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P1:JDW GRBT045-FM Doyle-2055G GRBT045-Doyle-v9.cls August6,2005 2:15 ORTHOPAEDIC SURGERY ESSENTIALS HAND AND WRIST i P1:JDW GRBT045-FM Doyle-2055G GRBT045-Doyle-v9.cls August6,2005 2:15 ORTHOPAEDIC SURGERY ESSENTIALS HAND AND WRIST ORTHOPAEDICSURGERYESSENTIALS AdultReconstruction DanielJ.Berry,MD ScottP.Steinmann,MD FootandAnkle DavidB.Thordarson,MD HandandWrist JamesR.Doyle,MD OncologyandBasicScience TimothyA.Damron,MD CarolD.Morris,MD Pediatrics KathrynE.Cramer,MD SusanA.Scherl,MD Spine ChristopherM.Bono,MD StevenR.Garfin,MD SportsMedicine AnthonyA.Schepsis,MD BrianD.Busconi,MD Trauma CharlesCourt-Brown,MD MargaretMcQueen,MD PaulTornettaIII,MD ii P1:JDW GRBT045-FM Doyle-2055G GRBT045-Doyle-v9.cls August6,2005 2:15 ORTHOPAEDIC SURGERY ESSENTIALS HAND AND WRIST SeriesEditors Author PAUL TORNETTA III, MD JAMES R. DOYLE, MD Professor EmeritusProfessorofSurgery(Orthopaedics) DepartmentofOrthopaedicSurgery JohnA.BurnsSchoolofMedicine BostonUniversitySchoolofMedicine; UniversityofHawaii DirectorofOrthopaedicTrauma Honolulu,Hawaii BostonUniversityMedicalCenter Boston,Massachusetts THOMAS A. EINHORN, MD ProfessorandChairman DepartmentofOrthopaedicSurgery BostonUniversitySchoolofMedicine Boston,Massachusetts iii P1:JDW GRBT045-FM Doyle-2055G GRBT045-Doyle-v9.cls August6,2005 2:15 AcquisitionsEditor:BobHurley DevelopmentalEditor:GraceCaputo,DovetailContentSolutions ManagingEditor:MichelleLaPlante ProjectManager:NicoleWalz SeniorManufacturingManager:BenRivera MarketingDirector:SharonZinner DesignCoordinator:HollyReidMcLaughlin CoverDesigner:AndrewGatto Compositor:TechBooks Printer:EdwardsBrothers (cid:1)C 2006byLIPPINCOTTWILLIAMS&WILKINS 530WalnutStreet Philadelphia,PA19106USA LWW.com Allrightsreserved.Thisbookisprotectedbycopyright.Nopartofthisbookmaybereproducedin anyformorbyanymeans,includingphotocopying,orutilizedbyanyinformationstorageand retrievalsystemwithoutwrittenpermissionfromthecopyrightowner,exceptforbriefquotations embodiedincriticalarticlesandreviews.Materialsappearinginthisbookpreparedbyindividuals aspartoftheirofficialdutiesasU.S.governmentemployeesarenotcoveredbythe above-mentionedcopyright. PrintedintheUSA. LibraryofCongressCataloging-in-PublicationData Handandwrist/bookeditor,JamesR.Doyle. p.;cm.—(Orthopaedicsurgeryessentials) Includesbibliographicalreferencesandindex. ISBN0-7817-5146-2(case) 1.Hand–Surgery.2.Wrist–Surgery.3.Orthopedicsurgery. I.Doyle,JamesR.II.Series. [DNLM:1.Hand–surgery–Handbooks.2.HandInjuries–surgery–Handbooks.3.Wrist– surgery–Handbooks.4.WristInjuries–surgery–Handbooks.WE39H2352005]RD559.H35725 2005617.5(cid:2)75–dc22 2005016072 Carehasbeentakentoconfirmtheaccuracyoftheinformationpresentedandtodescribe generallyacceptedpractices.However,theauthors,editors,andpublisherarenotresponsiblefor errorsoromissionsorforanyconsequencesfromapplicationoftheinformationinthisbookand makenowarranty,expressedorimplied,withrespecttothecurrency,completeness,oraccuracy ofthecontentsofthepublication.Applicationofthisinformationinaparticularsituationremains theprofessionalresponsibilityofthepractitioner. Theauthors,editors,andpublisherhaveexertedeveryefforttoensurethatdrugselectionand dosagesetforthinthistextareinaccordancewithcurrentrecommendationsandpracticeatthe timeofpublication.However,inviewofongoingresearch,changesingovernmentregulations, andtheconstantflowofinformationrelatingtodrugtherapyanddrugreactions,thereaderis urgedtocheckthepackageinsertforeachdrugforanychangeinindicationsanddosageandfor addedwarningsandprecautions.Thisisparticularlyimportantwhentherecommendedagentisa