Textbook of Orthopedics and Trauma - JP Medical Publishers

Textbookof

Orthopedics and Trauma

Textbookof

Orthopedics and Trauma

Editor

GS Kulkarni MS MS (Ortho) FRCS FICS

Director, Professor and HeadPostgraduate Institute ofSwasthiyog Pratishthan

Miraj, Maharashtra

DirectorSandhata Medical Research Society

Miraj, Maharashtra

Under the aegis ofIndian Orthopedic Association

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Textbook of Orthopedics and Trauma

© 2008, Editor

All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means:electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the author and the publisher.

This book has been published in good faith that the material provided by contributors is original. Every effort is made to ensure accuracyof material, but the publisher, printer and editor will not be held responsible for any inadvertent error(s). In case of any dispute, all legal mattersare to be settled under Delhi jurisdiction only.

First Edition: 1999Second Edition: 2008

ISBN 978-81-8448-242-3

Typeset at JPBMP typesetting unit

Printed at Ajanta Press

Tomy wife

Shashikalaand Children

Milind, Sunil, Rajiv, Vedavati, Ruta and Vidishafor the untiring help

Contributors

Abel Eric WUniversity of DundeeSchool of Biomedical EngineeringCaird Block. Royal InfirmaryDundee DD1 9ND

Acharya Kiran Kumar VAsst. Prof. Dept of OrthopedicsKasturba Medical CollegeManipal- 576 104

Acharya ShivLecturerGovt. Medical CollegeSurat

Agarwal Anil MS (Ortho)

131, Ankur Apartment7, IP Extension, ParparganjNew Delhi

Agarwal BRDept. of HematologyJJ HospitalMumbai

Agarwal ManishA 2/B, 38 A, Ekkta Aptts (MIG Flats)Pashchim ViharNew Delhi

Agarwal MG201-2A Deep Jyoti Housing SocietySus Road, 3, Petrol PumpOpp. Hotel Mayuri, ThaneWest, Mumbai

Agashe VMDr Agashe’s Maternity andSurgical Nursing HomeVrindavan, Off. LB Shastri MargKurlaMumbai

Aggarwal Aditya NDept. of OrthopedicsUniversity College of Medical SciencesNew Delhi

Aggarwal RajivProf. of OrthopedicsDept. of OrthopedicsGovt. Medical CollegePatiala

Agrawal AK MS (Ortho) FICS

FIMSA MAMS FGOP

Associate ProfessorDept. of Physical Medicine andRehabilitationKC Medical College, Lucknow

Aithal VK MS (Ortho)

Associate ProfessorDepartment of OrthopedicsKasturba Medical CollegeManipal

Aldegheri Roberto MD

Institute of Clinical Orthopedics andTraumatologyPoliclinico Di Borgo RomaVerona, Italy

Alquwayee KhalidMBBS Clinical and Reserach FellowDivision of Reconstructive OrthopedicsUniversity of British ColumbiaVancouver, BC Canada

Amin SN MD

Senior RheumatologistBombay Hospital PostgraduateInstitute of Medical SciencesBombay Hospital, Mumbai

Ammini ACDept. of EndocrinologyAll India Institute of Medical SciencesAnsari NagarNew Delhi

Anchar ChetanSenior Registrar, Orthopedic OncologyTata Memorial HospitalMumbai

Anderson E Megan MD

Beth Israel Deaconess Medical CentreChildren’s Hospital BostonBoston, MA, United States

Anderson GAMS (Ortho) D (Ortho) MNAMS MCh (Ortho)

(Liverpool) FAMS (Vienna) FIMSA

Professor of Ortho. Surg.Head Dept. of Hand Surgery andLeprosy Reconstr. SurgeryCMC Hospital, Vellore

Antoniou John MD FRCS

Clinical Fellow inCentral Dupage/RushAdult Reconstructive FellowshipChicagoIllinois

Aronson James MS (Ortho) D (Ortho)

MNAMS (Liverpool) FAMS (Vienna) FIMSA

Professor of Ortho. and Head, Dept. ofHand and LeprosyReconstruction SurgeryCMC HospitalVellore

Aroojis Allaric8/424, Church View14th Road, TPS III, Bandra (West)Mumbai

Arora AnilProfessor, Dept. of OrthopedicsUniversity College of Medical SciencesNew Delhi

Arwade DJSanjeen Hospital, Orth. Nursing HomeGulmohar ColonySangliMaharashtra

Ashok N MS (Ortho) D (Ortho)

Assistant ProfessorDept. of OrthopedicsKasturba Medical CollegeManipal

Athani BD MS (Ortho) DNB

Director, All India Institute of PhysicalMedicine and RehabilitationHazi AliMumbai

AV Gurava Reddy MB D (ortho)

DNB (Ortho) FRCS(Ed) MCh (Liverpool)

Consultant Joint Replacement Surgeon94, Happy Valley Road No.13Banjara Hills, HyderabadAndhra Pradesh

Babhulkar AshishAnuroop, 6, Vishrambag SocietySB RoadPune

Babhulkar SudhirSushrut Hospital and Research CentreRamdaspethNagpur

Babhulkar Sushrut SSushrut Hospital and Research CentreRamdaspethNagpur

Bakshi DPDA-3, Sector 1Salt Lake CityKolkata

Bapat Mihir RavindraShree Samratha Nursing Home121, Hindu Colony, 5th LaneDadar, MumbaiMaharashtra

Bhagwati SN MS MCh (Neurosurg)

Head, Dept. of NeurosurgBombay HospitalMumbai

Bhalla R MS (Ortho) MNAMS FICS FACS

Senior Consultant and Chairman ofOrthopedicsSir Ganga Ram HospitalNew Delhi

Bhan SuryaProf. and Head Dept. of OrthopedicsAll India Institute of Medical SciencesAnsari NagarNew Delihi

Bhatia Anil G MS (Ortho)

Orthopedic SurgeonPoona Hospital and Research CentrePune

Bhattacharya Sailendra MBBS (Cal)

FRCS (Eng)

21/7 Gariahat RoadGol ParkKolkata

Bhave Arvind MS (Ortho) IPTM (ISRAEL)

FICOE

Prof. of Orthopedics BharatiVidyapeeth Medical College PuneSpine Surgeon, DeenanathMangeshkar HospitalPune

Bhende Harish S5, Satjangad Co-Op. Housing Society166-D, Dr. Ambedkar Road, Dadar (E)Mumbai

Bhojraj Shekhar YChoudhari Spine SurgeonLilavati HospitalMumbai

Bhosale PB MS (Ortho) D (Ortho) DNB (Ortho)

ProfessorUnit Chief, KEM Hospital and Seth GSMedical CollegeParelMumbai

Bukshi Ashish MD

Department of Medical OncologyTata Memorial HospitalMumbai

Cavendish MEConsultant Orthopedic Surgeon88 Rodney StreetLiverpool, England

Chadha Manish MS (Ortho)

C-A/16 Tagore GardenNew Delhi

Chakraborty KDA-3, Sector 1Salt Lake CityKolkata

Chaudhary Milind MS (Ortho) (Mumb)

Centre for Ilizarov TechniquesChaudhary Trust HospitalCivil LinesAkola

Chawra GS MS (B Com)

26 Kala Bhawan3 Mathew RoadBehind Opera HouseMumbai

Chitale ARChief PathologistBombay HospitalMumbai

Chodankar Rohit8, Status Chambers1221/A, Wrangler Paranjape RoadOff. FC Road, Pune

Choong FM Peter MBBS MD FRACS FAOrth

Professor of OrthopedicsUniversity of MelbourneSt.Vincent’s HospitalMelbourneAustralia

Clement Joseph JOrthopedic Surgeon, Sports andArthroscopy Clinicgkm HospitalCoimbatoreTamil Nadu

Connor O’ I MaryDepartment of OrthopedicsJacksonville, FLUnited States

Currimbhoy ZEJJ HospitalMumbai

Dave PKProfessor and HeadAll India Institute of Medical SciencesAnsari NagarNew Delhi

Deendhayal JGanga HospitalCoimbatore

Deshmane P PrashantDept. of OrthopaedicsKEM HospitalMumbai

DeMuth BrianInsall Scott Kelly Institute forOrthopedics and Sport Medicine170 East End Avenue at 87th StreetNew York, USA

Devadoss A424, KK NagarMadurai, Tamil Nadu

Dhal AKG-41, Lajpat Nagar IIINew Delhi

Dhammi IK MS (Ortho)

Dept. of OrthopedicsUniversity College of Medical Sciencesand GTB HospitalNew Delhi

Dhanshekara RajaDepartment of Orthopedics andSpine SurgeryGanga Hospital, Swarnambika Lay outRamnagarCoimbatore, India

Dhar SanjayBombay Hospital and MedicalResearch CentreNair Hospital, Mumbai

viii Textbook of Orthopedics and Trauma (Volume 1)

Dhillon MSDepartment of Orthopedic SurgeryPostgraduate Institute of MedicalEducation and ResearchChandigarh

Dilip Patel54, B, Brahmin Mitramandal SocietyNear Old Sharda Mandir, EllisbridgeAhmedabad

Diwan BS MS(Ortho)

Consultant OrthopedicsDiwan HospitalSangli

Diwan SandeepPostgraduate Institute of SwasthiyogPratishthanExtension AreaMiraj

Diwanmal BMPostgraduate Institute of SwasthiyogPratisthan, Extension AreaMiraj

Doshi KTarabai ParkKolhapurMaharashtra

Dudani Baldev GE-23, Shanti Kunj. Opp. GPOPune

Duncan Clive P MD PRCSC

Prof. and ChairmanDivision of Reconstructive OrthopedicsUniversity of British ColumbiaVancouver, BC Canada

Durai VMedical OfficerCentral Leprosy Training and ResearchInstitute, Chengalpattu

Dutta SK MS (Cal) MS (Ortho) Cal

Orthopedic Surgeon and InchargeRegional Artificial Limb Fitting CentreNRS Medical CollegeKolkata

Ekbote SV BSc

Ashiwini Back InstituteAditya Nursing HomeGokhale Road, NaupadaThane, Mumbai

Garg BAll India Institute of Medical ScienceNew Delhi

Gajiwala Lobo AstridHead, Tissue BankTata Memorial HospitalMumbai

Ganjwala DhirenSantosh, Opp. PolytechnicAhmedabad 380015Gujrat

Garbuz Donald S MD FRCSC

Clinical InstructorDivision of Reconstructive OrthopedicsUniversity of British ColumbiaVancouverBC Canada

Garg HiteshResearch FellowAll India Institute of Medical SciencesNew Delhi

Garg RDeptt. of EndocrinologyAll India Institute of Medical SciencesAnsari NagarNew Delhi

