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TitleSelected References in Orthopaedic Trauma
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A.H.C. Ratliff • J.H. Dixon
P.A. Magnussen. S.K. Young

Selected References in
Orthopaedic Trauma

Foreword by A.Graham Apley

Spri nger-Verlag
London Berlin Heidelberg New York
Paris Tokyo

Page 68

THE HAND

In view of the increasing interest, three papers have been included on the subject of
carpal instability. Fisk presented a thoughtful review on the general subject of the wrist
and the causes, diagnosis and treatment of carpal instability are considered. He stressed
that the lunate is the "lynch pin" of the wrist. Linscheid described two types of post-
traumatic instability: dorsal and volar, depending essentially on the relation of the
lunate to the radius in the lateral view. Taleisnik proposed a classification of the subtle
forms of this condition exclusive of the more severe fractures, dislocations and
fracture-dislocations.

Fractures of the Hand

Review Article

Barton NJ Fractures of the hand J Bone Joint Surg [Br] 1984;66-B: 159-167

Bennett's Fracture

Pollen AG The conservative treatment of Bennett's fracture subluxation of
the thumb metacarpal J Bone Joint Surg [Br] 1968;50-B:91-101

Cannon SR, Dowd GSE, Williams DH, Scott 1M A long-term study following
Bennett's fracture J Hand Surg [Br] 1986; II-B:426-431

Foster RJ, Hastings H TreatmentofBennett, Rolando and vertical intra-articular
trapezial fractures Clin Orthop 1987;214:121-129

Fractures of the Metacarpals

Lamb DW Fractures of the neck and shaft of the metacarpals. In: Barton NJ,
ed. Fractures of the hand and wrist Edinburgh, etc: Churchill Livingstone, 1988:
108-119

In the article by Barton, a concise review is presented on the reduction, retention and
rehabilitation of fractures of the hand with special reference to principles and the use
of conservative and operative treatment.

Pollen reviewed 31 patients treated by manipulation and a carefully moulded plaster
cast as previously described by Charnley. Twenty-nine were successfully treated in this
way and operation was required in only two. In a study of 25 patients, reviewed for a
mean of nine years, Cannon showed that there was little evidence that imperfect
reduction leads to significant symptomatic arthritis in the long term. The operative
technique has been described in detail by Foster.

The treatment of fractures of the metacarpal bones is usually considered to be
uncontroversial, especially in the majority which are stable. However, Lamb has

54

Page 69

THE HAND

drawn attention to the prevention of a rotary deformity and to the trend towards inter-
nal fixation with Kirchner wires for unstable fractures, particularly when multiple or
associated with open injuries or skin loss.

Fractures of the Phalanges

James JIP Fractures of the shafts of the phalanges: conservative treatment
In: Barton NJ, ed. Fractures of the hand and wrist Edinburgh, etc: Churchill
Livingstone. 1988:22-31

Belsky MR, Eaton RG Fractures of the shafts of the phalanges: percutaneous
wire fixation In: Barton NJ, ed. Fractures of the hand and wrist Edinburgh. etc:
Churchill Livingstone. 1988:41-46

Kutz IE, Ruff ME Fractures of the shafts of the phalanges: open reduction
and internal fixation In: Barton NJ, ed. Fractures of the hand and wrist
Edinburgh. etc: Churchill Livingstone. 1988:47-54

Mulligan PJ Comminuted fractures In: Barton NJ, ed. Fractures of the hand and
wrist Edinburgh, etc: Churchill Livingstone, 1988:74-86

There are no trivial injuries of the hand, least of all, a fractured finger. There is now
increased awareness of the importance of skill and care in the management of fractures
of the phalanges, particularly those that are displaced and this is therefore reflected in
the short chapters chosen in this section. James has described in detail the method of
splintage which he has advocated for the maintenance of reduction of phalangeal
fractures and later, the restoration of function and avoidance of a stiff finger. There is
still considerable controversy concerning the indications for percutaneous wire fixa-
tion and open reduction of the displaced fracture and this is indicated by Belsky and
Kutz. Mulligan has stressed the importance of crush injuries which may lead to severe
oedema and stiffness. On many occasions, splintage is not possible and hence,
stabilisation is achieved by various methods of fixation including external fixation.

