Safe Orthopaedic Surgery: The Anatomic Principles and Techniques for Preventing Complications

✍ Scribed by S. Venkatesh Babu

• Publisher: Springer
• Year: 2021
• Tongue: English
• Leaves: 125
• Category: Library

✦ Synopsis

The patient safety is the paramount factor while treating them either conservatively or surgically. Iatrogenic injuries during surgery will cause significant morbidity and may lead to mortality.Although, the improvement made in the implants, instruments and techniques of orthopedic operations today, there are considerable surgical complications occurring. At the moment, the surgery has been well acknowledged for all the fractures and orthopedic diseases in adults and children. Also, the goal of treatment of limb fractures is to restore the limb length and anatomic articular surface alignment and rotation, also to create adequate fixation for early mobilization of associated joint with minimal complications. This Book includes safety facts explaining the anatomy and characteristic techniques for the surgeon in preventing neurovascular complications in various surgical approaches of the specific bones and joints, Hand surgery, Spine surgery and also explains every detail of performing safe surgery in the field of orthopedics and trauma. To avoid the neurovascular and other serious complications, the applied knowledge with extraordinary skills is requisite for the orthopedic surgeon while doing surgeries. This Book also highlights the prevention of surgical site infection, the current ideology of antibiotic therapy in orthopedic surgery, the precise need of anatomical skills and safe operative talent of the surgeon in avoiding hazardous complications during maximum and minimal invasive orthopedic surgery. This book will be a valuable read for MBBS students, orthopedic residents and practicing orthopedic surgeons.