Garude Sanjay36/A 1st Floor, Sai NivasRoad No. 2, Sion (E)Mumbai

Gebharodt C Mark MD

Beth Israel Deaconess Medical CentreChildren’s HospitalBoston, MAUnited States

George SelvarajKarunya Mann AnjhalaNalanchira POTrivandrumKerala

Ghosh MS21, Lake Avenue, KolkataWest Bengal

Gill Paramjeet MD FRCS

Clinical Fellow inCentral Dupage/RushAdult Reconstructive FellowshipChicagoIllinois

Gill Shivinder SinghDept. of Orthopedics8/H2 Sector 12 PGIMERChandigarh

Goel SCAmaravati, A23, Brij EnclaveSunderpur, VaranasiUttar Pradesh

Gopmes D CounhaHand and ReconstructiveMicrosurgeryLokmanya Tilak Municipal MedicalCollege and Hospital, SionMumbai

Gordon IJeslok Hospital, Mumbai

Goswami Nitingiri MS (Otho)

Kamal 11, Sangaita SocietyNear Ankur Bus Stop, NaranpuraAhmedabad

Govardhan RHNo. 5, 8th Street, T BlockAnna Nagar, ChennaiTamil Nadu

Goyal AtulGanga HospitalCoimbatore

Goyal HCAdditional Director of General HealthService (DGHS)Nirman BhavanNew Delhi

Goyal Manoj Kumar MS (Ortho)

DNB (Ortho)

A-6, Meera BaghPashchim ViharNew Delhi

Goyal Saurabh21, Laxminagar, NaranpurAhmedabadGujarat

Green Stuart A MD

DirectorThe Problem Fracture ServiceRancho Los Amigos Hospital7601 E Imperial HighwayDowney CAUSA

Greidarius Nelson MD FRCS

Clinical Fellow in CentralDupage/RushAdult Reconstructive FellowshipChicagoIllinois

Contributors ix

Grimer Robert J FRCS

Royal Orthopedic Hospital, NHS TrustBirmingham, UK

Gupta AK MBBS MS (Ortho)

Associate ProfessorCentral Institute of OrthopedicsSafdarjung Hospital, New Delhi

Gupta Sandeep MD

Associate Professor, Medical OncologyTata Memorial Hospital, Mumbai

Gupta SP MS (Ortho)

LecturerDept. of Ortho and RehabilitationMG Hospital and Dr SN MedicalCollegeJodhpur

Haddad Fares S BSc MCh (Orth) FRCS (Orth)

Clinical and Reserach FellowDivision of Reconstructive OrthopedicsUniversity of British ColumbiaVancouver, BC Canada

Hardikar SM FRCS (E)

Hardikar Hospital1160/61, Ganeshkhind RoadShivajinagar, Pune

Hardinge KWritington General Hospital, UK

Hathi SKDept. of PhysiologyBombay HospitalMumbai

Healey H John MD FACS

Chief Orthopedic ServiceMemorial Sloan Kettering CancerCentreNew York, United States

Herzenberg John E MD

Associate ProfessorDivision of Ortho SurgUniversity of MarylandBaltimoreUSA

Holz UProf. of OrthopedicKatharinen Hospital7000 StuttgartGermany

Huckstep Ronald L CMG MD FRCS FRACS

(Ann) 108 Sugarloaf CrescentCastlecrag, Sydney, NSW 2068Australia

Hugate Ronald Jr MD

Mayo Clinic, Department ofOrthopedicsRochester, MNUnited States

Ingalhalikar Vinod TAdity Nursing Home, Gokhare RoadThane (W)Maharashtra

Irani TZPostgraduate Institute of SwasthiyogPratishthanExtension Area, MirajMaharashtra

Iyer VM MS (Ortho)

Iyer Orthopedic Centre andPhysiotherapy Clinic103, Railway Line, Solapur 1

Jahagirdar PLKrishna Medical College and ResearchCentreDhebewadi, Karad

Jahagirdar SPKrishna Medical College and ResearchCentreDhebewadi, Karad

Jain Anil K MS (Ortho)

University College of Medical Sciencesand Guru Teg Bahadur HospitalNew Delhi

Jain SKOrthopedic Surgeon241 Jaipur House ColonyAgra

Jambhekar NA MD

Professor PathologyTata Memorial HospitalMumbai

Jhunjhunwala HRD/4, Sunita 62, Pedder RoadMumbai, Maharashtra

Jindalkar AshokAll India Institute of PhysicalMedicine and Rehabilitation, Hazi AliMumbai

Johar A7 Jilani Manzil 1st Floor120/128 Gokhale Road (North)Opp Portuguese ChurchDadar (W)Mumbai

John EbnezarParimala Hospital, BilekahalliNear IimbBannerghatta RoadBangalore, Karnataka

Joshi AnantE-52,Lokmanya Nagar, TH KatariaMarg MahimMumbai, Maharashtra

Joshi BBConsultant in Hand Surgery andReconstructive SurgeryJESS Research and DevelopmentCentreNo 10 ONGC Complex, BandraReclamation (W), Mumbai

Joshi KR MD PhD

Prof. and HeadDept. of MicrobiologySN Medical College, Jodhpur

Joshi NPost Graduate Institute of SwasthiyogPratishthanMiraj

Joshi VRConsultant Physician andRheumatologistPD Hinduja National Hospital andMedical Research CentreVeer Sarvarkar Marg, Mahim, Mumbai

Kanaji BBJESS Research and DevelopmentCentre, No 10 ONGC ComplexBandra Reclamation (W)Mumbai

Kanna RajClinical FellowBreach Candy Hospital, Mumbai

Kapoor AtulKitty Cottage,883 Circular Road, Amrutsar 143 001Panjab

Kapoor Sudhir K MS

HeadDept. of OrthopedicsLady Hardinge Medical CollegeNew Delhi

Kathju MNSanthokba Durlabhji HospitalBhawani Singh MargJaipur

x Textbook of Orthopedics and Trauma (Volume 1)

Katoch Kiran MD

Asst Director (Clin)Central JALMA Inst for LeprosyTaj GanjAgra

Kaushik Aditya403 C, Plot No. 5, GurukrupaSamrath Ngr Cross Rd No. 2Andheri (W), MumbaiMaharashtra

Kaveri DheerajShri Chintamani, 2nd FloorOpp. New English SchoolTilak Road, Pune

Kawans Hirotaka MD PhD

Orthopedic ServiceMemorial Sloan Kettering CancerCentreNew York, United States

Kher SSAshiwini Back InstituteAditya Nursing Home, Gokhale RoadNaupada, Thane, Mumbai

Krishna M MD

Associate ProfessorDepartment of AnatomyLTMM College, Mumbai

Korula Ravi JDProfessor and HeadDept. of Orthopedics andAccid Surg Unit IIChristian Medical College and HospitalVellore

Kotwal Prakash P MS (Ortho)

Additional ProfessorDept. of OrthopedicsAll India Institute of Medical SciencesAnsari Nagar, New Delhi

Krieger Abbott J MD

Section of Neurological SurgeryUniversity of Medicine andDentistry of New JerseyNew Jersey Medicine SchoolNewark, New Jersey, USA

Kripalani SureshKripalani Hospital, Tarabai ParkKolhapur

Kukure PATata Memorial HospitalParel, Mumbai

Kulkarni AADental ClinicOpp. Laxmi TempleBijapur

Kulkarni GSPostgraduate Institute of SwasthiyogPratisthan, Miraj

Kulkarni MPostgraduate Institute of SwasthiyogPratisthanExtension AreaMiraj

Kulkarni RPostgraduate Institute of SwasthiyogPratisthanMiraj

Kulkarni RM MS (Ortho)

Assistant ProfessorPostgraduate Institute of SwasthiyogPratisthanExtension AreaMiraj

Kulkarni RutaPostgraduate Institute of SwasthiyogPratisthan, Extension AreaMiraj

Kulkarni S MS (Ortho) D Ortho

ProfessorPostgraduate Institute of SwasthiyogPratisthan, Extension AreaMiraj

Kulkarni Sanjay B MD (Microbiology)

Flat 3/FF, Shete ComplexDufferin ChowkSolapur

Kulkarni Sunil GPostgraduate Institute of SwasthiyogPratisthan, Miraj

Kulkarni V MS (Ortho)

Assistant ProfessorPostgraduate Institute of SwasthiyogPratishthanExtension AreaMiraj

Kumar BhaskaranandDeputy Medical Supt. and Prof.and HeadOrthopedic SurgeryKasturba Medical College and HospitalManipal

Kumar KushDean, Prof and HeadDept. of OrthopedicsHimalayan Institute of MedicalSciencesPV Narasimha Rao Medical Collegeand Himalayan Institute HospitalJolly Grant, Dehradun

Kumar Sudhir MS (Ortho), M Ch (Ortho)

Head, Department of OrthopedisUniversity College of Medical SciencesShahdara, Delhi

Kumta SameerE-18, Shanti SocietyModgul Lane, Mahim (West)Mumbai

Lakhanpal Ved PrakashProf and Head, Deptt. of OrthoHP Medical CollegeSimla

Laskar SiddharthaAssistant ProfessorDept. of Radiation OncologyTata Memorial Hospital, ParelMumbai

Lele Vikram RChief of Nuclear Medicine Dept.Dept. of Radiol, Jaslok Hospital andResearch CentreMumbai

Limaye Rajeev8, St. Stephens GardensNorhallertonNorth YorkshireDl7 8xn

Lorenz IKatharinen Hospital7000 StuttgartGermany

Lype Wilson MS

Department of OrthopedicsAmala Institute of Medical SciencesThrissurKerala

Madhuri VrishaProfessor of OrthopedicsCMC and HospitalPO Box 3Vellore

Contributors xi

Magu NKDeptt. of OrthopedicsMedical College, Rohtak, Haryana

Maheshwari JDelhi Inst. of Trauma and OrthoSant Parmanand Hospital Civil LinesNew Delhi

Maini Lalit MS

Assistant Professor OrthopedicsMaulana Azad Medical CollegeNew Delhi

Maini PSOrtho Consultant430 Tower 11, Mount KailashEast of Kailash, New Delhi

Maitra TK MS (Ortho)

Lecturer and Ortho SurgeonBC Roy Polio Clinic and Hospital forCrippted ChildrenKolkata

Malaviya GNAsst. Director (Surg)GJILAgra

Marya SKS644, Sector A Pocket CVasant KunjNew Delhi

Masri Bassam A MD FRCSC

Clinical Ass. Prof. and HeadDivision of Reconstructive OrthopedicsUniversity of British ColumbiaVancouver, BC Canada

Mavre SMPost Graduate Institute of SwasthiyogPratishthanMiraj

Mazumdar N DeProf. and Head, Dept. of OrthopedicsVivekananda Institute of MedicalSciencesRamakrishna Mission Seva PratisthanKolkata

