By Kenneth Egol MD, Kenneth J. Koval MD, Joseph Zuckerman MD
Thoroughly up to date for its Fourth variation, this pocket-sized go-anywhere Handbook of Fractures is definitely the right on-the-spot reference for citizens and practitioners looking speedy evidence on fracture administration and category. Chapters equipped through anatomic web site offer key details on fractures in adults and in young ones, together with epidemiology, anatomy, mechanism of damage, scientific assessment, radiologic assessment, class, remedy, and administration of issues. The book's easy-access structure good points a variety of charts, tables, diagrams, illustrations, and bulleted lists.
This version comprises new and up to date details on aspiration of the joints, fracture aid, nerve-racking lacerations, and a number of trauma.
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Extra info for Handbook of fractures
Identify skeletal injury; obtain necessary radiographs. 2. 3. 4. 5. 6. COMPARTMENT SYNDROME ■ ■ ■ ■ An open fracture does not preclude the development of compartment syndrome, particularly with severe blunt trauma or crush injuries. Severe pain, decreased sensation, pain to passive stretch of fingers or toes, and a tense extremity are all clues to the diagnosis. A strong suspicion or an unconscious patient in the appropriate clinical setting warrants monitoring of compartment pressures. Compartment pressures Ͼ30 mm Hg raise concern and within 30 mm Hg of the diastolic blood pressure (ΔP) indicate compartment syndrome; immediate fasciotomies should be performed.
Soft Tissue Coverage and Bone Grafting ■ ■ ■ Wound coverage is performed once there is no further evidence of necrosis. The type of coverage—delayed primary closure, split-thickness skin graft, rotational or free muscle flaps—is dependent on the severity and location of the soft tissue injury. Bone grafting can be performed when the wound is clean, closed, and dry. The timing of bone grafting after free flap coverage is controversial. Some advocate bone grafting at the time of coverage; others wait until the flap has healed (normally 6 weeks).
The energy of the missile on impact (striking energy) 2. The energy of the missile on exiting the tissue (exit energy) 3. The behavior of the missile while traversing the target: tumbling, deformation, fragmentation TISSUE PARAMETERS ■ ■ ■ ■ ■ 36 The wounding potential of a bullet depends on the missile parameters, including caliber, mass, velocity, range, composition, and design, as well as those of the target tissue. The degree of injury created by the missile is generally dependent on the specific gravity of the traversed tissue: higher specific gravity ϭ greater tissue damage.