Trauma and Orthopaedics at a Glance

142 Pages·2016·10.782 MB·English

by  Henry Willmott

Trauma and
Orthopaedics
at a Glance
For Erika
This title is also available as an e‐book.
For more details, please see
www.wiley.com/buy/9781118802533
or scan this QR code:
Trauma and
Orthopaedics
at a Glance
Henry Willmott
Consultant Trauma and Orthopaedic Surgeon
East Sussex Healthcare NHS Trust
United Kingdom
iv
This edition first published 2016 © 2016 by John Wiley & Sons, Ltd.
Registered office
John Wiley & Sons, Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK
Editorial offices
9600 Garsington Road, Oxford, OX4 2DQ, UK
The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK
350 Main Street, Malden, MA 02148‐5020, USA
For details of our global editorial offices, for customer services and for information about how
to apply for permission to reuse the copyright material in this book please see our website at
www.wiley.com/wiley‐blackwell
The right of the authors to be identified as the authors of this work has been asserted in accordance
with the UK Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or
transmitted, in any form or by any means, electronic, mechanical, photocopying, recording
or otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the
prior permission of the publisher.
Designations used by companies to distinguish their products are often claimed as trademarks.
All brand names and product names used in this book are trade names, service marks, trademarks or
registered trademarks of their respective owners. The publisher is not associated with any product
or vendor mentioned in this book. It is sold on the understanding that the publisher is not engaged in
rendering professional services. If professional advice or other expert assistance is required, the
services of a competent professional should be sought.
The contents of this work are intended to further general scientific research, understanding, and
discussion only and are not intended and should not be relied upon as recommending or promoting
a specific method, diagnosis, or treatment by health science practitioners for any particular patient.
The publisher and the author make no representations or warranties with respect to the accuracy or
completeness of the contents of this work and specifically disclaim all warranties, including without
limitation any implied warranties of fitness for a particular purpose. In view of ongoing research,
equipment modifications, changes in governmental regulations, and the constant flow of information
relating to the use of medicines, equipment, and devices, the reader is urged to review and evaluate
the information provided in the package insert or instructions for each medicine, equipment, or
device for, among other things, any changes in the instructions or indication of usage and for added
warnings and precautions. Readers should consult with a specialist where appropriate. The fact that
an organization or Website is referred to in this work as a citation and/or a potential source of further
information does not mean that the author or the publisher endorses the information the organization
or Website may provide or recommendations it may make. Further, readers should be aware that
Internet Websites listed in this work may have changed or disappeared between when this work was
written and when it is read. No warranty may be created or extended by any promotional statements
for this work. Neither the publisher nor the author shall be liable for any damages arising herefrom.
Library of Congress Cataloging‐in‐Publication Data
Willmott, Henry, author.
Trauma and orthopaedics at a glance / Henry Willmott.
p. ; cm. – (At a glance series)
Includes bibliographical references and index.
ISBN 978-1-118-80253-3 (pbk.)
I. Title. II. Series: At a glance series (Oxford, England)
[DNLM: 1. Musculoskeletal Diseases–therapy. 2. Orthopedic Procedures.
3. Musculoskeletal System–injuries. 4. Wounds and Injuries–therapy. WE 140]
RC925 Proudly sourced and uploaded by [StormRG]
616.7–dc23 Kickass Torrents | TPB | ET | h33t
2014033409
A catalogue record for this book is available from the British Library.
Wiley also publishes its books in a variety of electronic formats. Some content that appears in print
may not be available in electronic books.
Cover image: iStock/ © Philartphace
Set in 9.5/11.5pt Minion by SPi Publisher Services, Pondicherry, India
1 2016
Contents
Preface   vii
Acknowledgements   viii
How to use your revision guide   ix
About the companion website   x
Part 1 Basic sciences   1
1 Musculoskeletal tissues   2
2 Bone metabolism   4
3 Osteoarthritis   6
4 Rheumatoid arthritis   8
5 Imaging in orthopaedics: X‐rays   10
6 Imaging in orthopaedics: other modalities   12
7 Infection   14
8 Clinical anatomy of the upper limb   16
9 Clinical anatomy of the lower limb   19
10 Clinical anatomy of the spine   22
11 Examination of the upper limb   24
12 Examination of the lower limb   26
13 Examination of the spine   28
14 The brachial plexus   30
Part 2 Adult orthopaedics   33