Mehta MT MS (Gen Surg) MS (Ortho)

Orthopedic Nursing HomeOpp. Shiv Cinema, Ashram RoadAhmedabad

Mehta Rujuta5, Garden View SocietySarojini Road, Vile Parel (West)Mumbai

Menon Padma MD

Prof. and Head of the Dept. MedicineGS Medical CollegeMumbai

Mittal RL MBBS MS (Ortho) (Gold Medalist)

Dip SICOT FICS FAMS FAIS

Mittal Orthopedic Centre97 New Lal Bagh ColonyPatiala

Mohanty Shubhanshu MS (Ortho)

FASIF (Swiss) FRCS(Edin)

Asst. Professor, Deptt. of OrthopedicsKing Edward Memorial HospitalMumbai

Mohite SM MS D (Ortho)

Kshema Orthopedic HospitalHubli

Muckaden MA MD

Professor, Radiation Oncology andPallative Care ServicesTata Memorial HospitalMumbai

Mudholkar SR MS DCP

Professor and HeadDept. of AnatomyGovt. Medical CollegeMiraj

Mukherjee DKP 281, Narkal DangaMain Road, Kolkata

Mullaji Arun FRCS (Ed) MCh (Orth) MS (Orth)

DNB (Orth) D (Orth)

Joint Replacement SurgeonBreach Candy Hospital and LilavatiHospitalMumbai

Muthu BCDOrthopedic SurgerySports MedicineInstitute for Orthopedics170 East End Avenue at 87th StreetNew York, USA

Nagalotimath SJPathologist, Ramdev GalliBelgaum

Nagi ONProf. and HeadDept. of OrthopedicsPSG Institute of OrthopedicsChandigarh

Naik Nagesh MS (Ortho) Dip NB (Ortho)

Dip NB (Phy Med and Reh)

Orthopedic HospitalNear ST Stand, Sangli

Naik PremalPediatric Orthopedic SurgeonAsso. Professor of OrthopedicsNHL Municipal Medical CollegeAhmedabad

Nair Narendra MD

Head, Radiation Medicine Centre(BARC), Mumbai

Nanda RAsst. Prof. of OrthopedicsProf. and Head Deptt. of OrthopedicsHP Medical CollegeShimla

Naneria VinodOrtho Surgeon53 Patrakar Colony, Indore

Natarajan MVProfessor of Orthopedic SurgeryMadras Medical College, Chennai

Nene AbhaySpine ConsultantPD Hinduja National HospitalMumbai

Oberoi IPSH-No. 2311, Sector 28Faridabad, Haryana

Oommen PKDy. Director (Surg)Central Leprosy Teaching andResearch Institute, Chengalpattu

Pachore JAPostgraduate Institute of MedicalSciencesBombay Hospital, Mumbai

Page AniruduhClinical FellowLilavati Hospital, Mumbai

Pai Vasant RTata Memorial HospitalParel, Mumbai

Paley Dror MD FRCSC

Professor of Ortho SurgMaryland Centre for LimbLengthening and ReconstructionBaltimoreUSA

xii Textbook of Orthopedics and Trauma (Volume 1)

Panchwagh Yogesh MD

Senior Registrar, Orthopedic OncologyTata Memorial HospitalMumbai

Pande HK MS MCh (Cardio)

Wanless Hospital, Miraj

Pande VKProfessor of Ortho (Hand Surgery)SMS Medical College and HospitalJaipur

Pandey KetanConsultant Orthopedic and SpinalSurgeonDivision of Spinal SurgerySushrut Hospital Research Centre andPostgraduate Institute of OrthoRamdaspeth, Nagpur

Pandey Sureshwar MBBS (Hons)

MS FICS FIAMS MS (Ortho) FACS

Ram Janam Sulakshana Institute ofOrthopedicsTrauma Rehabilitation and ResearchRameshwaramRanchi

Paramshetti VinodParamshetti Hospital Sangli Miraj RoadMiraj

Parikh Piyush5a, Nandita Aptts,Opp Pathik SocietyNaranpuraAhmedabadGujarat

Paprosky Wayne (MD FACS)

Director of Adult ReconstructiveFellowship andAssociate Prof. Rush Medical CollegeChicago, Illinois

Parasnis RArchic, 35/98Bhusari Colony, KothrudPune

Pardiwala DinshawJiwan-Flat. 7a, Ii LD Ruparel MargMalabar HillMumbaiMaharashtra

Parihar MangalMangal Anand Hospital48 Swastik Park, ChemburMumbai, Maharashtra

Patil DSushrut Hospital and Research CentreRamdas PethNagpur

Patil DayaneshSushrut Hospital and Research CentreRamdas PethNagpur

Patel Dinubhai AKhanpur Orthopedic HospitalAhmedabad

Patel PankajC-1, Parshwanath Habitat Patel Soc.Gulabai Tekra EllisbridgeAhmedabad, Gujarat

Patil JKApple Diagnostic Centre, Vyapari PethKolhapur

Patnakar KiranApple Diagnostic CentreVyapari Peth, Kolhapur

Patwa Jagadish JPatwa Nursing Home1 Dashaporwad Society, PaladiAhmedabad

Patwardhan Milind H MD (Med)

DM (Endocrinol)

Endocrine Research CentreVantamure Corner, Sangli RoadMiraj

Pawardhan SandeepB-7, ICCHAMANI HomesBehind Kothrud Petrol PumpMayur Colony, Kothrud, Pune

Pendsey SharadDiabetes Clinic and Research CentreShreeniwas, Opp. Dhantoli ParkNagpur

Phatak Uday MD

Consultant PhysicianSharada Research InstituteMiraj, Dist. Sangli

Poduwal MurliLecturer, Dept. of OrthopedicsKEM Hospital and Seth GS MedicalCollege, Mumbai

Ponseti Ignacio VEmeritus Prof.University of IOWAIowa, USA

Prabhoo RamW03, Carlton Court, Perry Cross RoadBandra (W)Mumbai, Maharashtra

Prabhu DeepAll India Institute of PhysicalMedicine and Rehabilitation, Hazi AliMumbai

Prabhu PVAll India Institute of PhysicalMedicine and Rehabilitation, Hazi AliMumbai

Pujari BDShree Hospital, Extension AreaMiraj

Punjabi M MD PhD

Professor of BiomechanicsYale University School of Medicine333 Cedar Street, New HavenConnecticut, USA

Puri AjayAssociate Professor OrthopedicOncologyTata Memorial Hospital, ParelMumbai

Purohit AK MBBS MS MCh (Neuro)

Additional Professor and HeadDept. of NeurosurgeryNizam’s Institute of Medical SciencesPanjagutta, Hyderabad

Purohit GVS Medical College, Ahemedabad

Purohit SPurohit Hospital, Sangli

Purvish M ParikhTata Memorial HospitalParel, Mumbai

Puthoor Dominic K MS

Department of OrthopedicsAmala Institute of Medical SciencesThrissur, Kerala

Raghava Dutta MulukutlaUdai Clinic, Orthopedic Centre5-9-94, Chapel RoadHydrabad, Andhra Pradesh

Ragurams TAdditional Professor and SeniorResident Dept. of OrthoAll India Institute of Medical SciencesNew Delhi

Contributors xiii

Rajan David MS (Ortho)

Prof. and Head of the Dept.Arthroscopy and Sports MedicineKovai Medical Center and HospitalAvanashi RoadCoimbatore

Rajderkar SSDept. of AnatomyGovt. Medical College, Miraj

Rajgopal AshokB181, Shivalik EnclaveMalaviya NagarNew Delhi

Rajsekharan S PhD

Director and HeadDepartment of Orthopedics and SpineSurgeryGanga Hospital, Swarnambika Lay out,RamnagarCoimbatore, India

Ranjalkar SA DNB (Ortho)

Postgraduate Institute of SwasthiyogPratisthan, Extension Area, Miraj

Rao AchutPostgraduate Institute of SwasthiyogPratisthanMiraj

Rao CG MS MS (Ortho) FICS (Ortho) D (Orth)

DMB (Ortho)

Asst. Prof. OrthoKMC HospitalManipal

Rao K Sharath MBBS MS (Ortho)

Assoc. Prof. of OrthopedicsKasturba Medical College and HospitalManipal

Rao P TejeswarMBBS (Hons) FRCS (Edin), FRCS (London) MCh

(Ortho) (Liverpool)

Prof. of OrthoRanihat Medical Road, Cuttack

Rao Sripathy MS (Ortho)

Prof. of OrthopedicsKasturba Medical CollegeManipal

Rastogi Shishir MS (Ortho) DNB (PMR)

Additional Prof. of OrthoAll India Institute of Medical SciencesAnsari NagarNew Delhi

Rathi PrasannaPostgraduate Institute of SwasthiyogPratisthanMiraj

Rohira RajeshJESS Research and Development CentreNo.10-ONGC ColonyBandra Reclamation, Bandra (W)Mumbai

Rowley DIUniversity of DundeeDepartment of Orthopedics andTrauma SurgDundee Royal InfirmaryCaird Block Royal InfirmaryDundee

Sabhapathy S RajaHeadDept. of Plastic SurgeryHand and MicrosurgeryGanga Hospital, Coimbatore

Sabharwal SanjivAssociate Prof. of OrthopedicsChief Pediatric OrthopedicsDept. of OrthopedicsU M DNG – New Jersey Medical School90, Bergen Street, DOC 7300New York NJ 07103, USA

Saini RaghavDepartment of Orthopedic SurgeryPostgraduate Institute of MedicalEducation and ResearchChandigarh

Sancheti Parag MS (Ortho) DNB

(Ortho) F ASIF (Swiss)

Sancheti Institute for Ortho andRehabilitation16 Shivajinagar, Pune

Sancheti KH MS (Ortho) PhD (Ortho)

Sancheti Institute for Orthopedics andRehabilitation16, Shivajinagar, Pune

Sandhu Hardas SKitty Cottage883 Circular Road, Amrutsar 143 001Panjab

Sandhu Parvinder SKitty Cottage883 Circular Road, Amrutsar 143 001Panjab

Sandhu MSKitty Cottage, 883, Circular RoadAmritsarPunjab

Sane SMSane Nursing HomeVaibhav ApartmentsGr. Floor, SK Bhole RoadDadar, Mumbai

Sangwan Sukhbir Singh6 J/14, Medical EnclaveRohtak, Haryana

Sarpotdar VG ND DCH

Shivaji Nagar, Extension AreaMiraj

Schlicht Stephen M MBBS FRANZCR

MANZAPNM

Director of Nuclear MedicineDepartment of Medical ImagingConsultant RadiologistSt. Vincent’s HospitalMelbourne, Australia

Scuderi Giles ROrthopedic SurgerySports MedicineInstitute for Orthopedics170 East End Avenue at 87th StreetNew YorkUSA

Scully Sean P MD PhD

Professor of OrthopedicsUniversity of Miami School ofMedicine, Miami, FLUnited States

Sen RKUniversity of DundeeSchool of Biomedical EngineeringCaird Block. Royal InfirmaryDundee DD1 9ND

Sengupta Dilip KAssistant ProfessorDepartment of Orthopedics SpineCenterDartmouth-Hitchcock Medical CenterOne Medical Center DriveLebanon, NH 03756, USA

Senoy RB MBBS D (Ortho) DNB (Ortho)

Assistant Professor of OrthopedicsKasturba Medical College and HospitalManipal

xiv Textbook of Orthopedics and Trauma (Volume 1)

Shah Manish MS (Ortho)

21 Shantinagar, Ashram Road, VadajAhmedabad

Shah KN MS (Ortho)

Fracture and Orthopedic HospitalNear Mahalaxmi Char Rasta Opp UnnatiVidyalayaB/h Krishnanand ComplexPaladiAhmedabad

Shah RR MS (Ortho)

Prof. of Orthopedics4-45 MakhalumduraGulberga

Shah Vikram21, Laxminagar, NaranpurAhmedabad, Gujarat

Shanmugsundaram TKMS MCh (Ortho) FRCS (Eng) FRCS (Edin) FAMS

Emeritus Professor of OrthopedicsSurgeryMadras Medical CollegeChennai

Sharma Amit MS (Ortho)

Research FellowBreach Candy HospitalMumbai

Sharma JC MS (Ortho)

Prof. and Head of the Dept. ofOrthopedicsSMS Medical College and HospitalJaipur

Sharma LRProf and Head of the Dept,Krishna Medical College and Hospital,Karad

Shinde KaustubhSushrut Hospital and Research CentreRamdaspeth, Nagpur

Shivshankar B MS (Orth)

Iyer Orthopedic CenterRailway LinesSolapur

Sinopidis ChrisRoyal Liverpool University HospitalLiverpool, UK

Sim Franklin H MD

Mayo Clinic, Department ofOrthopedicsRochester, MNUnited States

Contributors xv

Singh Arun Pal MS (Ortho)

2221, 48-CChandigarh

Siwach Ram Chander MS DNB FICS

Dept. of OrthopedicsPt. BD Sharma PGIMS31/9J, Medical EnclavesRohtak, Haryana

Shifiq PiraniAssist. Prof.205-245 EastBritish Columbia StreetBritish ColumbiaVancouver, Canada

Sohail Muhammad TariqProf. and Head of Orthopedics andSpine SurgeryServices Institute of Medical SciencesServices HospitalLahore, Punjab, Pakistan

Solomon SamuelHeadBranch of Surgery and Surgical RehabSchieffelin Leprosy Research andTraining CentreKarigiri

Sortur SV MD

Vantmure CornerSangi-Miraj Road , Miraj

Srijit SrinivasanPostgraduate Institute of SwasthiyogPratisthan, Miraj

Srinivasan H FRCS (Eng and Edin)

12/1 First Seaward Road, ValmikiNagar, Chennai

Srinivasan MVenkateswar Orth. Hospital, BodiTamil Nadu

Sriram K MS (Surg) MS (Ortho) FRCS

6 Sivaswamy StreetOff Radhakrishnan RoadChennai

Srivastava KPEmeritus Prof. of OrthopedicsSN Medical CollegeAgra

Srivastava RKConsultant and HeadDepartment of RehabilitationSafdarjung HospitalNew Delhi

Sundar Rajan SRConsultant Orthopedic SurgeonDepartment of Orthopedics and SpineSurgeryGanga Hospital, Swarnambika Lay outRamnagarCoimbatore: 641 009, India

Suryanarayan PAppolo HospitalChennai

Taneja DK178, Anoop NagarIndoreMadhya Pradesh

Tanna DD65, Pedder RoadPleasant ParkMumbai, Maharashtra

Tapasvi S8, Status Chambers1221/A, Wrangler Paranjape RoadOff. FC RoadPune

Taraporvala JC91-A Paradise Appt.44 Nepean Sea RoadMumbai

Thacker Mihir MS

Instructor, OrthopedicsUniversity of Miami School ofMedicineMiami, FL, United States

Thakur AJIrla Nursing Home and Polyclinic189, Sv.Rd, Irla, Vile Parle/WMumbai, Maharashtra

Thakur SRProf. and Head, Deptt. of OrthoHP Medical College, Simla

Thatte Mukund R MS (Gen) MCh (Plastic)

Hand and ReconstructiveMicrosurgeryLokmanya Tilak Municipal MedicalCollege and HospitalSion, Mumbai

Thatte Ravin LHon. Prof. and HeadDepartment of Plastic andReconstructive SurgeryLokmanya Tilak Municipal MedicalCollege and HospitalSion, Mumbai

Thomas Kishen D(Ortho) DNB

Spine FellowDepartment of Orthopedics andSpine SurgeryGanga HospitalSwarnambika Layout, RamnagarCoimbatore

Thomas Temple H MD

Professor of Orthopedics and PathologyUniversity of Miami School of MedicineMiami, FL, United States

Tuli SMProf and Head of the OrthopedicsUniversity College of Medical Scienceand Guru Teg Bahadur HospitalNew Delhi

Vaidya Ramesh B MS (Anat)

Associate ProfessorGovt. Medical CollegeMiraj

Vaidya VSKing Edward VII Memorial HospitalDepartment of Orthopedic Surgery6th Floor, R. No. 608MS Building, Parel, Mumbai

Vaishnavi AJProf. and Head of the Deptt. ofOrthopedicsSayajirao Medical CollegeVadodara

Vaz LaxmiPostgraduate Institute of SwasthiyogPratishthanMiraj

Venkatachalam S MS (Ortho) (London) FRCS

Consultant Orthopedic SurgeonKovai Medical Center and HospitalCoimbatore

Vidyadharan S MS(Ortho) DNB (Ortho)

Spine FellowDepartment of Orthopedics andSpine SurgeryGanga HospitalSwarnambika Lay out, RamnagarCoimbatore

Vora Pravin HHon. Orthopedic SurgeonChildren’s Orthopedic HospitalHaji AliMumbai

Wakankar HemantB-89, Tulshibagwale ColonyDevchhayaaSahakar Nagar Road ParvatiPuneMaharashtra

Warrier SS204, Silver NestSardar Vallabbhai Patel NagarAndheri (W)Mumbai

Yadav SS MS (Ortho)

Prof. and Head of the Dept. ofOrthopaedicsSMS Medical College and HospitalJaipur

Zaveru Goutam6 Bhaweshwar Kutir4th Road, RajawadiGhatakopar (E)Mumbai

Zha SSZha HospitalBoring RoadPatna

xvi Textbook of Orthopedics and Trauma (Volume 1)

Foreword to the Second Edition

The Herculean task of bringing out the second edition is taken up by the editor Prof Dr GS Kulkarni to update and editthe present knowledge of Orthopedics and Traumatology. The textbook has an excellent collection of topics written byexperienced and knowledgeable orthopedic surgeons. The scholarly work done by the editor is being published byIndian Orthopedic Association as its revised second edition.

All the contributors have taken tremendous efforts to incorporate the present day knowledge and recent trends ofthe concerned topics. Many Orthopedic problems in developing countries are different from those in the westerncountry and most of the books, journals and publications are published from the west. The problems associated withOsteosynthesis and recent trends in nailing interlocking have been elaborately written. The common problems ofneglected fractures and their management which every surgeon encounters in the practice are well covered. Theconditions associated with traumatology and their complications are nicely covered in this edition. The textbook hascovered almost all the topics and conditions which we face day-to-day.

This book will be relevant and definitely helpful to Orthopedic Surgeons and students. Dr GS Kulkarni with hisvast experience and dedicated efforts has brought us the new edition of this book with a very high standard which willbe helpful to the readers.

Prof (Dr) Sudhir BabhulkarMS (Orth), D.Ortho, PhD Orth, DSc Orth, FAMS

Past President Indian Orthopedic Association

The Textbook of Orthopedics and Trauma, being published by the Indian Orthopedic Association, edited by Dr. GSKulkarni, is the most useful undertaking. This textbook provides the collective experiences in the field of orthopedicsand trauma of all the senior and experienced orthopedic surgeons of India.

India is perhaps the foremost amongst the developing countries. The CATCH 22 of the word “developing” fails toreveal that if the whole population of countries like India is taken into account. A certain section may have reached alevel of development almost near to that developed by the so-called developed countries, and certain section is plaguedby poverty and ignorance.

The orthopedic surgeons practising in India are familiar and capable of dealing not only with diseases anddisabilities that affect the prosperous dominant elite, who expect the same kind of health care as is available in the mostdeveloped countries of the world but also to be able to look after and treat adequately such conditions which havealmost disappeared from those countries, e.g. paralytic poliomyelitis, pyogenic infections of bones and joints, tuberculousdisease of bone and joints, mycotic infections, the neural and osteoarticular damage caused by Hansen’s infectionsspecially among young children and infants including the newborn. These diseases usually affect the poorer section ofthe society.

The challenge of the orthopedic surgeons in developing countries, therefore, is more comprehensive and varied.They have to handle all these serious conditions with severe financial and infrastructural constraints. Consideringthese challenges the editor Dr. GS Kulkarni has done an excellent job of selecting the topics and contributors for thebook. Among all the developing countries India happens to have a fairly well-trained body of orthopedic surgeons,who have had experience in the management of dealing with these wide variety of diseases and disabilities of thelocomotor system. The contributors have taken great pains and have described in detail these subjects, which, I amsure, will be extremely useful to the orthopedists of the developing countries.

Lately, with the introduction of mechanization and high-speed transport facilities, there is increased incidence ofhigh-velocity trauma causing polytrauma, which requires a very well-planned system of casualty care, which does notexist in countries like India. I am pleased to read the chapters on polytrauma written by eminent personalities.

Dr. GS Kulkarni is known to me since long. He is a devoted orthopedic academician. I also know many of the sectioneditors and contributors. They are sincere hard working group of orthopedic surgeons.

The textbook points out the wisdom of senior orthopedic surgeons of India, fills the gap that exists in this field. Theenterprise that the Indian Orthopedic Association is undertaking, is indeed most gratifying.

I hope that this textbook will act as a pathfinder and a guide to help orthopedic surgeons, who are practising indeveloping countries.

B. MukhopadhyayEmeritus Professor

Patna

Orthopedics and Trauma is the largest specialty of surgery and especially with the subspecialties in orthopedicswhich are more than 15 now, it obviously becomes difficult to encompass the total spectrum in its fullness in anytextbook. However, I must give credit to Dr. GS Kulkarni, who has made tremendous efforts and that too successfully tocover most of the spectrum of this specialty in adequate manner.