✦ Table of Contents

Preface
Contents
About the Author
1: Safe Use of Antibiotics in Orthopaedic Surgery
1.1 Introduction
1.2 Microorganism Prevalence and Antibiotic Therapy in Orthopaedic Surgery
1.3 Antibiotic Prophylaxis in Orthopaedic and Trauma Surgery
1.4 Antibiotic Stewardship Programs in Orthopaedic Surgery
1.5 Discussion
References
2: Safe Clavicle Fracture Surgery
2.1 Introduction
2.2 Applied Surgical Anatomy of the Clavicular Region
2.3 Principles of Safe Clavicle Fracture Surgery [4, 24, 28, 29]
2.3.1 Safety Principles for Preoperative Planning and Anaesthesiology
2.3.2 Safety Principles for Patient Positioning
2.3.3 Safety Principles for the Surgical Incision
2.3.4 Safety Principles for the Surgical Approach
2.3.5 Safety Principles for the Plane of Surgical Exposure
2.3.6 Safety Principles for Drill, Screw Direction, and Depth
2.4 Specific Injuries in Clavicle Surgery and Their Management [4, 8, 18, 24, 25, 28, 30–34]
2.4.1 Subclavian Artery Injury
2.4.2 Brachial Plexus Injury: Traction, Compression, and Entrapment
2.4.3 Pneumothorax and Hemothorax
2.4.4 Subclavian Vein Injury
2.4.5 Other Vessel Injuries
2.4.6 Refracture
2.4.7 Thoracic Outlet Syndrome
2.5 Discussion
References
3: Safe Shoulder Surgery
3.1 Introduction
3.2 Applied Surgical Anatomy of the Shoulder
3.3 Principles of Safe Shoulder Surgery [2, 5–12]
3.3.1 Safety Principles for Approaching the Shoulder Joint Anteriorly
3.3.2 Safety Principles for Approaching the Acromioclavicular Joint and Subacromial Space Anterolaterally
3.3.3 Safety Principles for the Lateral Approach to the Proximal Humerus
3.3.4 Safety Principles for Accessing the Proximal Humerus by the Minimal Lateral Approach
3.3.5 Safety Principles for Approaching the Shoulder Joint Posteriorly
3.3.6 Safety Principles for Arthroscopic Shoulder Surgery
3.4 Discussion
References
4: Safe Humerus Surgery
4.1 Introduction
4.2 Applied Surgical Anatomy of the Humerus and Arm [3–9]
4.3 Safe Principles of Humerus Surgery [1, 3, 7, 10–21]
4.3.1 Safety Principles for the Anterior Approach to the Humeral Shaft
4.3.2 Safety Principles for the Minimally Invasive Anterior Approach to the Humeral Shaft
4.3.3 Safety Principles for the Anterolateral Approach to the Distal Humerus
4.3.4 Safety Principles for the Posterior Approach to the Distal Humerus
4.3.5 Safety Principles for the Lateral Approach to the Distal Humerus
4.3.6 Safety Principles for the Minimally Invasive Approach for Humeral Nailing
4.3.7 Safety Principles for External Fixation of the Humerus
4.4 Discussion
References
5: Safe Elbow Surgery
5.1 Introduction
5.2 Applied Surgical Anatomy of the Elbow
5.3 Principles of Safe Elbow Surgery [8–15]
5.3.1 Safety Principles for the Posterior Approach to Elbow Joint
5.3.2 Safety Principles for the Medial Approach to Elbow Joint
5.3.3 Safety Principles for the Anterolateral Approach to the Elbow Joint
5.3.4 Safety Principles for the Anterior Approach to the Cubital Fossa
5.3.5 Safety Principles for the Posterolateral Approach to the Radial Head
5.3.6 Safety Principles for Arthroscopic Elbow Surgery
5.3.7 Safety Principles for the Minimally Invasive Approach to the Elbow Joint
5.4 Discussion
References
6: Safe Forearm Surgery
6.1 Introduction
6.2 Applied Surgical Anatomy of the Forearm
6.3 Principles of Safe Forearm Surgery [1–4, 6–10, 12–18]
6.3.1 Safety Principles for the Anterior Approach to the Radius
6.3.2 Safety Principles for Exposure of the Shaft of the Ulna
6.3.3 Safety Principles for the Posterior Approach to the Radius
6.3.4 Safety Principles for External Fixation of Both Bones of the Forearm
6.3.5 Safety Principles for Intramedullary Nailing of Both Bones of the Forearm
6.3.6 Safety Principles for Elastic Flexible Nailing of Both Bones of the Forearm in Children
6.4 Discussion
References
7: Safe Wrist and Hand Surgery
7.1 Introduction
7.2 Applied Surgical Anatomy of the Hand and Wrist
7.3 Principles of Safe Wrist and Hand Surgery [1, 2, 5–11]
7.3.1 Safety Principles for the Dorsal Approach to the Wrist Joint
7.3.2 Safety Principles for the Volar Approach to the Wrist Joint
7.3.3 Safety Principles for the Volar Approach to the Ulnar Nerve
7.3.4 Safety Principles for the Volar Approach to the Flexor Tendons
7.3.5 Safety Principles for the Midlateral Approach to the Flexor Sheaths
7.3.6 Safety Principles for the Volar Approach to the Scaphoid
7.3.7 Safety Principles for the Dorsolateral Approach to the Scaphoid
7.3.8 Safety Principles for Arthroscopic Wrist Surgery
7.3.9 Safety Principles for the Drainage of Pus in the Hand
7.4 Discussion
References
8: Safe Spine Surgery
8.1 Introduction
8.2 Principles of Safe Spine Surgery [1–4, 7, 10–17]
8.2.1 Safety Principles for Preventing General Complications in Spine Surgery
8.2.2 Safety Principles for Anterior Cervical Spine Surgery
8.2.2.1 Preventing Recurrent Laryngeal, Superior Laryngeal, and Hypoglossal Nerve Injuries
8.2.2.2 Preventing Esophageal Injury
8.2.2.3 Preventing Vertebral and Carotid Artery Injuries
8.2.2.4 Preventing Tracheal Injury
8.2.2.5 Preventing Thoracic Duct and Cervical Sympathetic Chain Injury
8.2.2.6 Preventing Pharyngocutaneous Fistula
8.2.2.7 Preventing Spinal Cord and Nerve Root Injuries
8.2.2.8 Preventing Adjacent Segment Degeneration
8.2.2.9 Preventing Pseudarthrosis
8.2.3 Safety Principles for Corpectomy
8.2.4 Safety Principles for Surgery for Ossified Posterior Longitudinal Ligament
8.2.5 Safety Principles for Cervical Disc Arthroplasty/Replacement
8.2.6 Safety Principles for Posterior Cervical Spine Surgery
8.2.6.1 Preventing Spinal Cord and Nerve Root Injuries
8.2.6.2 Preventing C5 Palsy
8.2.6.3 Preventing Spring-Back Closure
8.2.6.4 Preventing Postlaminectomy Kyphosis
8.2.7 Safety Principles for Screw Fixation in Cervical Spine
8.2.8 Safety Principles for Posterior Occipitocervical Instrumentation
8.2.9 Safety Principles for Minimally Invasive Cervical Spine Surgery
8.2.10 Safety Principles for Vertebral Augmentation in Osteoporotic Fractures
8.2.11 Safety Principles for Pedicle Screw Fixation
8.2.12 Safety Principles for Preventing Deep Venous Thrombosis and Pulmonary Embolism
8.2.13 Safety Principles for Preventing Surgical Site Infection in Spine Surgery
8.3 Discussion
References
9: Safe Hip Surgery
9.1 Introduction
9.2 Applied Anatomy of the Hip Region (Fig. 9.1) [5]
9.2.1 Bony Landmarks
9.2.2 Muscles
9.2.3 Vessels
9.2.4 Nerves
9.2.5 Joint Capsule and Ligament
9.3 Principles of Safe Hip Surgery [5]
9.3.1 Safety Principles for the Anterior Approach
9.3.2 Safety Principles for the Anterolateral Approach
9.3.3 Safety Principles for the Lateral Approaches
9.3.3.1 Safety Principles for the Hardinge’s Approach
9.3.3.2 Safety Principles for the Transtrochaneric Approach
9.3.4 Safety Principles for the Posterior Approach
9.3.5 Safety Principles for the Medial Approach
9.3.6 Safety Principles for Minimally Invasive Two-Incision Hip Surgery
9.4 Discussion
References
10: Safe Femur Surgery
10.1 Introduction
10.2 Applied Surgical Anatomy of the Femur and Thigh
10.2.1 Muscles and Nerves of the Thigh
10.2.2 Arteries and Veins of the Thigh
10.2.3 Angles of the Femur
10.3 Principles of Safe Femur Surgery [16, 28, 35, 48, 50–58]
10.3.1 Safety Principles for the Lateral Approach to the Femur
10.3.2 Safety Principles for the Anteromedial Approach to the Distal Two-Thirds of the Femur
10.3.3 Safety Principles for the Posterior Approach to the Femur
10.3.4 Safety Principles for the Posterolateral Approach to the Femur
10.3.5 Safety Principles for the Minimally Invasive Approach for LISS to the Distal Femur
10.3.6 Safety Principles for the Minimally Invasive Approach to the Proximal Femur for Intramedullary Nailing
10.3.7 Safety Principles for the Minimally Invasive Approach to Retrograde Intramedullary Nailing of the Femur
10.3.8 Safety Principles for the Minimally Invasive Approach to TENS Nailing of the Femur
10.3.9 Safety Principles for Placing External Fixator Pins in the Femur
10.3.10 Safety Principles for Reducing the Risk of Pudendal Nerve Palsy by Using a Fracture Table
10.4 Discussion
References
11: Safe Knee Surgery
11.1 Introduction
11.2 Principles of Safe Knee Surgery [1, 9–16]
11.2.1 Safety Principles for Arthroscopic Surgery of the Knee
11.2.2 Safety Principles for the Medial Parapatellar Approach to the Knee
11.2.3 Safety Principles for Medial Meniscectomy of the Knee
11.2.4 Safety Principles for the Medial Approach to the Knee and Its Supporting Structures
11.2.5 Safety Principles for Lateral Meniscectomy of the Knee
11.2.6 Safety Principles for the Lateral Approach to the Knee
11.2.7 Safety Principles for the Posterior Approach to the Knee
11.2.8 Safety Principles for the Lateral Approach to the Distal Femur for Anterior Cruciate Ligament Surgery
11.2.9 Safety Principles for Minimally Invasive Surgical Approaches of LISS, Nailing, and Knee Replacement Surgery
11.3 Discussion
References
12: Safe Leg Surgery
12.1 Introduction
12.2 Applied Surgical Anatomy of the Leg
12.2.1 Common Peroneal Nerve
12.2.2 Saphenous Nerve
12.2.3 Popliteal Artery
12.2.4 Knee Joint Capsule
12.2.5 Tibiofibular Joint
12.2.6 Distal to the Tibial Tuberosity
12.3 Principles of Safe Tibia and Fibula Surgery [3, 11, 13, 23–30]
12.3.1 Safety Principles for the Anterolateral Approach to the Lateral Tibial Plateau
12.3.2 Safety Principles for Minimally Invasive Anterolateral Approach to the Proximal Tibia
12.3.3 Safety Principles for the Posteromedial Approach to the Proximal Tibia
12.3.4 Safety Principles for the Anterior Approach to the Tibia
12.3.5 Safety Principles for Minimally Invasive Surgery of the Distal Tibia
12.3.6 Safety Principles for the Posterolateral Approach to the Tibia
12.3.7 Safety Principles for the Approach to the Fibula
12.3.8 Safety Principles for the Minimally Invasive Approach for Tibial Intramedullary Nailing
12.3.9 Safety Principles for Externally Fixation of the Tibia
12.3.10 Safety Principles for Approaching the Compartments of the Leg
12.4 Discussion
References
13: Safe Ankle and Foot Surgery
13.1 Introduction
13.2 Applied Surgical Anatomy of the Foot and Ankle
13.3 Principles of Safe Foot and Ankle Surgery [9–15]
13.3.1 Safety Principles for the Anterior Approach to the Ankle
13.3.2 Safety Principles for the Anterior and Posterior Approaches to the Medial Malleolus
13.3.3 Safety Principles for the Medial Approach to the Ankle
13.3.4 Safety Principles for the Posteromedial Approach to the Ankle
13.3.5 Safety Principles for the Posterolateral Approach to the Ankle
13.3.6 Safety Principles for the Minimally Invasive Approach and Arthroscopic Ankle Surgery
13.3.7 Safety Principles for the Lateral Approach to the Lateral Malleolus
13.3.8 Safety Principles for the Anterolateral Approach to the Ankle and Hind Part of the Foot
13.3.9 Safety Principles for the Lateral Approach to the Hind Part of the Foot
13.3.10 Safety Principles for the Lateral Approach to the Posterior Talocalcaneal Joint
13.3.11 Safety Principles for the Lateral Approach to the Calcaneus
13.3.12 Safety Principles for the Dorsal and Dorsomedial Approaches to the Metatarsophalangeal Joint of the Great Toe (Hallux Valgus Surgery)
13.3.13 Safety Principles for the Dorsal Approach to the Metatarsophalangeal Joints of the Second, Third, Fourth and Fifth Toes
13.3.14 Safety Principles for the Approach to the Dorsal Web Spaces
13.4 Discussion
References