Textbook of Orthopedics A Thought from the Student God created the doctor and his patient. Together they created many hospitals and Medical Institutions. A happy world is what it would have been, had it not been the emergencies in between. Let this book come in ‘handy’ when it matters the most. Dr K Sarawana Textbook of Orthopedics Fourth Edition John Ebnezar MBBS D’Ortho, DNB (Ortho), MNAMS (Ortho), DAc, DMT, PhD (Yoga) Sports Medicine (Australia), INOR Fellow (United Kingdom) Consulting Orthopedic and Spine Surgeon and Holistic Orthopedic Expert, Sports Specialist Formerly Assistant Professor of Orthopedics Devaraj Urs Medical College Kolar, Karnataka Senior Specialist in Orthopedics Department of Orthopedics Victoria Hospital Bangalore Medical College Currently JAYPEE BROTHERS MEDICAL PUBLISHERS (P) LTD St Louis (USA) • Panama City (Panama) • New Delhi • Ahmedabad • Bengaluru Chennai • Hyderabad • Kochi • Kolkata • Lucknow • Mumbai • Nagpur Chief Consulting Orthopedic Surgeon and Medical Director Parimala Health Care Services, An ISO 9001:2000 hospital Bengaluru Chairman Ebnezar Orthopedic Center, Bengaluru Chairman Dr Ebnezar’s Medical Institute President Geriatric Orthopedic Society President All India Medical Author’s Association Chairman The Physically Handicapped and Paraplegic Charitable Trust of Karnataka President The Karnataka Orthopedic Academy Director Bangalore Holistic Orthopedic Centre, Bengaluru President Vaidya Kala Ranga, Bengaluru Chairman Rakesh Cultural Academy ® Published by Jitendar P Vij Jaypee Brothers Medical Publishers (P) Ltd Corporate Office 4838/24, Ansari Road, Daryaganj, New Delhi 110 002, India Phone: +91-11-43574357, Fax: +91-11-43574314 Registered Office B-3 EMCA House, 23/23B Ansari Road, Daryaganj, New Delhi 110 002, India Phones: +91-11-23272143, +91-11-23272703, +91-11-23282021, +91-11-23245672 Rel: +91-11-32558559 Fax: +91-11-23276490, +91-11-23245683 e-mail: