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AO Surgery Reference

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  1. Proximal humerus

    Diagnosis
    Overview
    Preparations
    Overview
    Preparation/Positioning
    Approaches
    Overview
    Deltopectoral approach
    Anterolateral approach
    Transdeltoid lateral approach
    Safe zones
    Reduction & Fixations
    Overview
    4-Part, dislocation, fragmentary metaphyseal +/- fragmentary articular
    Nonoperative
    ORIF - Plate fixation
    Hemiarthroplasty
    Reverse arthroplasty
    4-Part, dislocation, simple metaphyseal, intact articular
    Nonoperative
    ORIF - Plate fixation
    Hemiarthroplasty
    Reverse arthroplasty
    4-Part, marked displacement, fragmentary articular, varus malalignment
    Nonoperative
    ORIF - Plate fixation
    Hemiarthroplasty
    Reverse arthroplasty
    4-Part, marked displacement, intact articular, valgus malalignment
    Nonoperative
    ORIF - Plate fixation
    Hemiarthroplasty
    Reverse arthroplasty
    4-Part, marked displacement, intact articular, varus malalignment
    Nonoperative
    ORIF - Plate fixation
    Hemiarthroplasty
    Reverse arthroplasty
    4-Part, slight displacement, valgus malalignment
    Nonoperative
    MIO - Screw fixation
    MIO - Plate fixation
    ORIF - Plate fixation
    Reverse arthroplasty
    4-Part, slight displacement, varus malalignment
    Nonoperative
    MIO - Screw fixation
    MIO - Plate fixation
    ORIF - Plate fixation
    Reverse arthroplasty
    Extraarticular 2-part, greater tuberosity, displaced
    Nonoperative
    MIO - Screw fixation
    ORIF - Screw or suture fixation
    Extraarticular 2-part, greater tuberosity, nondisplaced
    Nonoperative
    MIO - Screw fixation
    Extraarticular 2-part, surgical neck, impaction
    Nonoperative
    MIO - Screw fixation
    MIO - Plate fixation
    Nailing (straight nail)
    Nailing (bent nail)
    ORIF - Screw fixation
    ORIF - Plate fixation
    Reverse arthroplasty
    Extraarticular 2-part, surgical neck, no impaction
    Nonoperative
    MIO - Screw fixation
    MIO - Plate fixation
    Nailing (straight nail)
    Nailing (bent nail)
    ORIF - Plate fixation
    Reverse arthroplasty
    Extraarticular 2-part, tuberosity, dislocation
    Nonoperative
    MIO - Screw fixation
    ORIF - Screw or suture fixation
    Extraarticular 3-part, surgical neck and greater tuberosity, impaction
    Nonoperative
    MIO - Screw fixation
    Nailing
    MIO - Plate fixation
    ORIF - Plate fixation
    Reverse arthroplasty
    Extraarticular 3-part, surgical neck and lesser tuberosity, impaction
    Nonoperative
    Nailing
    MIO - Plate fixation
    ORIF - Plate fixation
    Reverse arthroplasty
    Extraarticular 3-part, surgical neck and tuberosity, dislocation
    Nonoperative
    MIO - Screw fixation
    MIO - Plate fixation
    ORIF - Plate fixation
    Hemiarthroplasty
    Reverse arthroplasty
    Extraarticular 3-part, surgical neck and tuberosity, no impaction
    Nonoperative
    MIO - Screw fixation
    Nailing
    MIO - Plate fixation
    ORIF - Plate fixation
    Hemiarthroplasty
    Reverse arthroplasty
    Isolated anatomical neck, dislocation
    Nonoperative
    ORIF - Plate or screw fixation
    Hemiarthroplasty
    Isolated anatomical neck, slight displacement
    Nonoperative
    MIO - Screw fixation
    ORIF - Screw fixation
    ORIF - Plate fixation
    Hemiarthroplasty
    Special considerations
    Principles of management of open fractures
    Infection
    Compartment syndrome
  2. Humeral shaft

    Diagnosis
    Overview
    Preparations
    Overview
    Beach chair position
    Supine position
    Lateral position
    Prone position
    Approaches
    Overview
    Anterolateral approach
    Lateral approach
    Posterior approach
    Distal posterior approach
    MIPO approach
    Antegrade nailing approach
    Retrograde nailing approach
    Safe zones
    Reduction & Fixations
    Overview
    A1 Simple fractures, spiral
    Nonoperative treatment; brace
    External fixation
    Closed reduction; antegrade nailing
    Closed reduction; retrograde nailing
    Open reduction; lag screw(s) with neutralization plate
    A2 Simple fractures, oblique (>30°)
    Nonoperative treatment; brace
    External fixation
    Closed reduction; antegrade nailing
    Closed reduction; retrograde nailing
    Open reduction; lag screw(s) with neutralization plate
    Open reduction; compression plating
    A3 Simple fractures, transverse (<30°)
    Nonoperative treatment; brace
    External fixation
    Closed reduction; antegrade nailing
    Closed reduction; retrograde nailing
    Open reduction; compression plating
    B1 Spiral wedge fractures
    Nonoperative treatment; brace
    External fixation
    Closed reduction; antegrade nailing
    Closed reduction; retrograde nailing
    Closed reduction; bridge plating (MIO)
    Open reduction; bridge plating
    B2 Bending wedge fractures
    Nonoperative treatment; brace
    External fixation
    Closed reduction; antegrade nailing
    Closed reduction; retrograde nailing
    Closed reduction; bridge plating (MIO)
    Open reduction; bridge plating
    B3 Fragmented wedge fractures
    Nonoperative treatment; brace
    External fixation
    Closed reduction; antegrade nailing
    Closed reduction; retrograde nailing
    Closed reduction; bridge plating (MIO)
    Open reduction; bridge plating
    C1 Complex spiral fractures
    Nonoperative treatment; brace
    External fixation
    Closed reduction; antegrade nailing
    Closed reduction; retrograde nailing
    Closed reduction; bridge plating (MIO)
    Open reduction; bridge plating
    C2 Segmental complex fractures
    Nonoperative treatment; brace
    External fixation
    Closed reduction; antegrade nailing
    Closed reduction; retrograde nailing
    Closed reduction; bridge plating (MIO)
    Open reduction; bridge plating
    C3 Irregular complex fractures
    Nonoperative treatment; brace
    External fixation
    Closed reduction; antegrade nailing
    Closed reduction; retrograde nailing
    Closed reduction; bridge plating (MIO)
    Open reduction; bridge plating
    Special considerations
    Principles of management of open fractures
    Infection
    Compartment syndrome
  3. Distal humerus

    Diagnosis
    Overview
    Preparations
    Overview
    Supine for lateral approach
    Supine for medial approach
    Prone position
    Lateral decubitus position
    Approaches
    Overview
    Lateral approach (Kaplan)
    Medial approach
    Medial approach (Hotchkiss over the top)
    Medial approach (FCU split)
    Medial approach (Taylor and Scham)
    Transolecranon approach
    Posterior triceps-on approach
    Triceps-elevating approach
    Safe zones
    Anterior approach
    Reduction & Fixations
    Overview
    Complete articular, multifragmentary articular
    ORIF - Perpendicular plating
    ORIF - Parallel plating
    Complete articular, simple articular, fragmentary metaphyseal
    ORIF - Perpendicular plating
    ORIF - Parallel plating
    Complete articular, simple articular, simple metaphyseal
    ORIF - Perpendicular plating
    ORIF - Parallel plating
    Extraarticular, avulsion of lateral epicondyle
    Nonoperative treatment
    ORIF - Screw fixation
    Extraarticular, avulsion of medial epicondyle
    Nonoperative treatment
    ORIF - Screw fixation
    Extraarticular, avulsion of medial epicondyle, incarcerated
    ORIF - Screw fixation
    Extraarticular, multifragmentary
    Nonoperative treatment
    External fixation
    ORIF - Plate and screw fixation
    Extraarticular, simple, oblique
    Nonoperative treatment
    External fixation
    ORIF - Plate fixation
    Extraarticular, simple, transverse
    Nonoperative treatment
    External fixation
    ORIF - Plate fixation
    Extraarticular, wedge, intact or fragmentary
    Nonoperative treatment
    External fixation
    ORIF - Plate fixation
    Partial articular, frontal/coronal, capitellum and trochlea
    ORIF - Screw fixation +/- protection plate
    Partial articular, frontal/coronal, capitellum
    ORIF - Headless screw fixation
    Partial articular, frontal/coronal, trochlea
    ORIF - Headless screw fixation
    Partial articular, lateral sagittal
    ORIF - Screw fixation
    ORIF - Screw and protection plate
    ORIF - Plate fixation
    ORIF - Plate and screw fixation (+/- headless screws)
    Partial articular, medial sagittal, fragmentary, transtrochlear
    ORIF - Plate and screw fixation
    Partial articular, medial sagittal, simple, through medial articular surface
    ORIF - Screw fixation
    Partial articular, medial sagittal, simple, through trochlear groove
    ORIF - Plate and screw fixation
    Special considerations
    Principles of management of open fractures
    Infection
    Compartment syndrome
  4. Scapula

    Diagnosis
    Overview
    Preparations
    Overview
    Lateral
    Prone
    Beach chair
    Supine
    Approaches
    Overview
    Posterior approach
    Arthroscopic entry points
    Deltopectoral approach
    Delta split
    Superior approach
    Reduction & Fixations
    Overview
    Body and processes, acromion
    Nonoperative treatment
    ORIF - Lag screw fixation
    ORIF - Tension band
    Body and processes, body
    Nonoperative treatment
    Body and processes, coracoid
    Nonoperative treatment
    ORIF - Lag screw fixation
    Glenoid fossa, complete articular, multifragmentary articular
    Nonoperative treatment
    ORIF - Plate fixation
    Glenoid fossa, complete articular, simple articular, simple neck
    Nonoperative treatment
    ORIF - Plate fixation
    Glenoid fossa, complete articular, articular simple, neck complex/wedge
    Nonoperative treatment
    ORIF - Plate fixation
    Glenoid fossa, extraarticular, multifragmentary
    Nonoperative treatment
    ORIF - Plate fixation
    Glenoid fossa, extraarticular, simple
    Nonoperative treatment
    ORIF - Plate fixation
    Glenoid fossa, extraarticular, wedge
    Nonoperative treatment
    ORIF - Plate fixation
    Glenoid fossa, partial articular, anterior multifragmentary
    Nonoperative treatment
    ORIF - Lag screw fixation
    ORIF - Suture anchors
    Glenoid fossa, partial articular, anterior simple
    Nonoperative treatment
    ORIF - Lag screw fixation
    MIO - Lag screw fixation
    ORIF - Suture anchors
    Glenoid fossa, partial articular, posterior multifragmentary
    Nonoperative treatment
    ORIF - Lag screw fixation
    ORIF - Suture anchors
    Glenoid fossa, partial articular, posterior simple
    Nonoperative treatment
    ORIF - Lag screw fixation
    MIO - Lag screw fixation
    ORIF - Suture anchors
    Glenoid fossa, partial articular, transverse multifragmentary
    Nonoperative treatment
    ORIF - Lag screw fixation
    Glenoid fossa, partial articular, transverse simple
    Nonoperative treatment
    ORIF - Lag screw fixation
    MIO - Lag screw fixation
    Special considerations
    Complete LSSS Failure
    Floating shoulder - Sequence of repair
    Ligament reconstruction
  5. Clavicle

    Diagnosis
    Overview
    Preparations
    Overview
    Beach chair
    Supine
    Approaches
    Overview
    Anterior approach
    Nailing approach
    MIPO - anterior approach
    Superior approach
    Reduction & Fixations
    Overview
    Diaphyseal multifragmentary, fragmentary segmental
    Nonoperative treatment
    ORIF - Bridge plate
    MIO - Bridge plate
    Diaphyseal multifragmentary, fragmentary spiral
    Nonoperative treatment
    ORIF - Bridge plate
    Diaphyseal multifragmentary, intact segmental
    Nonoperative treatment
    ORIF - Compression plate
    Diaphyseal simple, oblique
    Nonoperative treatment
    ORIF - Lag screw with neutralization plate
    ORIF - Compression plate with lag screw
    Flexible intermedullary nail
    Diaphyseal simple, spiral
    Nonoperative treatment
    Diaphyseal simple, transverse
    Nonoperative treatment
    ORIF - Compression plate
    Flexible intermedullary nail
    Diaphyseal wedge, fragmentary wedge
    Nonoperative treatment
    ORIF - Bridge plate
    Diaphyseal wedge, Intact bending wedge
    Nonoperative treatment
    Flexible intermedullary nail
    ORIF - Lag screw with neutralization plate
    ORIF - Bridge plate
    Diaphyseal wedge, intact spiral wedge
    Nonoperative treatment
    ORIF - Bridge plate
    Lateral, displaced fracture with CC intact, extraarticular
    Nonoperative treatment
    ORIF - Pre-contoured distal plate
    Lateral, displaced fracture with CC intact, fragmentary
    Nonoperative treatment
    ORIF - Hook plate
    ORIF - Pre-contoured distal plate
    Lateral, displaced fracture with CC disrupted, articular
    Nonoperative treatment
    ORIF - Hook plate
    Lateral, displaced fracture with CC disrupted, extraarticular
    Nonoperative treatment
    ORIF - Hook plate
    ORIF - Pre-contoured distal plate
    Lateral, undisplaced fracture with CC intact, articular
    Nonoperative treatment
    Lateral, undisplaced fracture with CC intact, extraarticular
    Nonoperative treatment
    Medial, articular
    Nonoperative treatment
    Reduction of sternoclavicular dislocation
    Medial, extraarticular
    Nonoperative treatment
    Reduction of sternoclavicular dislocation
    Medial, complete articular
    Nonoperative treatment
    Reduction of sternoclavicular dislocation
    Special considerations
    Floating shoulder - Sequence of repair
    Complete LSSS Failure
  6. Proximal forearm

    Diagnosis
    Overview
    Preparations
    Overview
    Supine for anterior access
    Supine for lateral access
    Lateral decubitus position
    Supine for posterior access
    Approaches
    Overview
    Anterior approach
    Lateral approach
    Posterolateral approach
    Safe zones
    Medial: over the top
    Medial: Taylor and Scham
    Medial: FCU split
    Reduction & Fixations
    Overview
    Anterior fracture dislocation
    Open reduction internal fixation
    Hinged external fixation following ORIF
    Posterior fracture dislocation
    Open reduction internal fixation
    Hinged external fixation following ORIF
    Radius, complete articular
    Nonoperative
    Plate and screws
    Radial head excision
    Radial head arthroplasty
    Radius, partial articular
    Nonoperative
    Lag screw
    Radial head excision
    Radial head arthroplasty
    Radius, extraarticular, avulsion of bicipital tuberosity
    Nonoperative
    Biceps reinsertion
    Radius, extraarticular, multifragmentary
    Nonoperative
    Radial head arthroplasty
    Bridge plate
    Radius, extraarticular, simple
    Nonoperative
    Compression with T-plate and screws
    Terrible triad
    Open reduction internal fixation
    Hinged external fixation following ORIF
    Ulna, complete articular
    Nonoperative
    Temporary external fixation
    Bridge plate
    Ulna, articular, coronoid
    Nonoperative
    Temporary external fixation
    Repair of coronoid fracture
    Ulna, articular, olecranon
    Nonoperative
    Temporary external fixation
    Tension band wiring
    Bridge plate
    Lag screw with neutralization plate
    Ulna, extraarticular, avulsion of triceps insertion
    Nonoperative
    Tricepts reinsertion
    Ulna, extraarticular, multifragmentary
    Nonoperative
    Temporary external fixation
    Bridge plate
    Ulna, extraarticular, simple
    Nonoperative
    Temporary external fixation
    Compression plate
    Compression plate and lag screw
    Lag screw and protection plate
    Varus posteromedial rotational instability
    Open reduction internal fixation
    Hinged external fixation following ORIF
    Special considerations
    Principles of management of open fractures
    Infection
    Compartment syndrome
  7. Forearm shaft

    Diagnosis
    Overview
    Preparations
    Overview
    Preparation and positioning
    Approaches
    Overview
    Anterior approach (Henry)
    Posterolateral approach
    Approach to the ulna
    Combined posterior approach
    Speed and Boyd’s approach
    Approaches to the DRUJ
    Safe zones for pin placement
    Nailing approach for ulna
    Nailing approaches for radius
    Lateral approach to prox. radius
    Reduction & Fixations
    Overview
    Multifragmentary radial fracture with non-multifragmentary ulnar fracture
    Nonoperative treatment
    External fixation
    ORIF - Plating of one or both bones
    Intramedullary nailing
    Multifragmentary ulnar fracture with non-multifragmentary radial fracture
    Nonoperative treatment
    External fixation
    ORIF - Plating of one or both bones
    Intramedullary nailing
    Multifragmentary, fragmentary segmental fracture of both bones
    Nonoperative treatment
    External fixation
    Intramedullary nailing
    ORIF - Bridge plating
    Multifragmentary, intact segmental fracture of one bone, fragmentary of the other
    Nonoperative treatment
    External fixation
    Intramedullary nailing
    ORIF - Plating
    Multifragmentary, intact segmental fracture of both bones
    Nonoperative treatment
    External fixation
    ORIF - Compression plating
    Simple fracture of the radius and the ulna
    Nonoperative treatment
    External fixation
    ORIF - Compression Plating
    Oblique simple fracture of the radius
    Nonoperative treatment
    External fixation
    ORIF - Lag screw and plate fixation
    Transverse simple fracture of the radius
    Nonoperative treatment
    External fixation
    MIO - Minimally invasive compression plating
    ORIF - Compression plating
    Simple fracture of the radius, with dislocation of distal radioulnar joint (Galeazzi)
    Nonoperative treatment
    External fixation
    ORIF - Plating
    Oblique simple fracture of the ulna
    Nonoperative treatment
    External fixation
    ORIF - Lag screw and plate fixation
    Transverse simple fracture of the ulna
    Nonoperative treatment
    External fixation
    ORIF - Compression plating
    Simple fracture of the ulna, with dislocation of proximal radioulnar joint (Monteggia)
    Nonoperative treatment
    External fixation
    ORIF - Plating
    Wedge fracture of one bone, with a simple or wedge fracture of the other
    Nonoperative treatment
    External fixation
    ORIF - Compression plating
    Wedge fracture of the radius, with dislocation of distal radioulnar joint (Galeazzi)
    External fixation
    ORIF - Compression plating
    Wedge fracture of the radius with no dislocation
    Nonoperative treatment
    External fixation
    ORIF - Compression Plating
    Wedge fracture of the ulna, with dislocation of proximal radioulnar joint (Monteggia)
    External fixation
    ORIF - Compression Plating
    Wedge fracture of the ulna with no dislocation
    Nonoperative treatment
    External fixation
    ORIF - Compression Plating
    Special considerations
    Principles underlying forearm shaft fracture treatment
    Principles of management of open fractures
    Infection
    Compartment syndrome
  8. Distal forearm

    Diagnosis
    Overview
    Preparations
    Overview
    Supine positioning (distal ulna)
    Supine (dorsal approach)
    Supine (palmar approaches)
    Approaches
    Overview
    Anatomy of the distal forearm
    Direct to the radial styloid
    Ulnar palmar
    Dorsal approach
    Palmar approach
    Ulnar approach
    Dorsal approach
    Reduction & Fixations
    Overview
    Complete simple articular, fragmented metaphysis radial fracture
    Nonoperative treatment - Cast
    Joint-spanning external fixation (temporary or definitive)
    Closed reduction - K-wires and cast/external fixator
    ORIF - Palmar bridge plate
    ORIF - Dorsoradial double plate
    Complete multifragmentary fracture of the radius
    Nonoperative treatment - Cast
    Joint-spanning external fixation (temporary or definitive)
    ORIF - Palmar bridge plate
    ORIF - Joint-spanning distraction plate
    ORIF - Dorsoradial double plate
    ORIF - Dorsoradiopalmar triple plate
    Complete simple articular, simple metaphyseal radial fracture
    Nonoperative treatment - Cast
    Joint-spanning external fixation (temporary or definitive)
    Closed reduction - K-wires and cast/external fixator
    ORIF - Palmar plate
    ORIF - Dorsoradial double plate
    Extraarticular fracture of the radius with dorsal displacement or tilt
    Nonoperative treatment - Cast
    Joint-spanning external fixation (temporary or definitive)
    Closed reduction - K-wires and cast/external fixator
    ORIF - Palmar plate
    Extraarticular undisplaced fracture of the radius
    Nonoperative treatment - Cast
    Joint-spanning external fixation (temporary or definitive)
    ORIF - Palmar plate
    Extraarticular fracture of the radius with volar displacement or tilt
    Nonoperative treatment - Cast
    Joint-spanning external fixation (temporary or definitive)
    Closed reduction - K-wires and cast/external fixator
    ORIF - Palmar plate
    Extraarticular wedge or multifragmentary fracture of the radius
    Nonoperative treatment - Cast
    Joint-spanning external fixation (temporary or definitive)
    Closed reduction - K-wires and cast/external fixator
    ORIF - Palmar bridge plate
    Partial articular, simple fracture of the radius, involving the dorsal rim
    Nonoperative treatment - Cast
    Joint-spanning external fixation (temporary or definitive)
    ORIF - Dorsal plate
    Partial articular, fragmentary fracture of the radius, involving dorsal rim
    Nonoperative treatment - Cast
    Joint-spanning external fixation (temporary or definitive)
    ORIF - Dorsoradial double plate
    Partial articular fracture of the radius, with dorsal dislocation
    Nonoperative treatment - Cast
    Joint-spanning external fixation (temporary or definitive)
    ORIF - Dorsoradial double plate
    ORIF - Dorsal double plate
    Partial articular, sagittal multifragmentary radial fracture, involving scaphoid fossa
    Nonoperative treatment - Cast
    Joint-spanning external fixation (temporary or definitive)
    ORIF - Lag screws/K-wires
    ORIF - Radial column plate
    Partial articular, sagittal simple radial fracture, involving scaphoid fossa
    Nonoperative treatment - Cast
    Joint-spanning external fixation (temporary or definitive)
    Closed reduction - K-wires and cast/external fixator
    Closed reduction - Lag screws
    ORIF - Palmar plate
    ORIF - Radial column plate
    Partial articular, sagittal fracture of the radius, involving the lunate fossa
    Nonoperative treatment - Cast
    Joint-spanning external fixation (temporary or definitive)
    ORIF - Dorsal plate
    Partial articular fracture of the radius, involving the volar rim
    Nonoperative treatment - Cast
    Joint-spanning external fixation (temporary)
    ORIF - Palmar plate
    Extraarticular multifragmentary fracture of the ulna
    Nonoperative treatment - Cast
    ORIF - Bridge plate
    ORIF - Hook plate
    Extraarticular simple fracture of the ulna
    Nonoperative treatment - Cast
    ORIF - Lag screw and protection plate
    ORIF - Compression plate
    Extraarticular fracture of the ulnar styloid process
    Nonoperative treatment - Cast
    ORIF - Tension band wire
    ORIF - Lag screw
    Special considerations
    Principles of management of open fractures
    Infection
    Compartment syndrome
  9. Proximal femur

    Diagnosis
    Overview
    Preparations
    Overview
    Supine position (fracture table)
    Supine on conventional table
    Supine position for nailing
    Lateral decubitus position
    Approaches
    Overview
    Lateral approach (MIO)
    Nailing approach
    Posterolateral approach
    Anterolateral approach
    Iliofemoral approach
    Direct lateral approach
    Reduction & Fixations
    Overview
    Femoral head fracture, split
    ORIF - Small fragment screws
    Femoral neck fracture, subcapital, displaced
    MIO - Cancellous screws
    MIO - Sliding hip screw
    ORIF - Cancellous screws
    ORIF - Sliding hip screw
    Arthroplasty
    Femoral neck fracture, subcapital, undisplaced or impacted
    Nonoperative treatment
    MIO - Cancellous screws
    Femoral neck fracture, transcervical or basicervical
    MIO - Cancellous screws
    MIO - Sliding hip screw
    ORIF - Cancellous screws
    ORIF - Sliding hip screw
    Arthroplasty
    Trochanteric fracture, intertrochanteric
    Nailing
    ORIF - Dynamic condylar screw
    Trochanteric fracture, pertrochanteric, multifragmentary
    MIO - Sliding hip screw
    MIO - Sliding hip screw with plate
    Nailing
    Trochanteric fracture, pertrochanteric, simple
    MIO - Sliding hip screw
    Nailing
    ORIF - Sliding hip screw
    Special considerations
    Principles of management of open fractures
    Infection
    Compartment syndrome
  10. Femur shaft

    Diagnosis
    Overview
    Preparations
    Overview
    Supine with manual traction
    Supine knee flexed 30°
    Scissor position
    Lateral decubitus position
    Approaches
    Overview
    Locations for pin placement
    Lateral approach
    Antegrade nailing (piriformis)
    Antegrade nailing (trochanteric)
    Retrograde nailing
    MIO approach
    Reduction & Fixations
    Overview
    Segmental, fragmentary, distal 1/3 fractures
    Nonoperative treatment with limited resources
    Temporary Thomas splint
    Temporary external fixator
    MIO - Bridge plating (LISS or LCP)
    MIO - Bridge plating (DCS)
    ORIF - Bridge plating (DCS)
    Antegrade nailing
    Retrograde nailing
    Segmental, fragmentary, middle 1/3 fractures
    Nonoperative treatment with limited resources
    Temporary Thomas splint
    Temporary external fixator
    MIO - Bridge plating
    ORIF - Bridge plating
    Antegrade nailing
    Retrograde nailing
    Segmental, fragmentary, proximal 1/3 fractures
    Nonoperative treatment with limited resources
    Temporary Thomas splint
    Temporary external fixation
    MIO - Bridge plating (DSC)
    MIO - Bridge plating (Locking plate)
    ORIF - Bridge plating (DSC)
    ORIF - Bridge plating (Locking plate)
    Antegrade nailing
    Segmental, intact, distal 1/3 fractures
    Nonoperative treatment with limited resources
    Temporary Thomas splint
    Temporary external fixator
    MIO - Bridge plating (LISS or LCP)
    MIO - Bridge plating (DCS)
    ORIF - Bridge plating (DCS)
    Antegrade nailing
    Retrograde nailing
    Segmental, Intact, middle 1/3 fractures
    Nonoperative treatment with limited resources
    Temporary Thomas splint
    Temporary external fixator
    MIO - Bridge plating
    ORIF - Bridge plating
    Antegrade nailing
    Retrograde nailing
    Segmental, intact, proximal 1/3 fractures
    Nonoperative treatment with limited resources
    Temporary Thomas splint
    Temporary external fixation
    MIO - Bridge plating (DSC)
    MIO - Bridge plating (Locking plate)
    ORIF - Bridge plating (DSC)
    ORIF - Bridge plating (Locking plate)
    Antegrade nailing
    Simple, oblique, distal 1/3 fractures
    Nonoperative treatment with limited resources
    Temporary Thomas splint
    Temporary external fixator
    ORIF - DCS and compression plating
    Antegrade nailing
    Retrograde nailing
    Simple, oblique, mid 1/3 fractures
    Nonoperative treatment with limited resources
    Temporary Thomas splint
    Temporary external fixator
    ORIF - Lag screw with protection plate
    Antegrade nailing
    Retrograde nailing
    Simple, oblique, proximal 1/3 fractures
    Nonoperative treatment with limited resources
    Temporary Thomas splint
    Temporary external fixation
    ORIF - Compression plating (DCS)
    ORIF - Compression plating (Locking plate)
    Antegrade nailing
    Simple, spiral, distal 1/3 fractures
    Nonoperative treatment with limited resources
    Temporary Thomas splint
    Temporary external fixator
    ORIF - DCS and compression plating
    Antegrade nailing
    Retrograde nailing
    Simple, spiral, middle 1/3 fractures
    Nonoperative treatment with limited resources
    Temporary Thomas splint
    Temporary external fixator
    ORIF - Lag screw with protection plate
    Antegrade nailing
    Retrograde nailing
    Simple, spiral, proximal 1/3 fractures
    Nonoperative treatment with limited resources
    Temporary Thomas splint
    Temporary external fixation
    ORIF - Compression plating (DCS)
    ORIF - Compression plating (Locking plate)
    Antegrade nailing
    Simple, transverse, distal 1/3 fractures
    Nonoperative treatment with limited resources
    Temporary Thomas splint
    Temporary external fixator
    ORIF - DCS and compression plating
    Antegrade nailing
    Retrograde nailing
    Simple, transverse, middle 1/3 fractures
    Nonoperative treatment with limited resources
    Temporary Thomas splint
    Temporary external fixator
    ORIF - Compression plating
    Antegrade nailing
    Retrograde nailing
    Simple, transverse, proximal 1/3 fractures
    Nonoperative treatment with limited resources
    Temporary Thomas splint
    Temporary external fixation
    ORIF - Compression plating (DCS)
    ORIF - Compression plating (Locking plate)
    ORIF - Bridge plating (blade plate)
    Antegrade nailing
    Wedge, fragmentary, distal 1/3 fractures
    Nonoperative treatment with limited resources
    Temporary Thomas splint
    Temporary external fixator
    MIO - Bridge plating (LISS or LCP)
    MIO - Bridge plating (DCS)
    ORIF - Bridge plating (DCS)
    Antegrade nailing
    Retrograde nailing
    Wedge, fragmentary, middle 1/3 fractures
    Nonoperative treatment with limited resources
    Temporary Thomas splint
    Temporary external fixator
    MIO - Bridge plating
    ORIF - Bridge plating
    Antegrade nailing
    Retrograde nailing
    Wedge, fragmentary, proximal 1/3 fractures
    Nonoperative treatment with limited resources
    Temporary Thomas splint
    Temporary external fixation
    MIO - Bridge plating (DSC)
    MIO - Bridge plating (Locking plate)
    ORIF - Bridge plating (DSC)
    ORIF - Bridge plating (Locking plate)
    Antegrade nailing
    Wedge, Intact, distal 1/3 fractures
    Nonoperative treatment with limited resources
    Temporary Thomas splint
    Temporary external fixator
    MIO - Bridge plating (LISS or LCP)
    MIO - Bridge plating (DCS)
    ORIF - Bridge plating (DCS)
    Antegrade nailing
    Retrograde nailing
    Wedge, intact, middle 1/3 fractures
    Nonoperative treatment with limited resources
    Temporary Thomas splint
    Temporary external fixator
    ORIF - Lag screw with protection plate
    MIO - Bridge plating
    ORIF - Bridge plating
    Antegrade nailing
    Retrograde nailing
    Wedge, intact, proximal 1/3 fractures
    Nonoperative treatment with limited resources
    Temporary Thomas splint
    Temporary external fixation
    MIO - Bridge plating (DSC)
    MIO - Bridge plating (Locking plate)
    ORIF - Bridge plating (DSC)
    ORIF - Bridge plating (Locking plate)
    Antegrade nailing
    Special considerations
    Principles of management of open fractures
    Infection
    Compartment syndrome
  11. Distal femur

    Diagnosis
    Overview
    Preparations
    Overview
    Supine position
    Supine position knee flexed 30°
    Supine position on a split table
    Supine - unilateral leg support
    Supine position knee flexed 90°
    Supine position for arthroscopy
    Prone position
    Approaches
    Overview
    Lateral/anterolateral approach
    Lateral parapatellar approach
    Arthroscopic approach
    MIPO approach
    Medial approach
    Retrograde nailing approach
    Posterior approach
    Medial parapatellar approach
    Safe zones
    Reduction & Fixations
    Overview
    Complete articular fracture, multifragmentary articular
    Temporary external fixator
    Temporary skeletal traction
    Temporary long leg splint
    ORIF - condylar locking compression plate (LCP)
    ORIF - less invasive stabilization system (LISS)
    Complete articular fracture, simple articular, multifragmentary methapyseal
    Temporary external fixator
    Temporary skeletal traction
    Temporary long leg splint
    ORIF - dynamic condylar screw (DCS)
    ORIF - condylar locking compression plate (LCP)
    ORIF - less invasive stabilization system (LISS)
    ORIF - blade plate
    ORIF - retrograde nailing
    Complete articular fracture, simple articular, simple methaphyseal
    Temporary external fixator
    Temporary skeletal traction
    Temporary long leg splint
    ORIF - dynamic condylar screw (DCS)
    ORIF - condylar locking compression plate (LCP)
    ORIF - blade plate
    ORIF - retrograde nailing
    Extraarticular fracture, avulsion
    Long leg cast then hinged knee brace
    Temporary long leg splint
    Temporary external fixator
    ORIF - lag screws
    Extraarticular fracture, multifragmentary
    Long leg cast then hinged knee brace
    Temporary long leg splint
    Temporary external fixator
    Temporary skeletal traction
    MIO - dynamic condylar screw (DCS)
    MIO - condylar locking compression plate (LCP)
    MIO - less invasive stabilization system (LISS)
    MIO - retrograde nailing
    ORIF - dynamic condylar screw (DCS)
    ORIF - condylar locking compression plate (LCP)
    ORIF - blade plate
    Extraarticular fracture, simple
    Long leg cast then hinged knee brace
    Temporary long leg splint
    Temporary external fixator
    Temporary skeletal traction
    MIO - dynamic condylar screw (DCS)
    MIO - condylar locking compression plate (LCP)
    MIO - retrograde nailing
    ORIF - dynamic condylar screw (DCS)
    ORIF - condylar locking compression plate (LCP)
    ORIF - blade plate
    Extraarticular fracture, wedge
    Long leg cast then hinged knee brace
    Temporary long leg splint
    Temporary external fixator
    Temporary skeletal traction
    MIO - dynamic condylar screw (DCS)
    MIO - condylar locking compression plate (LCP)
    MIO - less invasive stabilization system (LISS)
    MIO - retrograde nailing
    ORIF - dynamic condylar screw (DCS)
    ORIF - condylar locking compression plate (LCP)
    ORIF - blade plate
    Partial articular fracture, frontal/coronal, anterior and lateral flake
    Long leg cast then hinged knee brace
    Temporary long leg splint
    Temporary external fixator
    ORIF - screw fixation
    Partial articular fracture, frontal/coronal, posterior condyle(s)
    Long leg cast then hinged knee brace
    Temporary long leg splint
    Temporary external fixator
    ORIF - anterior screws for large fragments
    ORIF - posterior screws for small fragments
    Partial articular fracture, lateral condyle, sagittal fragmentary
    Long leg cast then hinged knee brace
    Temporary long leg splint
    Temporary external fixator
    ORIF - lag screws
    ORIF - lag screws with buttress plate
    ORIF - cannulated lag screws
    ORIF - cannulated lag screws with buttress plate
    Partial articular fracture, lateral condyle, sagittal simple
    Long leg cast then hinged knee brace
    Temporary long leg splint
    Temporary external fixator
    MIO - lag screws
    MIO - cannulated lag screws
    ORIF - lag screws
    ORIF - lag screws with buttress plate
    ORIF - cannulated lag screws
    ORIF - cannulated lag screws with buttress plate
    Partial articular fracture, medial condyle, sagittal fragmentary
    Long leg cast then hinged knee brace
    Temporary long leg splint
    Temporary external fixator
    ORIF - lag screws
    ORIF - lag screws with buttress plate
    ORIF - cannulated lag screws
    ORIF - cannulated lag screws with buttress plate
    Partial articular fracture, medial condyle, sagittal simple
    Long leg cast then hinged knee brace
    Temporary long leg splint
    Temporary external fixator
    MIO - lag screws
    MIO - cannulated lag screws
    ORIF - lag screws
    ORIF - lag screws with buttress plate
    ORIF - cannulated lag screws
    ORIF - cannulated lag screws with buttress plate
    Special considerations
    Principles of management of open fractures
    Infection
    Compartment syndrome
  12. Patella

    Diagnosis
    Overview
    Preparations
    Overview
    Supine position
    Supine position on a split table
    Approaches
    Overview
    Midline longitudinal approach
    Reduction & Fixations
    Overview
    Complete articular, frontal/coronal multifragmentary fracture
    Cerclage wire
    Salvage techniques
    Complete articular, frontal/coronal simple fracture of the distal third
    Tension band wiring
    Salvage techniques
    Suture repair
    Complete articular, frontal/coronal simple fracture of the middle and proximal third
    Tension band wiring
    Complete articular, frontal/coronal wedge fracture
    Cerclage wire
    Salvage techniques
    Extraarticular avulsion fracture
    Salvage techniques
    Sleeve fracture fixation
    Suture repair
    Partial articular, lateral sagittal fragmentary fracture
    Long leg cast then hinged knee brace
    Lag screws
    Cerclage wire
    Partial articular, lateral sagittal simple fracture
    Long leg cast then hinged knee brace
    Lag screws
    Partial articular, medial sagittal fragmentary fracture
    Long leg cast then hinged knee brace
    Cerclage wire
    Lag screws
    Partial articular, medial sagittal simple fracture
    Long leg cast then hinged knee brace
    Lag screws
    Special considerations
    Principles of management of open fractures
    Infection
  13. Proximal tibia

    Diagnosis
    Overview
    Preparations
    Overview
    Lateral position
    Supine position
    Prone position
    Floating position
    Approaches
    Overview
    Safe zones in the tibia
    Anterolateral approach
    Arthroscopic approach
    MIO approach
    Posteromedial approach
    Posterior approach
    Reduction & Fixations
    Overview
    Complete articular fracture, fragmentary articular
    Nonoperative treatment
    Bridging external fixator (temporary)
    Hybrid external fixator (definitive)
    Ring external fixator (definitive)
    ORIF - Conventional plates
    MIO - Less invasive stabilization system
    Complete articular fracture, simple aricular, multifragmentary metaphyseal
    Nonoperative treatment
    Bridging external fixator (temporary)
    Hybrid external fixator (definitive)
    Ring external fixator (definitive)
    MIO - Angular stable plate (LISS)
    ORIF - Conventional plates
    Complete articular fracture, simple articular, simple metaphyseal
    Nonoperative treatment
    Bridging external fixation (temporary)
    Hybrid external fixation (definitive)
    Ring external fixation (definitive)
    MIO - Angular stable plate (LISS)
    ORIF - Plates without angular stability
    Extraarticular fracture, avulsion of fibular head
    Nonoperative treatment
    Tension band fixation
    Lag screws
    Suture anchors
    Extraarticular fracture, avulsion of tibial spine
    Nonoperative treatment
    Lag screws
    Tension band fixation
    Extraarticular fracture, avulsion of tibial tubercle
    Nonoperative treatment
    Lag screws
    Suture anchors
    Extraarticular fracture, metaphyseal simple
    Nonoperative treatment
    Bridging external fixator (temporary)
    Non-bridging external fixator (definitive)
    Hybrid external fixator (definitive)
    Ring external fixator (definitive)
    MIO - Angular stable plate (LISS)
    ORIF - Plates without angular stability
    Extraarticular fracture, metaphyseal wedge or multifragmentary
    Nonoperative treatment
    Bridging external fixator (temporary)
    Non-bridging external fixator (definitive)
    Hybrid external fixation (definitive)
    Ring external fixation (definitive)
    MIO - Angular stable plate (LISS)
    ORIF - Plates without angular stability
    Partial articular fracture, depression
    Nonoperative treatment
    Bridging external fixation (temporary)
    Ring external fixation (definitive)
    ORIF - Plates without angular stability
    Partial articular fracture, split
    Nonoperative treatment
    Bridging external fixation (temporary)
    Hybrid external fixation (definitive)
    Ring external fixator (definitive)
    MIO - Percutaneous lag screws
    ORIF - Lag screws
    ORIF - Plates without angular stability
    Partial articular fracture, split-depression
    Nonoperative treatment
    Bridging external fixation (temporary)
    Hybrid external fixation (definitive)
    Ring external fixation (definitive)
    ORIF - Plates without angular stability
    Special considerations
    Principles of management of open fractures
    Infection
    Compartment syndrome
  14. Tibial shaft

    Diagnosis
    Overview
    Preparations
    Overview
    Supine position
    Supine position for ring fixator
    Supine position for nailing
    Lateral position
    Prone position
    Approaches
    Overview
    Anteromedial approach
    Anterolateral approach
    Medial approach, MIO
    Lateral approach, MIO
    Intramedullary nailing approach
    Safe zones for pin insertion
    Posteromedial approach
    Posterolateral approach
    Reduction & Fixations
    Overview
    Multifragmentary frature, fragmentary segmental
    Modular external fixator
    Uniplanar external fixator
    Ring fixator (Ilizarov)
    Intramedullary nailing
    MIO - Bridge plating
    ORIF - Bridge plating
    Multifragmentary frature, intact segmental
    Nonoperative (casting)
    Modular external fixator
    Uniplanar external fixator
    Ring fixator (Ilizarov)
    Intramedullary nailing
    MIO - Compression plating
    MIO - Bridge plating
    ORIF - Compression plating
    ORIF - Lag screws with protection plate
    Simple fracture, oblique
    Nonoperative (casting)
    Modular external fixator
    Uniplanar external fixator
    Ring fixator (Ilizarov)
    Intramedullary nailing
    MIO - Compression plating
    ORIF - Lag screws through protection plate
    ORIF - Lag screws outside protection plate
    ORIF - Compression plate with lag screw
    Simple fracture, spiral
    Nonoperative (casting)
    Modular external fixator
    Uniplanar external fixator
    Ring fixator (Ilizarov)
    Intramedullary nailing
    ORIF - Lag screws through protection plate
    ORIF - Lag screws outside protection plate
    Simple fracture, transverse
    Nonoperative (casting)
    Modular external fixator
    Uniplanar external fixator
    Ring fixator (Ilizarov)
    Intramedullary nailing
    MIO - Compression plating
    ORIF - Compression plating
    Wedge fracture, fragmentary wedge
    Nonoperative (casting)
    Modular external fixator
    Uniplanar external fixator
    Ring fixator (Ilizarov)
    Intramedullary nailing
    MIO - Bridge plating
    Wedge fracture, intact wedge
    Nonoperative (casting)
    Modular external fixator
    Uniplanar external fixator
    Ring fixator (Ilizarov)
    Intramedullary nailing
    MIO - Bridge plating
    ORIF - Lag screws with protection plate
    ORIF - Compression plating
    Special considerations
    Principles of management of open fractures
    Infection
    Compartment syndrome
  15. Distal tibia

    Diagnosis
    Overview
    Preparations
    Overview
    Supine position
    Supine position (fracture table)
    Supine position with knee flexed
    Supine position for MIPO
    Supine position, figure-of-four
    Prone position
    Lateral position
    Approaches
    Overview
    Anteromedial approach
    Anterolateral approach
    Posteromedial approach
    Medial approach
    Minimally invasive approach
    Posterolateral approach
    Nailing approach
    Safe zones
    Reduction & Fixations
    Overview
    A1 Extraarticular fractures, metaphyseal simple
    Nonoperative treatment; casting for definitive treatment
    Nonoperative treatment; traction (initial provisional stabilization)
    Closed reduction; temporary joint-bridging modular external fixation
    Closed reduction; temporary joint-bridging triangular external fixation
    Closed reduction; hybrid external fixation
    Closed reduction; full ring fixation (Ilizarov)
    Closed reduction; intramedullary nailing (reamed) (MIPO)
    Closed reduction; compression plating (MIPO)
    Open reduction; compression plating with or without lag screw
    A2 Extraarticular wedge fractures
    Nonoperative treatment; casting as initial temporary treatment
    Nonoperative treatment; traction (initial provisional stabilization)
    Closed reduction; temporary joint-bridging modular external fixation
    Closed reduction; temporary joint-bridging triangular external fixation
    Closed reduction; hybrid external fixation
    Closed reduction; full ring fixation (Ilizarov)
    Closed reduction; intramedullary nailing (reamed) (MIPO)
    Closed reduction; bridge plating (MIPO)
    Open reduction; lag screw and protection plate fixation
    A3 Complex metaphyseal fractures
    Nonoperative treatment; casting as initial temporary treatment
    Nonoperative treatment; traction (initial provisional stabilization)
    Closed reduction; temporary joint-bridging modular external fixation
    Closed reduction; temporary joint-bridging triangular external fixation
    Closed reduction; hybrid external fixation
    Closed reduction; full ring fixation (Ilizarov)
    Closed reduction; intramedullary nailing (reamed) (MIPO)
    Closed reduction; bridge plating of 43-A3.1/3.2 fractures (MIPO)
    Closed reduction; bridge plating of 43-A3.3 fracture (MIPO)
    B1 Partial articular fractures – “pure split fractures"
    Nonoperative treatment; casting for definitive treatment
    Nonoperative treatment; traction (initial provisional stabilization)
    Closed reduction; temporary joint-bridging modular external fixation
    Closed reduction; temporary joint-bridging triangular external fixation
    Open reduction; buttress plating and lag screws
    B2 Partial articular fractures – “split-depression fractures”
    Nonoperative treatment; casting as initial temporary treatment
    Nonoperative treatment; traction (initial provisional stabilization)
    Closed reduction; temporary joint-bridging modular external fixation
    Closed reduction; temporary joint-bridging triangular external fixation
    Open reduction; buttress plating and lag screws
    B3 Partial articular fracture, multifragmentary depression
    Nonoperative treatment; casting as initial temporary treatment
    Nonoperative treatment; traction (initial provisional stabilization)
    Closed reduction; temporary joint-bridging modular external fixation
    Closed reduction; temporary joint-bridging triangular external fixation
    Open reduction; plating and screws
    C1 Complete articular fracture, articular simple, metaphyseal simple
    Nonoperative treatment; casting as definitive treatment
    Nonoperative treatment; traction (initial provisional stabilization)
    Closed reduction; temporary joint-bridging modular external fixation
    Closed reduction; temporary joint-bridging triangular external fixation
    Closed reduction; hybrid external fixation
    Closed reduction; full ring fixation (Ilizarov)
    Closed reduction; intramedullary nailing (reamed) (MIPO)
    Open reduction; plating and screws
    C2 Complete articular fracture, articular simple, metaphyseal multifragmentary
    Nonoperative treatment; traction (initial provisional stabilization)
    Closed reduction; temporary joint-bridging modular external fixation
    Closed reduction; temporary joint-bridging triangular external fixation
    Open reduction; plating and screws
    C3 Complete articular fractures, multifragmentary
    Nonoperative treatment; traction (initial provisional stabilization)
    Closed reduction; temporary joint-bridging modular external fixation
    Closed reduction; temporary joint-bridging triangular external fixation
    Open reduction; screws and plate fixation through anterolateral approach (complex)
    Open reduction; screw and plate fixation through anterolateral approach (3-part)
    Open reduction; screws and plate fixation through anteromedial approach
    Special considerations
    Principles of management of open fractures
    Infection
    Compartment syndrome
  16. Malleoli

    Diagnosis
    Overview
    Preparations
    Overview
    Supine positioning
    Lateral positioning
    Supine, figure-of-four
    Prone positioning
    Approaches
    Overview
    Lateral approach
    Medial approach
    Safe zones
    Posteromedial approach
    Posterior approach to Volkmann
    Safe zones
    Lateral approach (C-fractures)
    Reduction & Fixations
    Overview
    Infrasyndesmotic, lateral isolated ligament rupture/avulsion fracture
    Functional treatment
    Circular cast
    Infrasyndesmotic, lateral isolated fracture
    Functional treatment
    Circular cast
    Tension band wiring
    Tension band plate
    Infrasyndesmotic, medial fracture with LCL rupture
    Circular cast
    Lag screws (oblique or vertical fractures)
    Lag screws (transverse fracture)
    Lag screw and buttress plate
    Lag screw through buttress plate
    Infrasyndesmotic, medial fracture with lateral fracture/avulsion
    Circular cast
    External fixation
    Triangular external fixation
    ORIF
    Infrasyndesmotic, posteromedial fracture with LCL rupture
    Circular cast
    External fixation
    Triangular external fixation
    Lag screw
    Infrasyndesmotic, posteromedial fracture with lateral fracture/avulsion
    Circular cast
    External fixation
    Triangular external fixation
    ORIF
    Suprasyndesmotic multifragmentary fibula, medial injury, +/- posterior fracture
    Long-leg circular cast
    External fixation
    Triangular external fixation
    ORIF
    Suprasyndesmotic, proximal fibular fracture, medial injury, +/- posterior fracture
    Long-leg circular cast
    External fixation
    Triangular external fixation
    ORIF
    Suprasyndesmotic, simple fibular fracture, medial injury, +/- posterior fracture
    Long-leg circular cast
    External fixation
    Triangular external fixation
    ORIF
    Transsyndesmotic, lateral isolated multifragmentary fracture
    Circular cast
    External fixation
    Triangular external fixation
    Bridging plate
    Antiglide plate
    Transsyndesmotic, lateral multifragmentary fracture with medial injury
    Circular cast
    External fixation
    Triangular external fixation
    ORIF
    Transsyndesmotic, posterior, lateral multifragmentary, and medial fractures
    Circular cast
    External fixation
    Triangular external fixation
    ORIF
    Transsyndesmotic, posterior, lateral simple fractures, and deltoid rupture
    Circular cast
    External fixation
    Triangular external fixation
    ORIF
    Transsyndesmotic, posterior, lateral simple, and medial fractures
    Circular cast
    External fixation
    Triangular external fixation
    ORIF
    Transsyndesmotic, lateral isolated simple fracture
    Circular cast
    Lag screw and neutralization plate
    Antiglide plate
    Transsyndesmotic, lateral simple fracture with deltoid rupture
    Circular cast
    External fixation
    Triangular external fixation
    Transsyndesmotic, lateral simple fracture with medial fracture
    Circular cast
    External fixation
    Triangular external fixation
    ORIF
    Special considerations
    Principles of management of open fractures
    Infection
    Compartment syndrome
  17. Occipitocervical trauma

    Diagnosis
    Overview
    Preparations
    Overview
    Prone position
    Supine position
    Approaches
    Overview
    Posterior access to C1-C2
    Anterior access to C1-T2
    Reduction & Fixations
    Overview
    ATLAS Type I
    Soft collar
    ATLAS Type II
    Soft collar
    ATLAS Type IIIa
    Hard collar
    ATLAS Type IIIb
    Halo vest
    C1 lateral masses osteosynthesis
    Posterior C1-C2 fusion
    ATLAS Type IV
    Hard collar
    Halo vest
    Occipitocervical fusion
    ATLAS Type V
    Collar
    C0, Atlanto occipital dissociation Atlanto occipital dissociation
    Temporary halo and traction
    Occipitocervical fusion (screw fixation)
    C0, C0 Fractures C0 fractures
    Hard collar
    Occipitocervical fusion (screw fixation)
    C1-C2, Dislocation C1-C2 Dislocation
    Anterior C1-C2 fusion
    Posterior C1-C2 fusion
    C1-C2, Rotatory subluxation C1-C2 Rotatory subluxation
    Hard collar
    Halo vest
    Anterior C1-C2 fusion
    Posterior C1-C2 fusion
    C2, Body fracture C2 Body fracture
    Hard collar
    Halo vest
    Posterior fixation
    Anderson d'Alonzo Type I
    Hard collar
    Anderson d'Alonzo Type II
    Hard collar
    Halo vest
    Odontoid screw fixation
    Anterior C1-C2 trans articular screws
    Posterior C1-C2 fixation
    Anderson d'Alonzo Type III
    Hard collar
    Halo vest
    Odontoid screw fixation
    Posterior C1-C2 fixation
    Effendi Type I
    Hard collar
    Effendi Type II
    Halo vest
    Anterior fixation
    Posterior fixation
    Effendi Type III
    Halo vest
    Posterior fixation
    Levine IIa
    Halo vest
    Direct osteosynthesis of the isthmus
    Posterior fixation
    Anterior fixation
  18. Subaxial cervical trauma

    Diagnosis
    Overview
    Preparations
    Overview
    Supine position
    Prone position
    Approaches
    Overview
    Anterior to cervical spine
    Anterior access to C7-T2
    Posterior to cervical spine
    Posterior to cervical spine
    Posterior access to C7-T2
    Reduction & Fixations
    Overview
    A0 Minor, nonstructural fractures
    Nonoperative (collars)
    A1 Compression fracture single endplate
    Nonoperative (collars)
    Nonoperative (halo vest)
    Anterior plating
    A2 Coronal split/pincer fracture
    Nonoperative (collars)
    Nonoperative (halo vest)
    Combined anterior and posterior (360)
    Anterior plating
    A3 Burst fracture of single endplate
    Nonoperative (collars)
    Nonoperative (halo vest)
    Combined anterior and posterior (360)
    Anterior plating
    A4 Burst fracture or sagittal split involving both endplates
    Nonoperative (collars)
    Nonoperative (halo vest)
    Combined anterior and posterior (360)
    Anterior plating
    B1 Posterior tension band injury (bony)
    Nonoperative (collars)
    Cervical spine - posterior fixation
    B2 Posterior tension band injury (bony capsuloligamentous, ligamentous)
    Cervicothoracic junction - posterior fixation
    Cervical spine - posterior fixation
    Combined anterior and posterior (360)
    Anterior plating
    B3 Antgerior tension band injury
    Cervicothoracic junction - posterior fixation
    Cervical spine - posterior fixation
    Anterior plating
    C Translational injury
    Cervicothoracic junction - posterior fixation
    Cervical spine - posterior fixation
    Combined anterior and posterior (360)
    Anterior plating
    Special considerations
    Pediatric fractures
    Ankylotic spine
    Postoperative deformities
  19. Thoracic and lumbar trauma

    Diagnosis
    Overview
    Preparations
    Overview
    Right sided thoracotomy (T3-T10)
    Left sided thoracotomy (T3-L1/2)
    Thoracolumbar junction (T10-L2)
    Lumbotomy (L1-L4)
    Mini open approach (L4-S1)
    Posterior midline (T1-S1)
    MIS right sided thoracic(T4-T10)
    MIS left sided thoracic (T10-L2)
    MIS lumbotomy (L2-L4)
    Percutaneous pedicle screws
    Approaches
    Overview
    Right sided thoracotomy (T3-10)
    Left sided thoracotomy (T3-L1/2)
    Thoracolumbar junction approach
    Lumbotomy (L1-4)
    Mini open approach (L4-S1)
    Posterior midline (T1-S1)
    MIS right side thoracic (T4-T10)
    MIS left side thoracic (T10-L2)
    MIS lumbotomy (L2-L4)
    Percutaneous pedicle screws
    Reduction & Fixations
    Overview
    A0 Minor, nonstructural fractures
    Nonoperative treatment/ bracing
    A1 Wedge-compression fractures
    Nonoperative treatment/ bracing
    A2 Split fractures
    Nonoperative treatment/ bracing
    Anterior stabilization
    Posterior short segment fixation with Schanz pins
    MIS Anterior stabilization
    MIS posterior short segment fixation with Schanz pins
    A3 Incomplete burst fractures
    Nonoperative treatment/ bracing
    Anterior stabilization
    Posterior short segment fixation with pedicle screws
    Posterior short segment fixation with Schanz pins
    Posterior short segment fixation with intermediate screws
    MIS Anterior Stabilization
    MIS posterior short segment fixation with pedicle screws
    MIS posterior short segment fixation with Schanz pins
    A4 Complete burst fractures
    Nonoperative treatment/ bracing
    Anterior stabilization
    Posterior short segment fixation with pedicle screws
    Posterior short segment fixation with Schanz pins
    Posterior short segment fixation with intermediate screws
    Posterior long segment fixation
    MIS Anterior Stabilization
    MIS posterior short segment fixation with pedicle screws
    MIS posterior short segment fixation with Schanz pins
    B1 Transosseous tension band disruption / Chance fracture
    Posterior short segment fixation with pedicle screws
    Posterior short segment fixation with Schanz pins
    MIS posterior short segment fixation with pedicle screws
    MIS posterior short segment fixation with Schanz pins
    B2 Posterior tension band disruption
    Anterior stabilization
    Posterior short segment fixation with pedicle screws
    Posterior short segment fixation with Schanz pins
    Posterior short segment fixation with intermediate screws
    Posterior long segment fixation
    MIS Anterior Stabilization
    MIS posterior short segment fixation with pedicle screws
    MIS posterior short segment fixation with Schanz pins
    B3 Hyperextension
    Anterior stabilization
    Posterior long segment fixation
    MIS Anterior Stabilization
    C Displacement or dislocation
    Posterior long segment fixation (C)
  20. Sacral trauma

    Diagnosis
    Overview
    Preparations
    Overview
    Prone
    Supine
    Approaches
    Overview
    Midline approach
    Paramedian approach
    Reduction & Fixations
    Overview
    A1 A1 Coccygeal/sacral compression or ligamentous avulsion fractures
    Nonoperative
    A2 A2 Non-displaced transverse fracture below S-I joint
    Nonoperative
    A3 A3 Displaced transverse fracture below the S-I join
    Nonoperative
    ORIF - Sacral alar plating
    Laminectomy
    B1 B1 Central fracture
    Nonoperative
    ISS fixation
    Spinopelvic fixation
    Fixation of associated pelvic ring injuries
    B2 B2 Transalar fracture
    Nonoperative
    Spinopelvic fixation
    ISS fixation
    Fixation of associated pelvic ring injuries
    B3 B3 Transforaminal fracture
    Nonoperative
    Spinopelvic fixation
    ISS fixation
    Fixation of associated pelvic ring injuries
    C0 C0 Nondisplaced U-fracture
    Nonoperative
    ISS fixation
    C1 C1 B fracture with ipsilateral superior S1 facet discontinuous with medial part of sacrum
    Spinopelvic fixation
    Fixation of associated pelvic ring injuries
    C2 C2 Bilateral type B injury
    Spinopelvic fixation
    Fixation of associated pelvic ring injuries
    C3 C3 Non-displaced transverse fracture below S-I joint
    Spinopelvic fixation
    Fixation of associated pelvic ring injuries
  21. Adolescent Idiopathic Scoliosis

    Diagnosis
    Overview
    Preparations
    Overview
    Preparation posterior procedures
    Preparation anterior procedures
    Approaches
    Overview
    Posterior approach
    Thoracoscopic approach
    Anterior to lumbar spine
    Anterior to thoracic spine
    Reduction & Fixations
    Overview
    Lenke 1
    Posterior Screws - No direct vertebral body derotation
    Posterior Screws - With direct vertebral body derotation
    Posterior Hybrid
    Thoracoscopic release, posterior instrumentation
    Anterior open
    Lenke 2
    Posterior Screws - No direct vertebral body derotation
    Posterior Screws - With direct vertebral body derotation
    Posterior Hybrid
    Lenke 3
    Posterior Screws - No direct vertebral body derotation
    Posterior Screws - With direct vertebral body derotation
    Posterior Hybrid
    Lenke 4
    Posterior Screws - No direct vertebral body derotation
    Posterior Screws - With direct vertebral body derotation
    Posterior Hybrid
    Lenke 5
    Posterior Screws - No direct vertebral body derotation
    Posterior Screws - With direct vertebral body derotation
    Posterior Hybrid
    Anterior open
    Lenke 6
    Posterior Screws - No direct vertebral body derotation
    Posterior Screws - With direct vertebral body derotation
    Posterior Hybrid
  22. Deformity - Scheuermann Kyphosis

    Diagnosis
    Overview
    Preparations
    Overview
    Preparation posterior procedures
    Combined posterior and left side
    Approaches
    Overview
    Posterior approach
    Anterior thoracoscopic release
    MIS left side thorax
    Reduction & Fixations
    Overview
    Scheuermann Kyphosis
    Nonoperative procedure
    Posterior instrumentation without release
    Posterior instrumentation with release
  23. Spondylolisthesis

    Diagnosis
    Overview
    Preparations
    Overview
    Prone
    Supine
    Approaches
    Overview
    Wiltze approach
    Retroperitoneal approach
    Reduction & Fixations
    Overview
    Spondylolisthesis - Type 1
    Nonoperative
    Primary repair with pars screw
    Primary repair with pedicle screw and rod
    Anterior fusion of L5-S1
    Posterior fusion L5-S1
    Spondylolisthesis - Type 2
    Nonoperative
    Anterior fusion of L5-S1
    Posterior fusion of L5-S1
    Spondylolisthesis - Type 3
    Nonoperative
    Posterior fusion of L5-S1
    Combined anterior and posterior fusion
    Spondylolisthesis - Type 4
    Nonoperative
    Posterior fusion of L5-S1
    Spondylolisthesis - Type 5
    Nonoperative
    Posterior fusion of L5-S1
    Spondylolisthesis - Type 6
    Nonoperative
    Posterior fusion of L4-S1 (with or without pelvic fixation or ala)
  24. Pelvic ring

    Diagnosis
    Overview
    Preparations
    Overview
    Supine position
    Prone
    Approaches
    Overview
    Anterior to illiac wing/SI joint
    Approach to the pubic symphysis
    Modified Stoppa
    Posterium to sacrum
    Posterior to the SI joint
    Reduction & Fixations
    Overview
    Primary survey
    Airway
    Breathing
    Circulation
    Disability
    Exposure and environmental control
    Acute pelvic treatment
    Extraperitoneal pelvic packing
    Angio embolization
    External fixation: Emergency stabilization with a C-clamp
    External fixation
    Bilateral complete disruption of posterior arch
    External fixation and traction
    Operative treatment
    Unilateral complete, contralateral incomplete disruption of posterior arch
    External fixation and traction
    Operative treatment
    Unilateral complete distruption posterior arch through SI joint
    External fixation and traction
    Operative treatment
    Unilateral complete distruption posterior arch through ilium
    External fixation and traction
    Operative treatment
    Unilateral complete distruption posterior arch through Sacrum
    External fixation and traction
    Operative treatment
    Iliac fractures
    External fixation and traction (resource limited)
    External fixation
    ORIF - ilium
    Incomplete disruption posterior arch, bilateral injury
    Nonoperative
    External fixation and traction
    Operative treatment
    Incomplete disruption posterior arch, lateral compression fracture
    Nonperative
    External fixation and traction
    External fixation
    Operative treatment
    Incomplete disruption posterior arch, open book injury
    Nonoperative
    External fixation and traction
    Operative treatment
    Intact posterior arch, innominate bone, Iliac wing fracture
    Nonoperative
    ORIF - iliac crest
    Intact posterior arch, displaced transverse sacral fracture
    Nonoperative
    ORIF Plate
    Intact posterior arch, innominate bone avulsion fracture
    Nonoperative
    ORIF - apophyseal avulsion fracture
    Intact posterior arch, sacrococcygeal dislocation
    Nonoperative
    Intact posterior arch, uni- or bilateral fracture anterior arch
    Nonoperative
    ORIF - Pubic symphysis plate
    ORIF - Pubic ramus plate
    ORIF - Pubic ramus screw
    Intact posterior arch, unidsplaced transverse sacral fracture
    Nonoperative
    Pubic ramus fractures
    Nonoperative
    External fixation
    ORIF - Pubic ramus plate
    ORIF - Pubic ramus screw
    Pubic symphysis fractures
    ORIF - Pubic symphysis plate
    SI-joint fractures
    External fixation and traction
    External fixation
    ORIF - Anterior SI fracture fixation
    ORIF - Posterior SI fracture fixation
    MIO - Iliosacral screw for sacrum
    MIO - Iliosacral screw navigation
    ORIF - Anterior fixation SI Joint
    Secondary survey
    Secondary survey
    Sacral fractures
    External fixation and traction
    External fixation
    ORIF - Sacrum
    MIO - Iliosacral screw for sacrum
    MIO - Iliosacral screw navigation
    ORIF - Triangular osteosynthesis
    ORIF - Ilioiliac plate
    ORIF - Spinopelvic fixation
    Stable ring fractures
    Nonoperative
    ORIF - Apophyseal avulsion fracture
    ORIF - Iliac crest
    ORIF - Sacrum
  25. Acetabulum

    Diagnosis
    Overview
    Preparations
    Overview
    Prone position
    Lateral position
    Supine position
    Approaches
    Overview
    Kocher-Langenbeck approach
    Trochanter osteotomy
    Modified Stoppa approach
    Ilioinguinal approach
    Extended iliofemoral approach
    Reduction & Fixations
    Overview
    Anterior column and posterior hemitransverse
    Nonoperative treatment
    ORIF through modified Stoppa approach
    ORIF through ilioinguinal approach
    ORIF through sequential approaches
    Anterior column
    Nonoperative treatment
    ORIF through modified Stoppa approach
    ORIF through ilioinguinal approach
    Anterior wall
    Nonoperative treatment
    ORIF through ilioinguinal approach
    Both columns
    Nonoperative treatment
    ORIF through modified Stoppa approach
    ORIF through ilioinguinal approach
    ORIF through sequential approaches
    ORIF through extended iliofemoral approach
    Posterior column and wall
    Nonoperative treatment
    ORIF through Kocher-Langenbeck
    Posterior column
    Nonoperative treatment
    ORIF through Kocher-Langenbeck
    Posterior wall
    Nonoperative treatment
    ORIF through Kocher-Langenbeck
    ORIF through trochanter osteotomy extension
    T-type
    Nonoperative treatment
    ORIF through modified Stoppa approach
    ORIF through ilioinguinal approach
    ORIF through sequential approaches
    ORIF through extended iliofemoral approach
    Transverse and posterior wall
    Nonoperative treatment
    ORIF through Kocher-Langenbeck
    ORIF through extended iliofemoral approach
    Transverse
    Nonoperative treatment
    ORIF through Kocher-Langenbeck
    ORIF through modified Stoppa approach
    ORIF through extended iliofemoral approach
  26. Hand Carpal bones

    Diagnosis
    Overview
    Approaches
    Overview
    Anatomical structures
    Palmar to the scaphoid
    Dorsal to the scaphoid
    Combined to perilunate
    Reduction & Fixations
    Overview
    Lunate, dislocation
    Open reduction, internal fixation (ORIF)
    Perilunate, dissociation
    ORIF of Lunotriquetral dissociation
    Ligament repair of scapholunate dissociations
    Perilunate, fracture
    Open reduction, internal fixation (ORIF)
    Scaphoid, proximal pole
    Prograde screw fixation
    Scaphoid, waist
    Nonoperative treatment
    Percutaneous screw fixation
    Screw and K-wires fixation
    Special considerations
    Principles of management of open fractures
    Infection
    Compartment syndrome
  27. Hand Proximal phalanx

    Diagnosis
    Overview
    Approaches
    Overview
    Palmar to PIP joint
    Dorsal to the PIP joint
    Dorsal approach to the MCP joint
    Midaxial to the proximal phalanx
    Dorsal to phalangeal metaphysis
    Midaxial to the PIP joint
    Reduction & Fixations
    Overview
    Distal articular, bicondylar
    Lag screw fixation
    Distal articular, oblique
    Nonoperative treatment
    Lag screw fixation
    Distal articular, unicondylar fracture dislocation
    Lag screw fixation
    Distal metaphyseal (head), multifragmentary
    Nonoperative treatment
    Minicondylar bridge plate fixation
    Distal metaphyseal (head), oblique
    Nonoperative treatment
    Lag screw fixation
    Lag screw with protection plate
    Minicondylar plate with lag screw
    Distal metaphyseal (head), transverse
    Minicondylar compression plate fixation
    Proximal articular, avulsion
    Tension-band wiring
    Collateral ligament reattachment
    Lag screw fixation
    Proxmial articular, multifragmentary
    Minicondylar bridge plate fixation
    T-plate fixation
    Proximal articular, shearing
    Lag screw fixation
    Proximal metaphyseal, oblique
    Nonoperative treatment
    Lag screw fixation
    Minicondylar compression plate fixation
    T-compression plate fixation
    Proximal metaphyseal, transverse
    Nonoperative treatment
    Minicondylar plate fixation
    T-plate fixation
    Shaft, multifragmentary
    Nonoperative treatment
    Bridge plate fixation of oblique wedge fractures
    Bridge plate fixation of multifragmentary fractures
    Shaft, oblique
    Nonoperative treatment
    Compression plate fixation
    Shaft, transverse
    Nonoperative treatment
    Compression plate fixation
    Special considerations
    Principles of management of open fractures
    Infection
    Compartment syndrome
  28. Hand Middle phalanx

    Diagnosis
    Overview
    Approaches
    Overview
    Dorsal to the middle phalanx
    Midaxial to the PIP joint
    Dorsal to the PIP joint
    Palmar to PIP joint
    Midaxial to the middle phalanx
    Reduction & Fixations
    Overview
    Distal, bicondylar
    Nonoperative treatment
    Lag screw fixation
    Distal, unicondylar
    Nonoperative treatment
    Lag screw fixation
    Proximal, collateral ligament avulsion
    Lag screw fixation
    Tension-band wiring
    Proximal, dislocation
    Collateral ligament repair
    Proximal, dorsal avulsion fracture
    Dorsal lag screw fixation
    Tension-band wiring
    Proximal, multifragmentary
    Hemi-hamate arthroplasty with bone graft
    Joint reconstruction with bone graft
    Minicondylar plate fixation of Pilon compression fracture
    Screw fixation of lateral plateau compression fracture
    Screw fixation with bone graft of central impaction fracture
    Proximal, volar plate avulsion
    Lag screw fixation of volar plate
    Suture fixation
    Volar plate arthroplasty
    Shaft, multifragmentary
    Nonoperative treatment
    Minicondylar bridge plate
    Shaft, oblique
    Nonoperative treatment
    Lag screw fixation
    Shaft, transverse
    Nonoperative treatment
    K-wire fixation
    Compression plate fixation
    Special considerations
    Principles of management of open fractures
    Infection
    Compartment syndrome
  29. Hand Distal phalanx

    Diagnosis
    Overview
    Approaches
    Overview
    Percutaneous through finger tip
    Dorsal to the DIP joint
    Palmar to the DIP joint
    Reduction & Fixations
    Overview
    Distal and shaft, multifragmentary
    Nonoperative treatment
    K-wire fixation
    Distal and shaft, transverse
    Nonoperative treatment
    K-wire fixation
    Dislocation
    Nonoperative treatment
    K-wire fixation
    Dorsal avulsion
    Nonoperative treatment
    K-wire immobilization
    Lag screw fixation
    Tension-band wire
    K-wire fixation
    Palmar avulsion
    Nonoperative treatment
    K-wire fixation
    Suture fixation
    Lag screw fixation
    Special considerations
    Principles of management of open fractures
    Infection
    Compartment syndrome
  30. Hand Thumb

    Diagnosis
    Overview
    Approaches
    Overview
    Palmar to PIP joint
    Dorsal to the PIP joint
    Approach to thumb metacarpal
    Approach to base of the thumb
    Dorsal to MCP joint
    Dorsoulnar to MCP joint
    Midaxial to the proximal phalanx
    Midaxial to the PIP joint
    Percutaneous through finger tip
    Dorsal to the DIP joint
    Palmar to the DIP joint
    Dorsal to IP joint of the thumb
    Reduction & Fixations
    Overview
    Distal phalanx: Base - Dislocation
    Nonoperative treatment
    K-wire fixation
    Distal phalanx: Base - dorsal avulsion
    Nonoperative treatment
    K-wire immobilization
    Lag screw fixation
    Tension-band wire
    K-wire fixation
    Distal phalanx: Base - palmar avulsion
    Nonoperative treatment
    K-wire fixation
    Suture fixation
    Lag screw fixation
    Distal phalanx: Distal and Shaft - multifragmentary
    Nonoperative treatment
    K-wire fixation
    Distal phalanx: Distal and Shaft - transverse
    Nonoperative treatment
    K-wire fixation
    Metacarpal: Base
    External fixation
    Locking compression plate (LCP) fixation
    Metacarpal: Bennett fracture
    Nonoperative treatment
    K-wire fixation
    Lag screw fixation
    Metacarpal: Rolando fracture
    Nonoperative treatment
    Plate fixation
    Proximal phalanx: Articular (head) - bicondylar
    Lag screw fixation
    Proximal phalanx: Articular (head) - Oblique
    Nonoperative treatment
    Lag screw fixation
    Proximal phalanx: Articular (head) - unicondylar fracture dislocation
    Lag screw fixation
    Proximal phalanx: Base and shaft - multifragmentary
    Bridge plate fixation
    Proximal phalanx: Base and shaft - pilon fractures
    Open reduction, internal fixation (ORIF)
    Proximal phalanx: Base and shaft - Skiers thumb
    Ligament reattachment with suture anchors
    Proximal phalanx: Metaphyseal (head) - multifragmentary
    Nonoperative treatment
    Minicondylar bridge plate fixation
    Proximal phalanx: Metaphyseal (head), oblique
    Nonoperative treatment
    Lag screw fixation
    Lag screw with protection plate
    Minicondylar plate with lag screw
    Proximal phalanx: Metaphyseal (head) - transverse
    Minicondylar compression plate fixation
    Special considerations
    Principles of management of open fractures
    Infection
    Compartment syndrome
  31. Hand Metacarpals

    Diagnosis
    Overview
    Approaches
    Overview
    Dorsal approach to metacarpals
    Dorsal to 2nd metacarpal
    Dorsal to 5th metacarpal
    Dorsal to base of 5th metacarpal
    Dorso-ulnar to 5th metacarpal
    Dorsal to the MCP joint
    Reduction & Fixations
    Overview
    Base fracture
    Plate fixation
    Head, intraarticular
    Screw fixation
    Head, subcapital
    Intramedullary K-wire fixation
    Shaft, multifragmentary
    Nonoperative treatment
    Bridge plate fixation
    Shaft, oblique
    Nonoperative treatment
    Lag screw with protection plate
    Lag screw fixation
    Shaft, transverse
    Nonoperative treatment
    Compression plate fixation
    Special considerations
    Principles of management of open fractures
    Infection
    Compartment syndrome
  32. Foot Talus

    Diagnosis
    Overview
    Approaches
    Overview
    Anterolateral to the talus
    Anteromedial to the talus
    Direct lateral to the talus
    Posteromedial to the talus
    Posterolateral to the hindfoot
    Medial malleolar osteotomy
    Lateral malleolar osteotomy
    Reduction & Fixations
    Overview
    Body
    ORIF - screw and plate fixation
    Neck, displaced
    ORIF - screw fixation
    Lateral process
    ORIF - screw fixation
    Neck, multifragmentary
    ORIF - plate fixation
    Posterior process
    ORIF - screw fixation
    Neck, undisplaced
    Nonoperative treatment
    Special considerations
    Reinsertion of an extruded talus
    Combined hindfoot injuries
    Compartment syndrome
    Osteonecrosis
  33. Foot Calcaneus

    Diagnosis
    Overview
    Approaches
    Overview
    Extended lateral to calcaneus
    Medial approach to the calcaneus
    Sinus tarsi approach
    MIO lateral approach
    MIO posterior approach
    Reduction & Fixations
    Overview
    Displaced fracture of the calcaneus body
    ORIF - plate and screw fixation
    MIO - K-wire and screw fixation (joint-depression type)
    MIO - K-wire fixation (tongue type)
    Extreme tongue-type (beak) fracture of the calcaneus body
    ORIF - screw fixation
    Simple undisplaced fracture of the calcaneus body
    Nonoperative treatment
    Sustentacular fracture of the calcaneus body
    ORIF - screw fixation
    Special considerations
    Open fractures
    Combined hindfoot injuries
    Compartment syndrome
  34. Foot Midfoot

    Diagnosis
    Overview
    Approaches
    Overview
    Dorsomedial to the navicular
    Percutaneous to the navicular
    Dorsolateral to the cuboid
    Medial utility incision
    Reduction & Fixations
    Overview
    TMT (Lisfranc) injuries
    ORIF - screw fixation
    Cuboid, crush
    ORIF - plate fixation
    Intertarsal crush
    External fixation
    Intertarsal fractures
    ORIF - plate fixation
    Navicular, multifragmentary
    ORIF - plate fixation
    Navicular, split/stress
    Nonoperative treatment
    Screw fixation
    Cuboid, simple
    Nonoperative treatment
    Special considerations
    Compartment syndrome
  35. Foot Metatarsals

    Diagnosis
    Overview
    Preparations
    Overview
    Supine position
    Approaches
    Overview
    Medial approach to MT1
    Dorsal approach to MT1
    Dorsal approach to MT1 & MTPJ
    Dorsal intermetatarsal approach
    Lateral approach to MT5
    Dorsal approach to midfoot / MT
    Reduction & Fixations
    Overview
    1st, base, intraarticular
    ORIF: lag screw or plate fixation
    1st, head, intraarticular T-type
    ORIF or K-wire fixation
    1st, head, intraarticular comminuted
    ORIF or MTP joint fusion
    1st, head, intraarticular oblique
    ORIF or K-wire fixation
    1st, shaft, transverse or oblique
    ORIF: lag screw and plate fixation
    2nd-4th, diaphyseal fractures
    ORIF: screw and plate fixation
    2nd-4th, proximal metaphyseal fractures
    ORIF: screw and plate fixation
    2nd-4th, subcapital fractures
    ORIF: plate fixation
    5th, base, metaphyseal avulsion fractures
    Nonoperative treatment
    5th, base (Jones fracture)
    ORIF: screw fixation
    5th, long oblique diaphyseal fractures
    ORIF: screw fixation
    5th, multifragmentary diaphyseal fractures
    ORIF: plate fixation
    Crush injuries
    ORIF or K-wire fixation
    Special considerations
    Compartment syndrome
  36. Foot Phalanges