Medical education and training with its three-fold commitment to patient care, research and continuing educationalways presents a difficult challenge. The term “Core Curriculum” is used widely but seldom defined, therefore,selection and integration of essential information must form the basis for such publications.

Forewords to the First Edition

A good medical textbook should provide not only information but also a philosophy and approach which makesthe knowledge relevant. The authors must have experience, ability and dedication to the mission of teaching. Theyshould be scientifically accurate and capable of projecting their personalized approach. This is amply seen in thistextbook.

There are many reasons why prevention is still in its infantile stage. Grants for cancer and heart disease are largelyavailable as this is considered a real science. The life of a cell can be turned round more easily than the mind of amotorcyclist. Looking at the prevention means stepping outside our familiar role as a curative orthopedic surgeon.Road trauma is a great challenge and fills the hospital beds to a great extent.

Intoxication, designing of the roads, playground for children, police protection, bicycle tracks and maintenance oftrucks and safe driving are some of the few issues which should be considered very logically for prevention of trauma,and these are the legitimate areas for research even if they do not have the kudos of molecular biology or so muchfinancial support. “Prevention is wholesale. Treatment is retail”.

I am sure these remarks will be helpful to the future thinking and the present textbook mainly contributed by theIndian orthopedic surgeons will be a great boon for the orthopedic surgeons practising not only in developing countriesbut will be very informative to all who are devoted to this science and art. I am sure these volumes must find their placein academic libraries all over the world.

KT Dholakia Hon FRCS (Eng)Past President SICOT, Past President ASI

Past President IOA, Past President ASSIEmeritus Professor of Orthopedics

University of BombaySr. Orthopedics Surgeon, Bombay Hospital

Breach Candy Hospital andPD Hinduja National Hospital

The art and science of Orthopedics has changed remarkably. There has been an explosion in the orthopedic knowledgein recent years. The success of joint replacement, improvement in implant material with application of improvedtechniques and the new investigative techniques have made orthopedics a very exciting and rewarding specialty.

Indian Orthopedic Association felt the necessity of a textbook, which can give more importance to commonlyobserved problems in clinical practice in our specialty as our problems are not similar to those seen in westerncountries. The aim of this book is to provide authentic account of common conditions seen in our country morespecifically for the young surgeons during and after their training. The newer developments like joint replacement,distraction osteogenesis (Ilizarov and Jess), interlocking intramedullary nailing, spinal instrumentation and arthoscopyhave been included. The operative details have been excluded as they are available in many books on operativeorthopedics. The commonly prevailing problems of cold orthopedics have also been properly dealt with. There can beno better method of making the future of our specialty brighter than by ensuring that our trainee surgeons have thebenefit of the knowledge and experience of their seniors. The contributors deserve full appreciation for doing their bestin this regard and for giving their valuable time for this purpose.

Dr. GS Kulkarni is an expert editor, with enormous experience of editing journals and books. It is his dedicationand constructive efforts that could provide us Textbook of Orthopedics and Trauma of such a high standard and value. Hehas done a commendable job for the Indian Orthopedic Association.

I am sure this book will be of tremendous value and help to its readers.

KP SrivastavaMS (Surg) MS (Ortho) D (Ortho) FICS

FACS FAMS FAIS FIAMSPresident

Indian Orthopedic Association

xx Textbook of Orthopedics and Trauma (Volume 1)

Preface to the Second Edition

Since the publication of first edition of the Textbook of Orthopedics and Trauma, phenomenal advances have been seenin each sub-branch of orthopedics. Locking plate has revolutionized the management of fractures, especially intra-and juxta-articular fractures and fractures of osteoporotic bones. Arthroscopy has extended its indications. Surfacereplacement and unicompartmental arthroplasty are on the horizon. Similar developments have occurred in otherbranches too. Each chapter of the book has been revised and updated. The creation and production of a work of thismagnitude requires dedicated contribution of a large number of authors. Younger generation of orthopedic surgeonshave taken keen interest in the book and have contributed to a great extent. I am grateful to them.

This book will be very useful to postgraduate students, their teachers and to the practicing orthopedic surgeons asa reference book.

GS Kulkarni

Preface to the First Edition

Orthopedic knowledge is literally exploding at an astounding rate. No other surgical specialty has a greater numberof variety of procedures than orthopedics. The orthopedic market is also flooded with bewildering number ofimplants and instrumentation sets. The practicing orthopedic surgeons as well as the postgraduate students are ata loss to select the clinical material from the vast literature and the implants and instrumentation. This book will bea quick text as a refresher and an easy reference to orthopedic surgeons. For postgraduate students this book shouldbe indispensible.

Orthopedic problems of the developing countries are different from those in the West and most of the books andjournals on the subject emanate from the western countries. Incidence of paralytic poliomyelitis, tuberculosis,chronic osteomyelitis, leprosy, etc. are rampant and so are the road-side accidents which are common in thedeveloping countries. Conditions associated with trauma such as nonunion (with or without infection), malunion,deformity stiff joints, etc. are day-to-day taxing problems. Even the sizes of Indian/Asian bones are smaller thanthose in the West. This disparity creates problems in inserting implants for the replacement of joints and for thetreatment of fractures. Every orthopedic surgeon encounters a large number of cases of neglected trauma, deformities,infections and even tumors of bones and joints. Neglect of orthopedic disease is a common scenario, as also are thepoor conditions of the operating rooms, and low quality of implants. Often the surgical technique is not performedmeticulously as described by different methodology. All these add to the complications.

The textbook has been designed to adequately cover all such conditions which are missing from or inadequatelydescribed in the western textbooks. The main aim of this book is to give comprehensive information about diseaseand problems peculiar to the developing countries and to provide one source of orthopedic information. Eachchapter is written by a surgeon who has a special interest in the subject. I take particular pride in the list ofoutstanding contributors, many of whom are leading authorities in their fields. An attempt is made to give acomplete orthopedic knowledge including basic and applied sciences and rehabilitation of musculoskeletal system.

In a multiauthor book of this nature, some repetition is unavoidable, but is useful. This is mainly addressed tothe practicing orthopedic surgeons and postgraduate students in the developing countries. I am very much thankfulto the Indian Orthopedic Association for asking me to edit this prestigious book.

GS Kulkarni

I very sincerely thank the publisher Shri JP Vij, Chairman and Managing Director of Jaypee Brothers, New Delhi, whohave taken great pains in publishing this book in time, maintaining the international standards. My sincere thanks toMr Tarun Duneja, General Manager (Publishing), Mr PS Ghuman (Sr Production Manager) for excellent productionand layout, and the entire staff of Jaypee Brothers for their very active cooperation. I am very grateful to Dr. MS Ghoshof Kolkata, who convinced IOA to publish this book. I express my gratitude to Milind, Sunil, Ruta, Vidisha, RajeevLimaye, and PG students for their untiring help in completing this book. They have helped by proofreading, correctingarticles and writing a few articles. My thanks to my stenotypist Arthur Shikhamani and Subhash Marathe who havetolerated me for the last 7 years. I am obliged to our hospital artist Priyanka Pore who has done excellent job ofphotographs and line drawings. My special thanks to my wife Shashi. Lastly my sincere thanks to all the orthopedicpatients who are the backbone of this textbook.

Acknowledgements

Contents

VOLUME ONESection 1Introduction and Clinical ExaminationS Pandey

1. Introduction and Clinical Examination 3S Pandey

2. Damage Control Orthopedics 13Anil Agarwal, Anil Arora, Sudhir Kumar

Section 2Basic SciencesAnil Arora

3. Function and Anatomy of Joints 193.1 Part I—Joints: Structure and Function 19

Manish Chadha, Arun Pal Singh3.2 Part II—Synovium Structure

and Function 24N Naik

4. Growth Factors and Fracture Healing 27Anil Agarwal, Anil Arora

5. Metallurgy in Orthopedics 38Aditya N Aggarwal, Manoj Kumar Goyal, Anil Arora

6. Pathophysiology of Spinal Cord Injury andStrategies for Repair 41Manish Chadha

7. The Stem Cells in Orthopedic Surgery 53Manish Chadha, Anil Agarwal, Anil Arora

8. Bone: Structure and Function 59SR Mudholkar, RB Vaidya

9. Cartilage: Structure and Function 71SP Jahagirdar

10. Muscle: Structure and Function 76PL Jahagirdar

11. Tendons and Ligaments:Structure and Function 87PL Jahagirdar

Section 3Diagnostic Imaging in OrthopedicsJK Patil

12. MRI and CT in Orthopedics 93JK Patil

13. Musculoskeletal Ultrasound 146JK Patil, Kiran Patnakar

14. Nuclear Medicine in Orthopedics 155VR Lele

Section 4Metabolic Bone DiseasesShishir Rastogi, PS Maini

15. Osteoporosis and Internal Fixation inOsteoporotic Bones 167GS Kulkarni

16. Vertebroplasty for Osteoporotic Fractures 190Arvind Bhave

17. Ochronosis 197GS Kulkarni, P Menon

18. Gout 200VM Iyer

19. Crystal Synovitis 208V Kulkarni

20. Rickets 209KN Shah, Prasanna C Rathi

21. Scurvy and Other VitaminRelated Disorders 219KN Shah

22. Mucopolysaccharidosis 222R Kulkarni

23. Fluorosis 228R Aggarwal

24. Osteopetrosis 232B Shivshankar

Section 5Endocrine DisordersMH Patwardhan

25. Endocrine Disorders 237R Garg, AC Ammini, TZ Irani

26. Hyperparathyroidism and Bone 241MH Patwardhan, TZ Irani

Section 6Bone and Joint InfectionsSC Goel

27. Pyogenic Hematogenous Osteomyelitis:Acute and Chronic 249SC Goel

28. Septic Arthritis in Adults 268R Bhalla

xxviii Textbook of Orthopedics and Trauma (Volume 1)