neworinfrequentlyemployeddrug. SomedrugsandmedicaldevicespresentedinthispublicationhaveFoodandDrugAdministration (FDA)clearanceforlimiteduseinrestrictedresearchsettings.Itistheresponsibilityofthehealth careprovidertoascertaintheFDAstatusofeachdrugordeviceplannedforuseintheirclinical practice. Topurchaseadditionalcopiesofthisbook,callourcustomerservicedepartmentat (800)638-3030orfaxordersto(301)824-7390.Internationalcustomersshouldcall (301)714-2324. VisitLippincottWilliams&WilkinsontheInternet:http://www.LWW.com.Lippincott Williams&Wilkinscustomerservicerepresentativesareavailablefrom8:30amto6:00 pm,EST. 10 9 8 7 6 5 4 3 2 1 iv P1:JDW GRBT045-FM Doyle-2055G GRBT045-Doyle-v9.cls August6,2005 2:15 ThistextbookisdedicatedtotheorthopaedicteachingstaffoftheJohnA.Burns SchoolofMedicineattheUniversityofHawaii.Itisdedicatedtothememoryofthe illustriouspastchairsoftheDivisionofOrthopaedics,IvarLarsonandAllen Richardson,aswellasalivingemerituschair,friend,andmentor, LawrenceGordon. Itisdedicatedtothememoryofthoseoutstandingteachers,EugeneLanceand AlanPavel,whotaughtallofusthevalueofscholarshipandexcellenceinsurgery. Itisdedicatedtothosewhocontinuethetraditionofexcellenceinteaching, RobertAtkinson,DanielSinger,JohnSmith,andallthosewhocontinuetogive theirtimeandenergytotheadvancementoftheorthopaedicresidencytraining programattheUniversityofHawaii. Itisdedicatedtothosewhomadethepathstoexcellencestraightandlevelinso manyways,includingAlbertChunHoon,TomWhelan,RuthOno, SueArakakiHaradaandToriMarciel. Itisdedicatedtomyresidents—theytaughtmemorethantheywilleverknow. v P1:JDW GRBT045-FM Doyle-2055G GRBT045-Doyle-v9.cls August6,2005 2:15 vi P1:JDW GRBT045-FM Doyle-2055G GRBT045-Doyle-v9.cls August6,2005 2:15 CONTENTS KeytoAbbreviations InsideFrontCover ContributingAuthors ix SeriesPreface xi Preface xiii SECTION I: BASIC ANATOMY 1 Anatomy 1 1.2 SystemsAnatomy 7 1.1 SurfaceAnatomy 1 1.3 TerminologyofMovement 13 SECTION II: OUTPATIENT CLINIC 2 CongenitalDeformities 14 6 TenosynovitisandEpicondylitis 88 7 EntrapmentNeuropathies 98 3 Tumors 37 7.1 MedianNerve 98 4 Dupuytren’sDisease 64 7.2 UlnarNerve 106 5 Infections 78 7.3 RadialNerve 111 SECTION III: EMERGENCY DEPARTMENT 8 Anesthesia 116 12 TendonInjuries 179 CharlesL.McDowellandKevinCunningham 12.1 FlexorTendon 179 9 HandFracturesandFracture-Dislocations 128 12.2 ExtensorTendon 190 13 NerveInjuries 208 10 DislocationandLigamentInjuries 144 14 Amputations 226 11 CarpalInjuries 158 15 CompartmentSyndrome 242 11.1 CarpalFractures 158 16 InjectionInjuries 250 11.2 CarpalInstabilitiesandFracture-Dislocations oftheCarpus 169 Index 253 vii P1:JDW GRBT045-FM Doyle-2055G GRBT045-Doyle-v9.cls August6,2005 2:15 viii P1:JDW GRBT045-FM Doyle-2055G GRBT045-Doyle-v9.cls August6,2005 2:15 CONTRIBUTING AUTHORS KevinCunningham,MD CharlesL.McDowell,MD AttendingAnesthesiologist ClinicalProfessorofOrthopaedic McGuireVeteransAdministrationHospital andPlastic(Hand)Surgery Richmond,Virginia MedicalCollegeofVirginia ChiefofHandSurgeryService McGuireVeteransAdministrationHospital Richmond,Virginia ix P1:JDW GRBT045-FM Doyle-2055G GRBT045-Doyle-v9.cls August6,2005 2:15 x

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Written by an outstanding hand surgeon, this volume of our Orthopaedic Surgery Essentials Series presents all the information residents need during hand and wrist surgery rotations or services. It can easily be read cover to cover during a rotation or used for quick reference before a patient workup
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275 Pages·2005·8.43 MB·English
