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Orthopedic Traumatology Manish K. Sethi A. Alex Jahangir ● William T. Obremskey Editors Mohit Bhandari Mitchel B. Harris ● Michael D. McKee Steven A. Olson ● Paul Tornetta, III Roy W. Sanders ● Andrew H. Schmidt Section Editors Orthopedic Traumatology An Evidence-Based Approach Editors Manish K. Sethi A. Alex Jahangir Department of Orthopedic Surgery Department of Orthopedic Surgery and Rehabilitation and Rehabilitation Vanderbilt University Medical Center Vanderbilt University Medical Center Nashville, TN, USA Nashville, TN, USA William T. Obremskey Department of Orthopedic Surgery and Rehabilitation Vanderbilt University Medical Center Nashville, TN, USA ISBN 978-1-4614-3510-5 ISBN 978-1-4614-3511-2 (eBook) DOI 10.1007/978-1-4614-3511-2 Springer New York Heidelberg Dordrecht London Library of Congress Control Number: 2012940415 © Springer Science+Business Media New York 2013 This work is subject to copyright. 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Printed on acid-free paper Springer is part of Springer Science+Business Media (www.springer.com) Foreword Orthopedic surgeons who manage the injured patient have always sought the best information on which to make treatment decisions. In the past, this has generally consisted of large textbooks with a comprehensive listing of all articles on a particu- lar injury, with an author’s expert opinion and treatment recommendations synthesizing this information. With the evolution of higher quality clinical research methods, orthopedic trauma surgeons have been in the lead and the paradigm has shifted. Because levels of evidence are now routinely inserted into the medical literature and has scienti fi c presentations, the desire to have the strongest case for treatment decisions has increased. As the number of Level I and Level II studies has proliferated in the orthopedic trauma literature, the need for aggregation of this information into easily accessible formats has escalated. This need is speci fi cally for surgeons treating patients at the point of care. Drs. Sethi, Jahangir, and Obremskey have taken the next step in the synthesis of higher levels of evidence for the practicing orthopedic surgeon. The fi eld of orthopedic trauma surgery is wonderfully diverse in the types and locations of skeletal and soft tissue injury. This is one of the attractions of a career in orthopedic traumatology: the fact that while some injuries are common and managed frequently, oth- ers are extremely rare. The authors have taken the practical approach of taking the most commonly seen orthopedic injures, in which the most comprehensive evidence base exists, and aggregating the information in a useful format. They have organized the chapters around common clinical scenarios taken from real-life expe- rience. The case scenarios are then followed by a synthesis of the best clinical literature focusing on Level I and Level II studies. The scienti fi c technique of meta-analysis and the structured literature review are strictly employed to provide the reader with the best recommendations for management of an individual injury. Those principles of literature synthesis using scienti fi c methodology are explained in an introductory chapter to enhance the utility of the individual chapters. The progression of clinical research and orthopedic traumatology has de fi nitely moved towards collaborative focused research using multicenter teams. Each year the number and quality of clinical research articles improves. This book is a wonder- ful fi rst step in synthesizing this information into a format useful to the individual v vi Foreword surgeon working with the patient and their family in making treatment decisions. As the clinical research and datasets expand, the work will need to expand. I expect that this work will be frequently revised on a regular basis to help all of us in the orthopedic community to deliver the best care for our patients. I enthusiastically recommend this book to orthopedic surgeons everywhere. Marc Swiontkowski Contents Part I Evidence-Based Medicine in Orthopedic Trauma Surgery Mohit Bhandari 1 Introduction to Evidence-Based Medicine ............................................ 3 Clary Foote and Mohit Bhandari Part II Spine Trauma Mitchel B. Harris 2 Cervical Spine Clearance ....................................................................... 23 Andrew K. Simpson and Mitchel B. Harris 3 Cervical Spine Fracture Dislocation ..................................................... 41 Kevin R. O’Neill, Jesse E. Bible, and Clinton James Devin 4 Lumbar Burst Fractures ........................................................................ 55 Robert Greenleaf and Mitchel B. Harris Part III Upper Extremity Trauma Michael D. McKee 5 Scapula Fractures ................................................................................... 71 Peter A. Cole and Brian W. Hill 6 Clavicle Fractures ................................................................................... 87 Christopher R. Geddes and Michael D. McKee 7 Proximal Humerus Fracture .................................................................. 103 Daniel J. Stinner, Philipp N. Streubel, and William T. Obremskey 8 Humeral Shaft Fractures........................................................................ 129 Bill Ristevski and Jeremy Hall vii viii Contents 9 Distal Humerus Fractures ...................................................................... 141 Andrew Jawa and David Ring 10 Distal Radius Fractures .......................................................................... 151 Cameron T. Atkinson, Philipp N. Streubel, and Jeffry Watson Part IV Acetabular, Hip and Pelvic Trauma Steven A. Olson 11 Acetabular Fractures in the Elderly ...................................................... 169 John C. Weinlein, Edward A. Perez, Matthew I. Rudloff, and James L. Guyton 12 Pelvic Ring Injury I................................................................................. 185 Damien G. Billow and Steven A. Olson 13 Pelvic Ring Injury II ............................................................................... 195 Matthew D. Karam and David C. Templemen 14 Femoral Neck Fractures in the Elderly ................................................. 207 Dave Polga and Robert T. Trousdale 15 Intertrochanteric Femur Fractures ....................................................... 219 Hassan R. Mir and George J. Haidukewych Part V Lower Extremity Trauma Paul Tornetta, III 16 Diaphyseal Femur Fractures .................................................................. 235 Manish K. Sethi, Kyle Judd, A. Alex Jahangir, and William T. Obremskey 17 Distal Femur Fractures........................................................................... 247 A. Alex Jahangir and William M. Ricci 18 Knee Dislocations .................................................................................... 261 Samuel N. Crosby Jr., Manish K. Sethi, and William T. Obremskey 19 Tibial Plateau Fractures ......................................................................... 277 Jodi Siegel and Paul Tornetta III 20 Closed Diaphyseal Tibia Fractures........................................................ 291 Marlis T. Sabo and David W. Sanders 21 Open Diaphyseal Tibia Fractures .......................................................... 303 Scott P. Ryan, Christina L. Boulton, and Robert V. O’Toole Contents ix Part VI Foot and Ankle Trauma Roy W. Sanders 22 Pilon Fractures ........................................................................................ 323 David P. Barei 23 Ankle Fractures ....................................................................................... 345 Conor P. Kleweno and Edward K. Rodriguez 24 Calcaneus Fractures ............................................................................... 359 Theo Tosounidis and Richard Buckley 25 Talus Fractures ........................................................................................ 373 Hassan R. Mir and Roy W. Sanders Part VII Polytrauma, Infection, and Perioperative Management of the Orthopedic Trauma Patient Andrew H. Schmidt 26 Damage Control ...................................................................................... 389 Laurence B. Kempton and Michael J. Bosse 27 DVT Prophylaxis in Orthopedic Trauma ............................................. 405 Keith D. Baldwin, Surena Namdari, and Samir Mehta 28 The Infected Tibial Nail .......................................................................... 417 Megan A. Brady and Brendan M. Patterson 29 Perioperative Optimization in Orthopedic Trauma ............................ 431 Clifford Bowens Jr. and Jesse M. Ehrenfeld Index ................................................................................................................. 445

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Physicians are under increasing pressure to provide quality health care in the most cost-effective way possible. The escalating costs of orthopedic care are driving the need to base clinical decision making on evidence-based data that will help physicians provide optimal care to every patient. Evide