29. Fungal Infections 272KR Joshi, JC Sharma

30. Miscellaneous Types of Infections 27930.1 Gonococcal Arthritis 279

PT Rao, Irani30.2 Bones and Joints in Brucellosis 281

SJ Nagalotimath30.3 Congenital Syphilis 285

SC Goel30.4 Salmonella Osteomyelitis 289

SC Goel30.5 Hydatid Disease of the Bone 290

GS Kulkarni, TZ Irani31. Surgical Site Infection 293

V Naneria, K Taneja32. Prevention of Surgical Site

Infection in India 301Sanjay B Kulkarni

33. AIDS and the Orthopedic Surgeon 311SS Rajderkar, SA Ranjalkar

Section 7Tuberculosis of Skeletal SystemSM Tuli, SS Babhulkar

34. Epidemiology and Prevalence 319SM Tuli

35. Pathology and Pathogenesis 321SM Tuli

36. The Organism and its Sensitivity 328SM Tuli

37. Diagnosis and Investigations 330SM Tuli

38. Evolution of Treatment ofSkeletal Tuberculosis 337SM Tuli

39. Antitubercular Drugs 340SM Tuli

40. Principles of Management ofOsteoarticular Tuberculosis 344SM Tuli

41. Tuberculosis of the Hip Joint 352SM Tuli

42. Tuberculosis of the Knee Joint 366SM Tuli

43. Tuberculosis of the Ankle and Foot 373SM Tuli

44. Tuberculosis of the Shoulder 376SM Tuli

45. Tuberculosis of the Elbow Joint 379SM Tuli

46. Tuberculosis of the Wrist 382SM Tuli

47. Tuberculosis of Short Tubular Bones 384SM Tuli

48. Tuberculosis of the Sacroiliac Joints 386SM Tuli

49. Tuberculosis of Rare Sites, Girdle and Flat Bones 388SM Tuli

50. Tuberculous Osteomyelitis 392SM Tuli

51. Tuberculosis of Tendon Sheaths andBursae 396SM Tuli

52. Tuberculosis of Spine: Clinical Features 398SM Tuli

53. Tuberculosis of Spine: RadiographicAppearances and Findings onModern Imaging 404SM Tuli

54. Tuberculosis of Spine:Differential Diagnosis 416SM Tuli

55. Tuberculosis of Spine:Neurological Deficit 423AK Jain

56. Management and Results 446SM Tuli

57. Surgery in Tuberculosis of Spine 464SM Tuli

58. Operative Treatment 476SM Tuli

59. Relevant Surgical Anatomy of Spine 493SM Tuli

60. Atypical Spinal Tuberculosis 497AK Jain

61. The Problem of Deformity inSpinal Tuberculosis 503Rajsekharan

Section 8PoliomyelitisBD Athani

Poliomyelitis: General Considerations62. Acute Poliomyelitis and Prevention 513

VG Sarpotdar63. Convalescent Phase of Poliomyelitis 518

M Kulkarni64. Residual Phase of Poliomyelitis 520

SM Mohite65. Patterns of Muscle Paralysis Following

Poliomyelits 524K Kumar

Contents xxix

66. Clinical Examination of a Polio Patient 527GS Kulkarni

67. Management of Shoulder 538SK Dutta

68. Surgical Management of PostpolioParalysis of Elbow and Forearm 545MN Kathju

69. Affections of the Wrist and Hand inPoliomyelitis 551GA Anderson

Polio Lower Limb and Spine70. Surgical Management of Sequelae of

Poliomyelitis of the Hip 560MN Kathju

71. Knee in Poliomyelitis 567DA Patel

72. Management of Paralysis AroundAnkle and Foot 574MT Mehta

73. Equinus Deformity of Foot inPolio and its Management 576PK Dave

74. Valgus Deformity of Foot 580PH Vora, GS Chawra

75. Varus Deformity of Foot in Poliomyelitis 584S Pandey

76. Postpolio Calcaneus Deformity andits Management 590TK Maitra

77. Management of Flail Foot andAnkle in Poliomyelitis 595KH Sancheti

78. Spinal Deformities in Poliomyelitis 599K Sriram

Miscellaneous Methods ofManagement of Polio

79. Comprehensive Rehabilitation 606SM Hardikar, RL Huckstep

80. Comprehensive Management of Poliomyelitisand Deformities of Foot and Ankle with theIlizarov Technique 609M Chaudhary

81. Correction of Foot, Ankle and KneeDeformities by the Methods of Ilizarov 620MT Mehta, N Goswami, M Shah

Adult Poliomyelitis82. Late Effects of Poliomyelitis

Management of Neglected Cases 626VM Agashe

83. Management of Neglected Cases ofPoliomyelitis Presenting for Treatment inAdult Life 631JJ Patwa

Section 9LeprosyH Srinivasan

84. Leprosy 641K Katoch

85. Consequences of Leprosy andRole of Surgery 649H Srinivasan

86. Deformities and Disabilities in Leprosy 654H Srinivasan

87. Clinical and Surgical Aspects of Neuritis 658in LeprosyPK Oommen, H Srinivasan

88. Hand in Leprosy 674H Srinivasan

89. Infections of the Hand 678H Srinivasan

90. Paralytic Claw Finger and itsManagement 685GN Malaviya, H Srinivasan

91. Surgical Correction of Thumb in Leprosy 706PK Oommen

92. Drop Wrist and Other Less CommonParalytic Problems in Leprosy 716GA Anderson

93. Hand in Reaction 721PK Oommen

94. Salvaging Severely Disabled Handsin Leprosy 724GA Anderson

95. Foot in Leprosy 730H Srinivasan

96. Neuropathic Plantar Ulceration and itsManagement 732H Srinivasan

97. Surgery for Prevention of Recurrent 745Plantar UlcerationH Srinivasan

98. Paralytic Deformities of theFoot in Leprosy 754PK Oommen

99. Neuropathic Disorganization of theFoot in Leprosy 767GN Malaviya

100. Amputations and Prosthesis forLower Extremities 779S Solomon

xxx Textbook of Orthopedics and Trauma (Volume 1)

101. Physiotherapy and OccupationalTherapy in Leprosy 782PK Oommen, V Durai

102. Footwear for Anesthetic Feet 797S Solomon

Section 10Systemic Complications in OrthopedicsUday A Phatak

103. Shock 807Uday Phatak

104. Crush Syndrome 811V Paramshetti, Srijit Srinivasan

105. Disseminated Intravascular Coagulation 812U Phathak

106. Thromboembolism 814U Phatak

107. Fat Embolism Syndrome: Adult RespiratoryDistress Syndrome (ARDS) 817U Phatak

108. Orthopedic Manifestations of SickleCell Hemoglobinopathy 820SS Babhulkar

109. Systemic Infection 827109.1 Gas Gangrene 827

SV Sortur109.2 Tetanus 828

SV Sortur

Section 11Diseases of JointsPT Rao, Surya Bhan

110. Synovial Fluid 833Surya Bhan

111. Synovial Disorders 840Surya Bhan

Section 12Rheumatoid DisordersJC Taraporvala, Surya Bhan

112. Rheumatoid Arthritis andAllied Disorders 849JC Taraporvala, SN Amin, AR Chitale, SK Hathi

113. Ankylosing Spondylitis 873Surya Bhan

114. Arthritis in Children 879VR Joshi, S Venkatachalam

115. Seronegative Spondyloarthropathies 886Surya Bhan

Section 13Peripheral Nerve InjuriesAnil Kumar Dhal, M Thatte, R Thatte

116. Injuries of Peripheral Nerve 895MR Thatte, R Thatte

117. Electrodiagnostic Assessment ofPeripheral Nerve Injuries 900M Thatte

118. Painful NeurologicalConditions of Unknown Etiology 908GS Kulkarni

119. Management of Adult BrachialPlexus Injuries 910Anil Bhatia, MR Thatte, RL Thatte

120. Obstetrical Palsy 924Anil Bhatia, MR Thatte, RL Thatte

121. Injection Neuritis 931RR Shah

122. Median, Ulnar and Radial Nerve Injuries 932V Kulkarni

123. Tendon Transfers 940MR Thatte, RL Thatte

124. Entrapment Neuropathy in theUpper Extremity 950MR Thatte, RL Thatte

125. Affections of Sciatic Nerve 954S Kulkarni

126. Peroneal Nerve Entrapment 956S Kulkarni

127. Anterior Tarsal Tunnel Syndrome 960V Kulkarni

128. Lateral Femoral CutaneousNerve Entrapment 962V Kulkarni

VOLUME TWOSection 14Bone TumorsMV Natarajan, Ajay Puri

129. Bone Tumors—Introduction,Classification and Assessment 967MV Natarajan

130. Bone Tumors—Diagnosis, StagingTreatment Planning 974Ajay Puri, MG Agarwal

131. The Role of Bone Scanning in Malignant 990Narendra Nair

Contents xxxi

132. Biopsy for Musculoskeletal Neoplasms 997MG Agarwal, Ajay Puri, NA Jambhekar

133. Principles of Treatment of Bone Sarcomasand Current Role of Limb Salvage 1005Robert J Grimer

134. Systemic Therapy and Radiotherapy 1012134.1 Systemic Therapy of Malignant

Bone and Soft Tissue Sarcomas 1012PM Parikh, A Baskhi, PA Kurkure

134.2 Radiotherapy for Bone andSoft Tissue Sarcomas 1016Siddhartha Laskar

135. Benign Skeletal Tumors 1020135.1 Benign Cartilage Lesions 1020

Dominic K Puthoor, Wilson Lype135.2 Benign Fibrous Histocytic Lesions 1034

Dominic K Puthoor, Wilson Lype135.3 Benign Osteoblastic Lesions 1036

Dominic K Puthoor Wilson Lype136. Giant Cell Tumor of Bone 1043

Ajay Puri, MG Agarwal, Dinshaw Pardiwala137. Osteogenic Sarcoma 1048

Hirotaka Kawans, John H Healey138. Chondrosarcoma 1061

Ajay Puri, Chetan AncharYogesh Panchwagh, Manish Agarwal

139. Ewing Sarcoma Bone 1071H Thomas, Mihir Thocker, Sean P Scully

140. Miscellaneous Tumors of Bone 1081Dinshaw Pardiwala

141. Evaluation of Treatment of BoneTumors of the Pelvis 1090Ronald Hugate, Mary I O’ ConnorFranklin H Sim

142. Metastatic and PrimaryTumors of the Spine 1105142.1 Metastatic Disease of the Spine 1105

Shekhar Y Bhojraj, Abhay Nene142.2 Primary Tumors of the Spine 1111

Shekhar Y Bhojraj, Abhay Nene143. Metastatic Bone Disease 1121

Sudhir K Kapoor, Lalit Maini144. Role of Custom Mega Prosthetic

Arthroplasty in Limb Salvage Surgeryof Bone Tumors 1129MV Natarajan

145. Bone Banking and Allografts 1137Manish Agarwal, Astrid Lobo Gajiwala, Ajay Puri

146. Palliative Care in Advanced Cancer andCancer Pain Management 1148MA Muckaden, PN Jain

147. The Management of Soft TissueSarcomas 1153Peter FM Choong, Stephen M Schlicht

148. Multiple Myeloma 1162Sandeep Gupta, Ashish Bukshi, Vasant R PaiPurvish M Parikh

149. The Future of Orthopedic Oncology 1168Megan E Anderson, Mark C Gebharodt

Section 15BiomaterialNagesh Naik

150. Biomechanics and Biomaterials inOrthopedics 1175Vikas Agashe, Nagesh Naik

151. Implants in Orthopedics 1179151.1 Metals and Implants in

Orthopedics 1179DJ Arwade

151.2 Bioabsorbable Implants inOrthopedics 1187MS Dhillon

Section 16Fractures and Fracture Dislocation:General ConsiderationsGS Kulkarni

152. Fractures Healing 1193GS Kulkarni

153. Principles of Fractures and FractureDislocations 1204MS Ghosh, GS Kulkarni

154. Stress Fractures 1218Achut Rao

155. Principles of Two Systems of FractureFixation—Compression System andSplinting System 1224GS Kulkarni

156. Recent Advances in Internal Fixation ofFractures 1249I Lorenz, U Holz

157. Nonoperative Treatment of Fracturesof Long Bones 1265157.1 Functional Treatment of Fractures 1265

DK Taneja157.2 Treatment of Fracture of Shaft of

Long Bones by Functional Cast 1273GS Kulkarni

158. Open Fractures 1279Rajshekharan

159. Soft Tissue Coverage for LowerExtremity 1306S Raja Sabhapathy

160. Bone Grafting and Bone Substitutes 1312GS Kulkarni, Muhammad Tariq Sohail

xxxii Textbook of Orthopedics and Trauma (Volume 1)