Upper limb   34
15 Shoulder 1   34
16 Shoulder 2   36
17 Elbow   38
18 Wrist and hand 1   40
19 Wrist and hand 2   42
20 Wrist and hand 3   44
Lower limb   46
21 Hip   46
22 Hip replacement   48
23 Knee 1   50
24 Knee 2   52
25 Foot and ankle  54
26 Spine   56
27 Tumours   58
28 Rehabilitation   60
v
Part 3 Paediatric orthopaedics   63
29 Developmental dysplasia of hip (DDH)   64
30 Other paediatric hip conditions   66
31 Paediatric spinal disorders   68
32  Paediatric foot conditions   70
33 Neuromuscular conditions   72
34 Lower limb alignment   74
Part 4 Trauma   77
35 General principles 1   78
36 General principles 2   80
37 Advanced trauma life support (ATLS)   82
38 Upper limb trauma 1   84
39 Upper limb trauma 2   86
40 Upper limb trauma 3   88
41 Lower limb trauma 1   90
42 Lower limb trauma 2   92
43 Lower limb trauma 3   94
44 Proximal femoral fracture 1   96
45 Proximal femoral fracture 2   98
46 Cervical spine trauma   100
47 Thoracolumbar spine trauma   102
48 Trauma in children 1   104
49 Trauma in children 2   106
50 Compartment syndrome   108
51 Non‐union and malunion   110
Part 5 Working as a junior doctor in orthopaedics   113
52 Being an orthopaedic F2   114
53 Assessment of patients   116
54 The operating theatre   118
Part 6 Practical procedures   121
55 Practical procedures 1   122
56 Practical procedures 2   124
Index   126
vi
vii
Preface
This compact book provides a general overview of the most first. Therefore many junior doctors start their foundation job
common orthopaedic problems encountered on wards and in feeling underprepared. This book addresses that deficit. It is aimed
clinics. It is not an exhaustive tome, but will furnish the reader with at senior medical students and foundation doctors, though those
key facts on which to base further reading. It is also suitable as a in other professions such as nurses, physiotherapists and
revision guide for medical school finals. occupational therapists will find it helpful. I would suggest that
Orthopaedics is a fascinating and hugely varied speciality. foundation doctors spend around 15 minutes on each chapter, and
The patients range from newborn infants to the elderly. The read two every day. By the end of the first month you will have read
pathologies vary from minor aches and pains to life‐threatening the whole book and have a good understanding of the main
trauma. Orthopaedic operations are hands‐on procedures, conditions you are likely to encounter.
combining knowledge of anatomy and biomechanics. Working as I have followed the proven at a Glance format: full‐page
a junior doctor in orthopaedics should be one of the best jobs of illustrations are paired with concise text. There are six sections:
the foundation years: there is something for everyone. Those basic sciences; adult orthopaedics; paediatric orthopaedics;
leaning towards a future in general medicine will enjoy managing trauma; a section for a junior doctor in orthopaedics and finally
the many medical conditions encountered on the ward, while a simple guide on performing a selected range of practical
those looking to a career as a GP will have the opportunity to learn procedures. The last two sections are unique and will be helpful
about the myriad musculoskeletal injuries that we treat. Finally, to those starting out in clinical orthopaedics. I have tried to use
those intending to pursue a career as a surgeon will have the as many X‐rays as possible throughout, all taken from real
opportunity to acquire surgical skills in theatre. patients with genuine problems. The online material consists of
Sadly, many medical schools still spend far too little time multiple‐choice questions and case studies, which will help
teaching orthopaedics. This speciality is quite different from any reinforce knowledge.
other. The nature of the work is unique and the terminology is I hope that this book fuels your interest in orthopaedics and
different. It is often the first time many foundation doctors are helps you deliver compassionate care to your patients. Good luck
given significant responsibility on the wards. and enjoy the job!
In addition, new doctors will be expected to present cases in the
morning trauma meetings, invariably a harrowing experience at Henry Willmott
vii
Acknowledgements
Many of the X‐rays in the illustrations have been provided by professional images. Finally, I want to express my gratitude to
colleagues. Particular thanks are due to Om Lahoti who Chris Ferguson whose critical eye and attention to detail kept
supplied images for the paediatric section. I am indebted to Matt my grammar and syntax on the straight and narrow!
Stephenson who kindly put me in touch with the publishers. The Material is used from the following source, with permission:
editorial and production staff at Wiley have been tireless in
converting my vision into reality. I am also very grateful to Faiz O, Blackburn S & Moffat D. Anatomy at a Glance, 3rd edn, 2011.
the illustrators who converted my cartoon‐like scrawlings into Wiley‐Blackwell: Oxford.
viii