Imaging of Orthopaedic Fixation Devices and Prostheses PDF
Preview Imaging of Orthopaedic Fixation Devices and Prostheses
Imaging of Orthopaedic Fixation Devices and Prostheses Imaging of Orthopaedic Fixation Devices and Prostheses Thomas H. Berquist, MD, FACR ProfessorofDiagnosticRadiology MayoClinicCollegeofMedicine Rochester,Minnesota; ConsultantinDiagnosticRadiology MayoClinicJacksonville Jacksonville,Florida AcquisitionsEditor:LisaMcAllister ManagingEditor:RyanShaw ProjectManager:AliciaJackson ManufacturingCoordinator:KathleenBrown SeniorMarketingManager:AngelaPanetta Designer:StephenDruding CoverDesigner:LarryDidona ProductionServices:LaserwordsPrivateLimited,Chennai,India ©2009byLIPPINCOTTWILLIAMS&WILKINS,aWOLTERSKLUWERbusiness 530WalnutStreet Philadelphia,PA19106USA LWW.com Allrightsreserved.Thisbookisprotectedbycopyright.Nopartofthisbookmaybereproducedinanyformbyany means,includingphotocopying,orutilizedbyanyinformationstorageandretrievalsystemwithoutwrittenpermissionfrom thecopyrightowner,exceptforbriefquotationsembodiedincriticalarticlesandreviews.Materialsappearinginthisbook preparedbyindividualsaspartoftheirofficialdutiesasU.S.governmentemployeesarenotcoveredbytheabove-mentioned copyright. PrintedinChina LibraryofCongressCataloging-in-PublicationData Imagingoforthopaedicfixationdevicesandprostheses/editor,ThomasH.Berquist. p.;cm. Includesbibliographicalreferencesandindex. ISBN-13:978-0-7817-9252-3(alk.paper) ISBN-10:(invalid)0-7817-9252-3(alk.paper) 1. Orthopedicapparatus—Imaging. 2. Musculoskeletalsystem—Diseases—Imaging. 3. Musculoskeletalsystem— Diseases—Surgery. I. Berquist,ThomasH.(ThomasHenry),1945- [DNLM:1. MusculoskeletalDiseases—diagnosis. 2. DiagnosticImaging. 3. MusculoskeletalDiseases—surgery. 4. OrthopedicFixationDevices.WE141I3012009] RD755.5.I382009 617(cid:1).9—dc22 2008024236 Care has been taken to confirm the accuracy of the information presented and to describe generally accepted practices. However, the authors, editors, and publisher are not responsible for errors or omissions or for any consequences from application of the information in this book and make no warranty, expressed or implied, with respect to the currency, completeness,oraccuracyofthecontentsofthepublication.Applicationofthisinformationinaparticularsituationremains theprofessionalresponsibilityofthepractitioner. Theauthors,editors,andpublisherhaveexertedeveryefforttoensurethatdrugselectionanddosagesetforthinthis textareinaccordancewithcurrentrecommendationsandpracticeatthetimeofpublication.However,inviewofongoing research,changesingovernmentregulations,andtheconstantflowofinformationrelatingtodrugtherapyanddrugreactions, thereaderisurgedtocheckthepackageinsertforeachdrugforanychangeinindicationsanddosageandforaddedwarnings andprecautions.Thisisparticularlyimportantwhentherecommendedagentisaneworinfrequentlyemployeddrug. SomedrugsandmedicaldevicespresentedinthispublicationhaveFoodandDrugAdministration(FDA)clearancefor limiteduseinrestrictedresearchsettings.ItistheresponsibilityofhealthcareproviderstoascertaintheFDAstatusofeach drugordeviceplannedforuseintheirclinicalpractice. Topurchaseadditionalcopiesofthisbook,callourcustomerservicedepartmentat(800)638-3030orfaxordersto(301) 223-2320.Internationalcustomersshouldcall(301)223-2300. Visit Lippincott Williams & Wilkins on the Internet: at LWW.com. Lippincott Williams & Wilkins customer service representativesareavailablefrom8:30amto6pm,EST. 10 9 8 7 6 5 4 3 2 1 I dedicate this text to my loving wife, Mary, for her continued support and understanding. Preface In 1995 we published an Atlas of Orthopaedic Appliances and Prostheses. This was a work dedicated to bridging the gap between orthopaedic surgeons and imagers. I have continued to dedicate efforts to improve the understanding of orthopaedic procedures and ‘‘what the surgeon needstoknow’’whenorderingpreoperativeandpostoperativeimagingstudies. Orthopaedicinstrumentationandprosthesescontinuetoevolve,makingitdifficultforimagers tokeepupwithallpossibleimplantsthatmayappearonradiographsorotherimagingmodalities. Withthisinmind,itisessentialforsurgeonsandradiologiststoworkcloselyandwe,asimagers, needtobecomefamiliarwiththeinstrumentationsystemsoursurgeonsprefer. Thiseditionisdesignedtobemoreconcisethantheprioratlaswithnoattempttodemonstrate everypossiblefixationdeviceorprostheses.Wereviewtheimportantclinicalandimagefeaturesof orthopaedic devices including clinical concepts and patient selection, the normal appearance of orthopaedic devices and the image features, and most appropriate modalities for evaluating complications. Chapter 1 is a concise review of image modalities that may play a role in evaluation of orthopaedicfixationdevicesandprostheses.Chapter2providesalistanddefinitionsofcommonly used orthopaedic terms and an overview of general fixation devices including screws, plates, intramedullary nails, wires and cables, and soft tissue anchors. These chapters serve to reduce redundancy in later chapters where these devices may be used. Chapters 3 through 13 are anatomically oriented and focus on fixation devices, prostheses, and procedures for a given anatomic region. Emphasis is placed on indications, clinical data and decision making, as well as preoperative and postoperative imaging and complications. Each chapter includes trauma, orthopaedicclassificationswhereappropriate,andjointreplacementandothercommonorthopaedic proceduresrelatedtotheanatomicregioncoveredinthechapter.Chapter14reviewsclinicaldata, staging,andpreoperativeandpostoperativeimaginginpatientswithmusculoskeletalneoplasms. This text will be most useful to practicing radiologists and radiologists in training. Other physicianswhodealwithorthopaedicproblemswillalsofindtheinformationprovidedinthistext extremelyuseful. vii Acknowledgments Preparation of this text required the support of numerous individuals and colleagues. I first wish to thank my colleagues in musculoskeletal imaging at Mayo Jacksonville, Laura Bancroft, Mark Kransdorf,andJeffreyPetersonfortheirsupportandassistanceinprovidingthenecessaryimages neededtofulfillthemissionofthistext.Ialsowanttothankmycolleaguesinorthopaedicsurgery, MarkBroderson,StephenTrigg,CedricOrtiguera,PeterMurry,MaryO’Connor,KurtisBlasser, andJosephWhalenfortheirconsultativesupport. Daniel Huber and John Hagen were instrumental in providing images and art required to demonstrateanatomy,normalandabnormalimagefeaturesfordevicesdescribedinthistext.The vendors of orthopaedic devices were also very helpful in providing photographs and artwork to assistwithdemonstrationofdevicesandtheirindicationstousealongwiththeimagesinthistext. Finally,IwishtothankRyanShaw,LisaMcAlliser,andKerryBarrettfromLippincottWilliams &Wilkinsfortheirassistanceandsupportwiththisproject. ix
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