161. Polytrauma 1323Pankaj Patel

162. Abdominal Trauma 1328BD Pujari

163. Chest Trauma 1333HK Pande

164. Trauma to the Urinary Tract 1338S Purohit

165. Head Injury 1342Sanjay Kulkarni

166. Fractures of the Mandible 1344AA Kulkarni

167. Temporomandibular Joint Disorders 1350AA Kulkarni

168. Compartment Syndrome 1356R Aggarwal, Prasanna Rathi

169. Anesthesia in Orthopedics 1365169.1 Orthopedic Anesthesia and

Postoperative Pain Management 1365BM Diwanmal

169.2 Local Anesthesia and PainManagement in Orthopedics 1383Sandeep M Diwan

170. Medicolegal Aspects 1393170.1 Medicolegal Aspects in

Orthopedics 1393S Sane

170.2 Medical Practice and Law 1397BS Diwan

Section 17Intramedullary NailingDD Tanna, VM Iyer

171. Intramedullary Nailing of Fractures 1405DD Tanna

172. Plate Fixation of Fractures 1420GS Kulkarni

Section 18External FixatorAJ Thakur

173. External Fixation 1459AJ Thakur

174. The Dynamic Axial Fixator 1483R Aldegheri

175. Management of Trauma by Joshi’sExternal Stabilization System (JESS) 1488BB Joshi, BB Kanaji, Ram Prabhoo, Rajesh Rohira

Section 19Ilizarov MethodologyGS Kulkarni

176. The Magician of Kurgan:Prof GA Ilizarov 1505HR Jhunjhunwala

177. Biomechanics of Ilizarov Ring Fixator 1506GS Kulkarni

178. Biology of Distraction Osteogenesis 1519J Aronson, GS Kulkarni

179. Operative Technique of Ilizarov Method 1527M Kulkarni

180. Advances in Ilizarov Surgery 1537SA Green

181. Bone Transport 1546GS Kulkarni

182. Fracture Management 1548RM Kulkarni

183. Nonunion of Fractures of Long Bones 1552GS Kulkarni, R Limaye

184. Correction of Deformity of Limbs 1575D Paley184.1 Normal Lower Limbs, Alignment

and Joint Omentation 1575184.2 Radiographic Assessment 1582184.3 Frontal Plane Mechanical and

Anatomic Axis Planning 1584184.4 Translation and Angulation-

Translation Deformities 1587184.5 Oblique Plane Deformity 1609184.6 Sagittal Plane Deformities 1616

185. Calculating Rate and Duration ofDistraction for Deformity Correction 1634JE Herzenberg

186. Bowing Deformities 1637RM Kulkarni

187. Osteotomy Consideration 1651Dror Paley

188. Taylor Spatial Frame 1665Milind Choudhari

189. Congenital Pseudarthrosis of the Tibia 1674RM Kulkarni

190. Management of Fibular HemimeliaUsing the Ilizarov Method 1686Ruta Kulkarni

191. Foot Deformities 1692GS Kulkarni

192. Multiple Hereditary Exostosis 1713RM Kulkarni

Contents xxxiii

193. Stiff Elbow 1716Vidisha Kulkarni

194. Limb Length Discrepancy 1723DK Mukherjee

195. Limb Lengthening in Achondroplasiaand Other Dwarfism 1747RM Kulkarni

196. Postoperative Care in the IlizarovMethod 1753Mangal Parihar

197. Problems, Obstacles, and Complicationsof Limb Lengthening by the IlizarovTechnique 1759D Paley

198. Complications of Limb Lengthening:Role of Physical Therapy 1776A Bhave

199. Aggressive Treatment of ChronicOsteomyelitis 1780GS Kulkarni, Muhammad Tariq Sohail199.1 Aggressive Treatment by Bone

Transport199.2 Use of Calcium Sulphate in Chronic

Osteomyelitis200. Use of Ilizarov Methods in Treatment

of Residual Poliomyelitis 1785MT Mehta, N Goswami, MJ Shah

201. Arthrodiatasis 1790GS Kulkarni

202. Thromboangiitis Obliterans 1801GS Kulkarni

Section 20ArthroscopyAnant Joshi, D Pardiwala, Sunil Kulkarni

203. Arthroscopy 1811203.1 Introduction 1811

Dinshaw Pardiwala203.2 Diagnostic Knee Arthroscopy 1812

P Sripathi Rao, Kiran KV Acharya203.3 Loose Bodies in the Knee Joint 1818

Sanjay Garude203.4 Arthroscopy in Osteoarthritis

of the Knee 1822J Maheshwari

203.5 The ACL Deficient Knee 1824D Pardiwala

203.6 The Failed ACL Reconstructionand Revision Surgery 1831D Pardiwala, Anant Joshi

203.7 The Posterior Cruciate LigamentDeficient Knee 1837D Pardiwala

203.8 Medial Collateral LigamentInjuries of the Knee 1843David V Rajan, Clement Joseph

203.9 Posterolateral RotatoryInstability of the Knee 1849D Pardiwala

203.10 Allografts in KneeReconstructive Surgery 1856D Pardiwala

203.11 Shoulder Arthroscopy—Introduction, Portals andArthroscopic Anatomy 1861Clement Joseph, David V Rajan

203.12 SLAP Tears of Shoulder 1868D Pardiwala

Section 21Trauma Upper LimbKP Srivastava, Vidisha Kulkarni

204. Fractures of the Clavicle 1879Sudhir Babhulkar

205. Injuries of the Shoulder Girdle 1885205.1 Acute Traumatic Lesions of the

Shoulder Sprains, Subluxationand Dislocation 1885GS Kulkarni

205.2 Fractures of Proximal Humerus 1889J Deendhayal

205.3 Scapular Fractures andDislocation 1904Sudhir Babhulkar

206. Fractures of the Shaft Humerus 1913KP Srivastava, Murli Poduwal

Section 22Injuries of ElbowVidisha S Kulkarni

207. Fractures of Distal Humerus 1929Murli Poduwal

208. Injuries Around Elbow 1941208.1 General Considerations 1941

DP Bakshi, K Chakraborty208.2 Fractures of the Olecranon 1949

PP Kotwal208.3 Sideswipe Injuries of the Elbow 1956

PP Kotwal209. Dislocations of Elbow and

Recurrent Instability 1961PP Kotwal

210. Fractures of the Radius and Ulna 1967PP Kotwal

xxxiv Textbook of Orthopedics and Trauma (Volume 1)

VOLUME THREESection 23Trauma Lower LimbsGS Kulkarni

211. Fractures of Pelvic Ring 1973Dilip Patel

212. Fractures of Acetabulum 1986Parag Sancheti

213. Fractures and Dislocations of the Hip 2004GS Kulkarni213.1 Main Considerations 2004

John Ebnezar, GS Kulkarni213.2 Protrusio Acetabuli 2016

K Doshi213.3 Osteitis Condensans Ilii 2017

K Doshi214. Fractures of Neck of Femur 2018

GS Kulkarni214.1 Anatomical and Biomechanical

Aspects 2018Sameer Kumta

214.2 Evaluation of Fracture NeckFemur 2024GS Kulkarni

214.3 Pathology of Fracture NeckFemur 2027GS Kulkarni

214.4 Treatment of Fracture NeckFemur 2029GS Kulkarni

215. Intertrochanteric Fractures of Femur 2053GS Kulkarni, Rajeev Limaye, SG Kulkarni

216. Subtrochanteric Fractures of the Femur 2074SS Babhulkar

217. Diaphyseal Fractures of the Femur inAdults 2087Sunil G Kulkarni

218. Fractures of the Distal Femur 2093NK Magu, GS Kulkarni

219. Extensor Apparatus Mechanism:Injuries and Treatments 2112SS Zha

220. Intra-articular Fractures of theTibial Plateau 2119GS Kulkarni220.1 General Considerations 2119220.2 Hybrid Ring Fixator 2129220.3 Fractures of Tibial Plateau Treated

by Locking Compression Plate 2134

221. Diaphyseal Fractures of Tibia andFibula in Adults 2138S Rajshekharan, Dhanasekara Raja, SR Sundararajan

222. Pilon Fracture 2162GS Kulkarni

Section 24Injuries of the SpinePB Bhosale, Ketan Pandey

223. Cervical Spine Injuries andtheir Management 2175Ketan C Pande

224. Fractures and Dislocations of theThoracolumbar Spine 2191Ketan C Pandey

225. Pressure Sores and its Surgical Management in Paraplegics 2199RL Thatte, D Counha Gopmes, SS Sangwan

Section 25Neglected TraumaGS Kulkarni

226. Neglected Trauma in Upper Limb 2207GS Kulkarni226.1 Displaced Neglected Fracture of

Lateral Condyle Humerus inChildren 2215R Nanda, LR Sharma,SR Thakur, VP Lakhanpal