Operative Technique

Barton NJ Operative treatment of fractures of the hand In: Birch R.
Brooks D, ed. The Hand. 4th edn. (Rob and Smith's Operative Surgery) London:
Butterworth, 1984:184-195

Heirn U, pfeiffer KM The hand In: Internal fixation of small fractures.
Technique recommended by the AO-ASIF Group. 3rd edn Berlin, etc:
Springer-Verlag, 1988: 179-246

55

Page 136

Median nerve 61
Meniscus, injuries of 95
Menisectomy 95
Metacarpal fractures 54
Midtarsal joint injuries III
Monteggia fracture 44
Muscular skeletal injuries, in children 24
Musculo-skeletal injuries 4

in children 24
Myelomatosis 14

Nerve grafting 22
Nerve injuries, hand 60--1
Neuroma, evaluation 21
Nicoll-graft treatment 7
Nutrition 4

Odontoid fractures 71
Olecranon fractures 42
Osteomalacia 16, 83
Osteomyelitis 7
Osteoporosis 15,83
Osteosynthesis 4

Paediatric trauma 23-6
Paget's disease of bone 14
Papineau technique 7
Paraplegia 68, 74
Partial physeal arrest 24
PateU,a

dislocations 98-9
fractures 98

Pelvis, fractures 76--8
Perichondrial ring 24
Perineal nerve repair 21
Peripheral nerve disorders 28
Peripheral nerve injuries 20--2
Phalangeal fractures 55
Pipkin fracture-dislocation of the hip 81
Plasma cell tumours 14
Post-traumatic ischaemia 18
Proximal humeral fractures 33-4
Pseudarthroses 7
Putti -Platt operation 31

Radial head fractures 40
in children 41

Radial neck fractures, in children 41
Radial shaft fractures 42-3

in children 43
Reflex sympathetic dystrophy 23
Remodelling 24
Renalosteodystrophy 16
Replantation 64-5
Respiratory failure 4

Rheumatoid arthritis, hip fracture in 85
Rickets 16
Ring of the axis fractures 72
Road accidents 2
Rotator cuff tears 33

Scaphoid fractures 52
Sensation 20
Sensibility, hand 21
Shock, recognition and treatment 2
Shoulder joint dislocation 31-3
Skeletal disorders 12
Skeletal metastases 12
Skull fracture 25
Skull traction 70
Smith's fracture 47
Soft tissue injuries, knee 94-7
Spinal cord deficiency 69
Spinal cord injuries 68-9
Spinal fractures, dislocations and fracture-

dislocations 68
Spinal injuries

classification and mechanisms of 68
hyperextension 71
see also Cervical spine injuries; Dorso-lumbar

spine;
Thoracolumbar spine

Spinal instability 68
Spinal metastases 13
Spinal trauma 68
Sternoclavicular joint 30
Stress fractures 16-17, 86
Subcapital fractures 84
Subscapularis tendon 32
Sudeck's atrophy 23

Talus fracture 108-9
Tarso-metatarsal injuries III
Tendon injuries

extensor 59-60
flexor 57-9

Tendon sheaths, infection 63
Tendons, subscapularis 32
Tetanus 26
Tetraplegia 68, 73
Thoracolumbar spine injuries 74-6
Thumb

amputations 62
metacarpophalangeal joint 56-7
reconstruction 62

Tibia
associated injuries 91
ipsi-lateral fractures 104
management of fractures 104
plateau fractures 100
shaft fractures 101-4

Tibiofibular joint dislocation 100

123

Page 137

Trauma
care evaluation 2
multiple 3, 4
nutrition 4

TRISS method 2

Ulna shaft fractures 42-3
in children 43

Ulnar nerve 61
Upper limb

metastases 12
paralysis 73

Urethra injury 77-8
Urinary tract trauma 77

124

Vascular injuries 17-20
Vertebral fractures 74
Volkmann's contracture 19-20,38,44

Wick catheter 18
Wrist

fractures 53
septic arthritis 63

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