    Diagnosis
    Overview
    Preparations
    Overview
    Supine position
    Approaches
    Overview
    Medial approach to the hallux
    Dorsal approach to MT1 & MTPJ
    Dorsal approach to P1
    Plantar approach to DIP joint
    Dorsal approach to DIP joint
    Reduction & Fixations
    Overview
    2nd-5th row, MTP-joint dislocation
    CRIF: K-wire fixation
    2nd-5th row, distal phalanx, multifragmentary
    Reinsertion of the nail
    2nd-5th row, proximal phalanx, base, intraarticular, T-type
    K-wire fixation
    2nd-5th row, proximal phalanx, excessively displaced
    K-wire fixation
    2nd-5th row, proximal phalanx, head, intraarticular
    K-wire fixation
    2nd-5th row, proximal phalanx, head, small fragment
    Nonoperative treatment
    Hallux, distal phalanx, base, impression fractures
    Excision
    Hallux, proximal phalanx, base, intraarticular, T-type
    ORIF: screws or plate
    Hallux, proximal phalanx, base, intraarticular, comminuted
    ORIF or MTP joint fusion
    Hallux, proximal phalanx, base, shear fracture
    ORIF: screw fixation
    Hallux, proximal phalanx, diaphysis, simple
    ORIF: screw fixation
    Hallux, proximal phalanx, head, intraarticular
    ORIF or K-wire fixation
    Special considerations
    Compartment syndrome
  37. Mandible

    Diagnosis
    Overview
    Approaches
    Overview
    Use of existing lacerations
    Intraoral approach to symphysis
    Intraoral approach to the angle
    Submental approach
    Submandibular approach
    Retromandibular approaches
    Facelift (rhytidectomy) approach
    Preauricular approach
    Intraoral approach to the ramus
    Safe zones
    Reduction & Fixations
    Overview
    Angle and ramus, complex
    Closed treatment
    ORIF, two plates (basal triangle)
    ORIF, reconstruction plate (basal triangle)
    ORIF, reconstruction plate (comminuted fracture)
    External fixator
    Angle and ramus, simple
    Observation
    Closed treatment
    ORIF, wire
    ORIF, miniplate fixation to the oblique ridge
    ORIF, two miniplates
    ORIF, reconstruction plate
    Body, complex
    Closed treatment
    ORIF, two plates (basal triangle)
    ORIF, reconstruction plate
    External fixator
    Body, simple
    Observation
    Closed treatment
    ORIF, lag screws
    ORIF, one miniplate
    ORIF, two plates
    ORIF, one large plate
    Condylar process and head, simple and complex
    Observation
    Closed treatment
    ORIF, one/two plate(s) - extraoral approach
    ORIF, one/two plate(s) - intraoral approach
    ORIF, one/two plate(s) - endoscopically assisted
    Symphysis and parasymphysis, complex
    Closed treatment
    ORIF, two plates (basal triangle)
    ORIF, reconstruction plate (basal triangle)
    ORIF, reconstruction plate (comminuted fracture)
    External fixator
    Symphysis and parasymphysis, simple
    Closed treatment (MMF)
    ORIF, two lag screw fixation
    ORIF, lag screw and plate
    ORIF, one plate and arch bar
    ORIF, two plates
    Special considerations
    Multiple fractures
    Edentulous atrophic fractures
    Teeth in the line of fracture
    Involvement of alveolar area
    Infected fractures with or without bone loss
    Coronoid process fractures
    Complications
  38. Midface

    Diagnosis
    Overview
    Approaches
    Overview
    The use of existing lacerations
    Approaches to the maxilla
    Lower eyelid - transcutaneous
    Lower eyelid - transconjunctival
    Glabellar approach
    Coronal approach
    Not recommended
    Superolateral orbital rim
    Preauricular approach
    Endonasal approaches
    External rhinoplasty approach
    Extended glabellar approach
    Zygomatic arch (indirect)
    Reduction & Fixations
    Overview
    Le Fort I, bilateral comminution
    Open reduction internal fixation
    Le Fort I, edentulous patients
    Observation
    Open reduction internal fixation
    Le Fort I, linear fracture
    Observation
    Closed treatment
    Open reduction internal fixation
    Le Fort I, unilateral comminution
    Closed treatment
    Open reduction internal fixation
    Le Fort II
    Observation
    Closed treatment
    Open reduction internal fixation
    Le Fort III
    Observation
    Closed treatment
    Open reduction internal fixation
    NOE Type I
    Observation
    Open reduction internal fixation
    NOE, Type II
    Open reduction internal fixation
    NOE, Type III
    Open reduction internal fixation
    Nasal bone
    Observation
    Closed reduction
    Open reduction
    Septorhinoplasty
    Nasal septal hematoma drainage
    Orbit, combined fracture
    Observation
    Orbital reconstruction
    Orbit, medial orbital wall fracture
    Observation
    Orbital reconstruction
    Orbit, orbital floor fracture
    Observation
    Open reduction with or without internal fixation
    Orbital reconstruction
    Orbital reconstruction, CAS: Intraoperative imaging
    Orbital reconstruction, CAS: Virtual planning and intraoperative navigation
    Orbit, orbital roof fracture
    Observation
    Open treatment
    Palatoalveolar fracture, complex injury
    Observation
    Closed treatment
    Open reduction internal fixation
    Palatoalveolar fracture, simple injury
    Observation
    Closed treatment
    Open reduction internal fixation
    Zygoma, isolated zygomatic arch
    Closed treatment
    Open reduction without fixation
    Open reduction with fixation
    CAS: Intraoperative imaging in closed treatment
    Zygoma, zygomatic complex fracture
    Closed treatment
    ORIF, 1-point fixation (without orbital reconstruction)
    ORIF, 2-point fixation (without orbital reconstruction)
    ORIF, 3-point fixation (without orbital reconstruction)
    ORIF, 3-point fixation (with orbital reconstruction)
    ORIF, 4-point fixation (with orbital reconstruction)
    CAS: Intraoperative imaging (ORIF without orbital reconstruction)
    CAS: Virtual planning and intraoperative imaging (ORIF without orbital reconstruction)
    CAS: Virtual planning and intraoperative imaging (ORIF with orbital reconstruction)
    CAS: Virtual planning and intraoperative navigation (ORIF with orbital reconstruction)
    Special considerations
    Airway considerations
    Panfacial fractures (sequencing of repair)
    Intraoperative imaging (closed reduction)
    Intraoperative imaging
    Virtual planning and intraoperative imaging
    Intraoperative imaging
    Virtual planning and intraoperative navigation
    Virtual planning and intraoperative imaging
    Virtual planning and intraoperative navigation
    Virtual planning and intraoperative navigation
  39. Skull base & Cranial vault

    Diagnosis
    Overview
    Approaches
    Overview
    Lacerations
    Coronal approach
    Lateral skull base approach
    Posterior skull base approach
    Transmatoid approach
    Endoscopy: Transnasal
    Endoscopy: Central skull base
    Endoscopy: Anterior table
    Reduction & Fixations
    Overview
    Cranial vault fracture
    Observation
    Treatment of depressed cranial vault fractures
    Frontal sinus fracture, anterior table
    Observation
    Open reduction internal fixation
    Obliteration
    Delayed endoscopic repair
    Frontal sinus fracture, frontal recess
    Obliteration
    Observation (and when indicated frontal sinus endoscopy)
    Frontal sinus fracture, posterior table
    Observation
    Cranialization
    Obliteration
    Skull base fracture, anterior
    Observation
    Intradural repair
    Extradural repair
    Skull base fracture, central (anterior)
    Observation
    Endoscopic repair of CSF leak
    Skull base fracture, lateral
    Observation
    Extradural middle fossa repair using temporal fascia flap
    Skull base fracture, posterior
    Observation
    Treatment modalities
    Skull base fracture, temporal bone (lateral skull base)
    Observation
    Surgical management
    Delayed management of hearing loss
    Special considerations
    Traumatic brain injury/Vascular injury
    Infections
    Late sequelae
    Cranioplasty (bone versus alloplast)
  40. Congenital deformities

    Approaches
    Overview
    Reduction & Fixations
    Overview
  41. Orthognathic

    Approaches
    Overview
    Reduction & Fixations
    Overview
  42. Corrections of posttraumatic deformities

    Approaches
    Overview
    Reduction & Fixations
    Overview
  43. Postablative reconstruction

    Approaches
    Overview
    Reduction & Fixations
    Overview
  44. Nose Reconstruction

    Diagnosis
    Overview
    Reduction & Fixations
    Overview
    Full thickness defects
    Three stage forehead folded flap
    Four stage forehead flap with radial forearm flap for lining
    Large partial thickness defect
    Two stage forehead flap - Ala reconstruction
    Two stage forehead flap - Tip reconstruction
    Three stage forehead flap
    Small superficial defect
    Secondary healing
    Full thickness skin graft
    One stage nasolabial flap
  45. Dentoalveolar trauma

    Diagnosis
    Overview
    Reduction & Fixations
    Overview
    Alveolar fracture, segmental
    Closed treatment
    Open reduction internal fixation
    Tooth fracture, crown-root fracture
    Various treatment options
    Tooth fracture, enamel only/dentin exposure
    Enamel only - no immediate treatment
    Dentin exposure - sealing dentin
    Tooth fracture, pulp exposure
    Pulp capping / partial amputation / extirpation
    Tooth fracture, root fracture
    Splint
    Tooth luxation, avulsion (total luxation)
    Various treatment options
    Tooth luxation with displacement - Extrusion
    Repositioning and fixation
    Tooth luxation with displacement - Intrusion
    Repositioning and fixation
    Tooth luxation, with displacement - Lateral luxation
    Repositioning and fixation
    Tooth luxation, without displacement - Concussion
    No active treatment
    Tooth subluxation, without displacement - Subluxation
    No active treatment
    Special considerations
    Computer assisted dental implant surgery
  46. Facial nerve paralysis

    Diagnosis
    Overview
    Preparations
    Overview
    Patient preparation
    Approaches
    Overview
    Modified facelift
    Use of existing lacerations
    Reduction & Fixations
    Overview
    Irreversible paralysis, eye complex
    Lateral tarsorrhaphy
    Direct brow lift
    Upper eyelid weight
    Lower eyelid - Lateral strip canthopexy
    Lower eyelid - Tendon sling
    Irreversible paralysis, midface and mouth
    Static suspension with tendons
    Masseter muscle transposition
    Temporalis muscle (antidromic) mini-sling
    Temporalis muscle transposition
    Innervated free muscle transfer (Gracilis)
    Irreversible paralysis, mouth - Lower lip
    Horizontal shortening
    Contralateral depressor angularis muscle excision
    Reversible paralysis
    Observation
    Lateral tarsorrhaphy
    Direct nerve repair
    Interpositional nerve graft
    Reinnervation with masseteric nerve transposition
    Reinnervation with hypoglossal nerve
    Selective reinnervation with proximal facial nerve and masseteric nerve
    Reinnervation with cross facial nerve graft
    Selective reinnervation with contralateral facial nerve and masseteric nerve
    Static suspension with tendons