
| Infection and pin loosening | 261 | ||
| Pin related causes | 261 | ||
| Soft tissue related causes | 262 | ||
| Surgeon related causes | 262 | ||
| External fixator, what next? | 262 | ||
| Removal of an external fixator | 262 | ||
| Regional considerations | 263 | ||
| The tibia | 263 | ||
| Periarticular fractures of the lower leg | 264 | ||
| The femur | 264 | ||
| The radius and ulna | 264 | ||
| External fixation of the wrist and hand | 264 | ||
| The humerus | 265 | ||
| The pelvis | 265 | ||
| Screw placement in the pelvis | 266 | ||
| Polytrauma patient | 266 | ||
| Use of external fixation in children | 267 | ||
| The developing countries and external fixation | 268 | ||
| War, natural catastrophe and external fixation | 269 | ||
| Supplement | 271 | ||
| Ring fixators | 271 | ||
| Rings | 271 | ||
| Half-ring with curved ends | 272 | ||
| Arches | 272 | ||
| Ring connections | 273 | ||
| Bolts and nuts | 273 | ||
| Nuts | 274 | ||
| Rods and plates | 275 | ||
| Rods | 275 | ||
| Threaded sockets and bushings | 277 | ||
| Supports, posts, and half-hinges | 277 | ||
| Washers | 277 | ||
| Wrenches | 278 | ||
| Frame assemblage | 279 | ||
| General | 279 | ||
| Ring position and force distribution | 279 | ||
| Ring inclination | 280 | ||
| Space between skin and ring | 281 | ||
| Ring position at FON sites | 281 | ||
| Ring orientation | 282 | ||
| Wire positioning on the same ring | 283 | ||
| Wire with stopper | 284 | ||
| Wire tensioning | 285 | ||
| Wire fixation | 285 | ||
| Guide wire | 286 | ||
| Pulling or traction wire | 286 | ||
| Schanz screws or half pins | 286 | ||
| Hinges | 286 | ||
| Hinge function | 288 | ||
| Acknowledgement | 288 | ||
| Chapter 9 - Osteoporosis and fracture fixation | 289 | ||
| Osteoporosis | 289 | ||
| Impaction | 291 | ||
| Buttressing | 292 | ||
| Splintage | 292 | ||
| Augmentation | 293 | ||
| Anchoring methods | 294 | ||
| EXTRAMEDULLARY IMPLANTS | 294 | ||
| Sliding hip screw (SHS) | 295 | ||
| Talon hip compression screw | 296 | ||
| Locked proximal femur plate | 296 | ||
| INTRAMEDULLARY IMPLANTS | 297 | ||
| Load distribution and angle stable fixation | 301 | ||
| PLATE OSTEOSYNTHESIS UTILIZING ANCHORING ARMS | 301 | ||
| Tension band wiring | 303 | ||
| Load dispersing washer | 303 | ||
| Augmentation techniques using bone substitutes | 303 | ||
| PMMA | 303 | ||
| Hydroxyapatite-coated pins | 305 | ||
| Resorbable polymeric insert | 305 | ||
| Regional considerations | 305 | ||
| The proximal humerus | 305 | ||
| The distal radial | 306 | ||
| The hip | 307 | ||
| The lower end of femur | 308 | ||
| The tibial plateau | 309 | ||
| Ankle fractures and the distal fibula | 309 | ||
| Bibliography | 313 | ||
| Index | 321 |