by  James R. Doyle MD
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P1:JDW GRBT045-FM Doyle-2055G GRBT045-Doyle-v9.cls August6,2005 2:15 ORTHOPAEDIC SURGERY ESSENTIALS HAND AND WRIST i P1:JDW GRBT045-FM Doyle-2055G GRBT045-Doyle-v9.cls August6,2005 2:15 ORTHOPAEDIC SURGERY ESSENTIALS HAND AND WRIST ORTHOPAEDICSURGERYESSENTIALS AdultReconstruction DanielJ.Berry,MD ScottP.Steinmann,MD FootandAnkle DavidB.Thordarson,MD HandandWrist JamesR.Doyle,MD OncologyandBasicScience TimothyA.Damron,MD CarolD.Morris,MD Pediatrics KathrynE.Cramer,MD SusanA.Scherl,MD Spine ChristopherM.Bono,MD StevenR.Garfin,MD SportsMedicine AnthonyA.Schepsis,MD BrianD.Busconi,MD Trauma CharlesCourt-Brown,MD MargaretMcQueen,MD PaulTornettaIII,MD ii P1:JDW GRBT045-FM Doyle-2055G GRBT045-Doyle-v9.cls August6,2005 2:15 ORTHOPAEDIC SURGERY ESSENTIALS HAND AND WRIST SeriesEditors Author PAUL TORNETTA III, MD JAMES R. DOYLE, MD Professor EmeritusProfessorofSurgery(Orthopaedics) DepartmentofOrthopaedicSurgery JohnA.BurnsSchoolofMedicine BostonUniversitySchoolofMedicine; UniversityofHawaii DirectorofOrthopaedicTrauma Honolulu,Hawaii BostonUniversityMedicalCenter Boston,Massachusetts THOMAS A. EINHORN, MD ProfessorandChairman DepartmentofOrthopaedicSurgery BostonUniversitySchoolofMedicine Boston,Massachusetts iii P1:JDW GRBT045-FM Doyle-2055G GRBT045-Doyle-v9.cls August6,2005 2:15 AcquisitionsEditor:BobHurley DevelopmentalEditor:GraceCaputo,DovetailContentSolutions ManagingEditor:MichelleLaPlante ProjectManager:NicoleWalz SeniorManufacturingManager:BenRivera MarketingDirector:SharonZinner DesignCoordinator:HollyReidMcLaughlin CoverDesigner:AndrewGatto Compositor:TechBooks Printer:EdwardsBrothers (cid:1)C 2006byLIPPINCOTTWILLIAMS&WILKINS 530WalnutStreet Philadelphia,PA19106USA LWW.com Allrightsreserved.Thisbookisprotectedbycopyright.Nopartofthisbookmaybereproducedin anyformorbyanymeans,includingphotocopying,orutilizedbyanyinformationstorageand retrievalsystemwithoutwrittenpermissionfromthecopyrightowner,exceptforbriefquotations embodiedincriticalarticlesandreviews.Materialsappearinginthisbookpreparedbyindividuals aspartoftheirofficialdutiesasU.S.governmentemployeesarenotcoveredbythe above-mentionedcopyright. PrintedintheUSA. LibraryofCongressCataloging-in-PublicationData Handandwrist/bookeditor,JamesR.Doyle. p.;cm.—(Orthopaedicsurgeryessentials) Includesbibliographicalreferencesandindex. ISBN0-7817-5146-2(case) 1.Hand–Surgery.2.Wrist–Surgery.3.Orthopedicsurgery. I.Doyle,JamesR.II.Series. [DNLM:1.Hand–surgery–Handbooks.2.HandInjuries–surgery–Handbooks.3.Wrist– surgery–Handbooks.4.WristInjuries–surgery–Handbooks.WE39H2352005]RD559.H35725 2005617.5(cid:2)75–dc22 2005016072 Carehasbeentakentoconfirmtheaccuracyoftheinformationpresentedandtodescribe generallyacceptedpractices.However,theauthors,editors,andpublisherarenotresponsiblefor errorsoromissionsorforanyconsequencesfromapplicationoftheinformationinthisbookand makenowarranty,expressedorimplied,withrespecttothecurrency,completeness,oraccuracy ofthecontentsofthepublication.Applicationofthisinformationinaparticularsituationremains theprofessionalresponsibilityofthepractitioner. Theauthors,editors,andpublisherhaveexertedeveryefforttoensurethatdrugselectionand dosagesetforthinthistextareinaccordancewithcurrentrecommendationsandpracticeatthe timeofpublication.However,inviewofongoingresearch,changesingovernmentregulations, andtheconstantflowofinformationrelatingtodrugtherapyanddrugreactions,thereaderis urgedtocheckthepackageinsertforeachdrugforanychangeinindicationsanddosageandfor addedwarningsandprecautions.Thisisparticularlyimportantwhentherecommendedagentisa neworinfrequentlyemployeddrug. SomedrugsandmedicaldevicespresentedinthispublicationhaveFoodandDrugAdministration (FDA)clearanceforlimiteduseinrestrictedresearchsettings.Itistheresponsibilityofthehealth careprovidertoascertaintheFDAstatusofeachdrugordeviceplannedforuseintheirclinical practice. Topurchaseadditionalcopiesofthisbook,callourcustomerservicedepartmentat (800)638-3030orfaxordersto(301)824-7390.Internationalcustomersshouldcall (301)714-2324. VisitLippincottWilliams&WilkinsontheInternet:http://www.LWW.com.Lippincott Williams&Wilkinscustomerservicerepresentativesareavailablefrom8:30amto6:00 pm,EST. 10 9 8 7 6 5 4 3 2 1 iv P1:JDW GRBT045-FM Doyle-2055G GRBT045-Doyle-v9.cls August6,2005 2:15 ThistextbookisdedicatedtotheorthopaedicteachingstaffoftheJohnA.Burns SchoolofMedicineattheUniversityofHawaii.Itisdedicatedtothememoryofthe illustriouspastchairsoftheDivisionofOrthopaedics,IvarLarsonandAllen Richardson,aswellasalivingemerituschair,friend,andmentor, LawrenceGordon. Itisdedicatedtothememoryofthoseoutstandingteachers,EugeneLanceand AlanPavel,whotaughtallofusthevalueofscholarshipandexcellenceinsurgery. Itisdedicatedtothosewhocontinuethetraditionofexcellenceinteaching, RobertAtkinson,DanielSinger,JohnSmith,andallthosewhocontinuetogive theirtimeandenergytotheadvancementoftheorthopaedicresidencytraining programattheUniversityofHawaii. Itisdedicatedtothosewhomadethepathstoexcellencestraightandlevelinso manyways,includingAlbertChunHoon,TomWhelan,RuthOno, SueArakakiHaradaandToriMarciel. Itisdedicatedtomyresidents—theytaughtmemorethantheywilleverknow. v P1:JDW GRBT045-FM Doyle-2055G GRBT045-Doyle-v9.cls August6,2005 2:15 vi P1:JDW GRBT045-FM Doyle-2055G GRBT045-Doyle-v9.cls August6,2005 2:15 CONTENTS KeytoAbbreviations InsideFrontCover ContributingAuthors ix SeriesPreface xi Preface xiii SECTION I: BASIC ANATOMY 1 Anatomy 1 1.2 SystemsAnatomy 7 1.1 SurfaceAnatomy 1 1.3 TerminologyofMovement 13 SECTION II: OUTPATIENT CLINIC 2 CongenitalDeformities 14 6 TenosynovitisandEpicondylitis 88 7 EntrapmentNeuropathies 98 3 Tumors 37 7.1 MedianNerve 98 4 Dupuytren’sDisease 64 7.2 UlnarNerve 106 5 Infections 78 7.3 RadialNerve 111 SECTION III: EMERGENCY DEPARTMENT 8 Anesthesia 116 12 TendonInjuries 179 CharlesL.McDowellandKevinCunningham 12.1 FlexorTendon 179 9 HandFracturesandFracture-Dislocations 128 12.2 ExtensorTendon 190 13 NerveInjuries 208 10 DislocationandLigamentInjuries 144 14 Amputations 226 11 CarpalInjuries 158 15 CompartmentSyndrome 242 11.1 CarpalFractures 158 16 InjectionInjuries 250 11.2 CarpalInstabilitiesandFracture-Dislocations oftheCarpus 169 Index 253 vii P1:JDW GRBT045-FM Doyle-2055G GRBT045-Doyle-v9.cls August6,2005 2:15 viii P1:JDW GRBT045-FM Doyle-2055G GRBT045-Doyle-v9.cls August6,2005 2:15 CONTRIBUTING AUTHORS KevinCunningham,MD CharlesL.McDowell,MD AttendingAnesthesiologist ClinicalProfessorofOrthopaedic McGuireVeteransAdministrationHospital andPlastic(Hand)Surgery Richmond,Virginia MedicalCollegeofVirginia ChiefofHandSurgeryService McGuireVeteransAdministrationHospital Richmond,Virginia ix P1:JDW GRBT045-FM Doyle-2055G GRBT045-Doyle-v9.cls August6,2005 2:15 x

Description:
Written by an outstanding hand surgeon, this volume of our Orthopaedic Surgery Essentials Series presents all the information residents need during hand and wrist surgery rotations or services. It can easily be read cover to cover during a rotation or used for quick reference before a patient workup
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