227. Neglected Trauma in Lower Limb 2217GS Kulkarni227.1 Neglected Fracture Neck,

Miscellaneous and OtherFractures of Femur 2217GS Kulkarni

227.2 Neglected Fracture Neck ofFemur 2227Hardas Singh Sandhu, Parvinder SinghSandhu, Atul Kapoor

227.3 Neglected TraumaticDislocation of Hip in Children 2232S Kumar, AK Jain

228. Neglected Trauma in Spine and Pelvis 2235GS Kulkarni

Section 26HandBB Joshi, Sudhir Warrier

229. Functional Anatomy of the Hand, BasicTechniques and Rehabilitation 2239PP Kotwal

230. Biomechanics of the Deformities of Hand 2245M Srinivasan

Contents xxxv

231. Examination of the Hand 2254S Pandey

232. Fractures of the Hand 2263Part I 2263SS WarrierPart II 2269SS Babhulkar

233. Dislocations and LigamentousInjuries of Hand 2276SS Babhulkar

234. Crush Injuries of the Hand 2281234.1 Tissue Salvage by Early External

Stabilization in MutilatingInjuries of the Hand 2281BB Joshi

234.2 Open and Crushing Injuries ofHand 2284SS Warrier

235. Skin Cover in Upper Limb Injury 2289Sameer Kumtha

236. Flexor Tendon Injuries 2296SS Warrier

237. Extensor Tendon Injuries 2305BB Joshi

238. Congenital Deformities of Upper Limbs 2314A Kaushik238.1 Congenital Malformations 2324

S Navare238.2 A Boy with Three Lower Limbs 2325

AK Purohit239. Complex Regional Pain Syndrome 2327

Sandeep Diwan240. Infections of Hand 2340

VK Pande241. Contractures of Hand and Forearm 2345

241.1 Volkmann’s IschemicContracture 2345VK Pande

241.2 Dupuytren’s Contracture 2352V Kulkarni, N Joshi

241.3. Postburn Hand Contractures 2357Vidisha Kulkarni, PP Kotwal

242. Nail and its Disorders and HypertrophicPulmonary Arthropathy 2359Vidisha Kulkarni

243. Stiff Hand and Finger Joints 2362Vidisha Kulkarni

244. Ganglions, Swellings and Tumorsof the Hand 2366GA Anderson

245. Hand Splinting 2380BB Joshi

246. Amputations in Hand 2400SS Warrier

247. Arthrodesis of the Hand 2409VS Kulkarni

Section 27Injuries of WristBB Joshi, SS Warrier, K Bhaskaranand

248. Surgical Anatomy of the Wrist 2417PP Kotwal, Bhavuk Garg

249. Examination of the Wrist 2420S Pandey

250. Fracture of the Distal End Radius 2427GS Kulkarni, VS Kulkarni

251. Distal Radioulnar Joint 2447VS Kulkarni

252. Fractures of the Scaphoid 2455SS Warrier

253. Fracture of the Other Carpal Bones 2464SS Warrier

254. Carpal Instability 2467Vidisha Kulkarni

255. Kienbock’s Disease 2476K Bhaskaranand

Section 28Disorders of WristK Bhaskaranand

256. de Quervain’s Stenosing Tenosynovitis 2485K Bhaskaranand

257. Carpal Tunnel Syndrome 2487K Bhaskaranand

258. Chronic Tenosynovitis 2492K Bhaskaranand

Section 29Diseases of ElbowS Bhattacharya

259. Clinical Examination andRadiological Assessment 2499S Pandey

260. The Elbow 2508S Bhattacharya

261. Abnormal (Heterotropic) Calcification andOssification 2524VS Kulkarni261.1 Traumatic Myositis Ossificans 2526261.2 Pelligrimi-Stieda’s Disease 2527261.3 Calcifying Tendinitis of

Rotator Cuff 2528

xxxvi Textbook of Orthopedics and Trauma (Volume 1)

Section 30Diseases of ShoulderA Devadoss, A Babhulkar

262. Functional Anatomy of Shoulder Joint 2533A Devadoss

263. Biomechanics of the Shoulder 2537A Devadoss

264. Clinical Examination andX-ray Evaluation 2540Ashish Babhulkar

265. Anomalies of Shoulder 2553ME Cavendish, Sandeep Pawardhan

266. Chronic Instability of Shoulder—Multidirectional Instability of Shoulder 2560Chris Sinopidis

267. Posterior Shoulder Instability 2569IPS Oberoi

268. Superior Labral Anteroposterior Lesion 2579Sachin Tapasvi

269. Rotator Cuff Lesion and ImpingementSyndrome 2586Ashish Babhulkar

270. Miscellaneous Affections of Shoulder 2595270.1 Deltoid Contracture 2595

HR Jhunjhunwala270.2 Bicipital Tenosynovitis 2598

A Devadoss270.3 Winging of Scapula 2600

M Natarajan, RH Govardhan, Selvaraj271. Adhesive Capsulitis 2602

A Devadoss272. Shoulder Rehabilitation 2606

Ashish Babhulkar, Dheeraj Kaveri273. Thoracic Outlet Syndrome 2614

RL Mittal, MS Dhillon

Section 31Cervical SpineS Rajshekharan

274. Functional Anatomy of the Cervical Spine 2627274.1 General Considerations 2627

M Krishna274.2 Movements, Biomechanics and

Instability of the Cervical Spine 2628M Punjabi

275. Surgical Approaches to theCervical Spine 2631Thomas Kishen

276. Craniovertebral Anomalies 2643Atul Goel

277. Cervical Disc Degeneration 2650S Vidyadharan

278. The Inflammatory Diseases of theCervical Spine 2672Dilip K Sengupta

279. Cervical Canal Stenosis 2684SN Bhagwati

280. Ossification of the PosteriorLongitudinal Ligament 2687AJ Krieger

Section 32Lumbar Spine DisordersVT Ingalhalikar, SH Kripalani

281. Clinical Biomechanics of theLumbar Spine 2691Raghav Dutta Mulukutla

282. Examination of Spine 2695Suresh Kripalani

283. Back Pain Phenomenon 2718VT Ingalhalikar

284. Backache Evaluation 2730A Vaishnavi

285. Rehabilitation of Low Back Pain 2741Ekbote, SS Kher

286. Conservative Care of Backpain andBackschool Therapy 2751GS Kulkarni

287. Psychological Aspects of Back Pain 2765VT Ingalhalikar

288. Degenerative Diseases of Disc 2769Abhay Nene

289. Lumbar Disc Surgery 2788Abhay Nene289. 1 Acute Disc Prolapse 2788289.2 Newer Surgical Techniques 2792

290. Surgery of Lumbar Canal Stenosis 2800VT Ingalhalikar, Suresh Kriplani, PV Prabhu

291. Spondylolisthesis 2809Rajesh Parasnis

292. Failed Back Surgery Syndrome (FBSS) 2818Sanjay Dhar

293. Complications in Spinal Surgery 2824Goutam Zaveri

294. Spinal Fusion 2832Mihir Bapat

295. Diffuse Idiopathic Skeletal Hyperostosis(DISH) Syndrome 2838M Kulkarni

296. Postoperative Spinal Infection 2840KP Srivastava

Contents xxxvii

VOLUME FOURSection 33The HipSS Babhulkar

297. Surgical Anatomy of Hip Joint 2855SS Babhulkar

298. Surgical Approaches to the Hip Joint 2858K Hardinge

299. Examination of the Hip Joint 2866S Pandey

300. Biomechanics of the Hip Joint 2888SS Babhulkar, S Babhulkar

301. Avascular Necrosis of Femoral 2890Head and Its ManagementSS Babhulkar, DP Baksi

302. Soft Tissue Lesions Around Hip 2898SS Babhulkar, D Patil

303. Girdlestone Arthroplasty of the Hip 2900SS Babhulkar, S Babhulkar

304. Osteotomies Around the Hip 2903SS Babhulkar, S Babhulkar

305. Pelvic Support Osteotomy by Ilizarov 2914Technique in ChildrenRuta Kulkarni

Section 34

Injuries of the Knee JointRJ Korula, Sunil G Kulkarni

306. Surgical Anatomy and Biomechanics 2923of the KneeRJ Korula

307. Knee Injuries 2929GR Scuderi, BCD Muth

308. Dislocations of Knee and Patella 2953DP Baksi

Section 35

Diseases of the Knee JointDP Baksi, Sunil G Kulkarni

309. Clinical Examination of Knee 2961SS Mohanty, Parag Sancheti

310. Congenital Deformities of Knee 2977Shubhranshu S Mohanty, Shiv AcharyaAmit Sharma

311. Disorders of Patellofemoral Joint 2980Shubhranshu S Mohanty, Shiv Acharya

312. Osteoarthrosis of Knee and 2988High Tibial OsteotomyShubhranshu S Mohanty, Hitesh Garg

313. Osteochondritis Dissecans of the Knee 2994RJ Korula, V Madhuri

314. Miscellaneous Affections of the Knee 2998314.1 Quadriceps Contracture 2998

John Ebnezar314.2 Bursae Around the Knee 3002

N Naik314.3 Stiff Knee 3004

Tuhid Irani, GS Kulkarni

Section 36Injuries of the Ankle and FootMandeep Dhillon

315. Functional Anatomy of Foot and Ankle: 3013Surgical ApproachesS Pandey

316. Biomechanics of the Foot 3021S Pandey

317. General Considerations of the Ankle Joint317.1 Examination of the Ankle Joint 3023

S Pandey, MS Sandhu, Mandeep Dhillon317.2 Radiological Evaluation of the 3030

Foot and AnkleMS Sandhu, Mandeep Dhillon

318. Fractures of the Ankle 3043S Pandey

319. Ligamentous Injuries Around Ankle 3061S Pandey

320. Fractures of the Calcaneus 3069GS Kulkarni

321. Talar and Peritalar Injuries 3086S Pandey

322. Injuries of the Midfoot 3098S Pandey

323. Injuries of the Forefoot 3102S Pandey

324. Tendon Injuries Around Ankle and Foot 3107S Pandey, Rajeev Limaye

Section 37

Disorders of Ankle and FootMandeep Dhillon

325. Management of Clubfoot 3121Dhiren Ganjwala325.1 Idiopathic Congenital Clubfoot 3121

Dhiren Ganjwala, Ruta Kulkarni325.2 Pirani Severity Score 3125

Shafique Pirani325.3 Ponseti Technique 3129

Ignacio V Ponseti325.4 Clubfoot Complications 3138

Dhiren Ganjwala, AK Gupta

xxxviii Textbook of Orthopedics and Trauma (Volume 1)

326. Metatarsus Adductus 3143R Kulkarni

327. Pes Planus 3145RL Mittal

328. Congenital Vertical Talus 3152MS Dhillon, SS Gill, Raghav Saini

329. Pes Cavus 3159GS Kulkarni

330. Pain Around Heel 3167RL Mittal

331. Metatarsalgia 3174RL Mittal

332. Disorders of Toes 3181JC Sharma, A Arora, SP Gupta

333. Diabetic Foot 3214Sharad Pendsey

334. Tumors of the Foot 3229MS Dhillon, RL Mittal

Section 38

Pediatric Orthopedics: TraumaK Sriram

335. Peculiarities of the Immature Skeleton 3239(The Child is not a Miniature Adult)C Rao

336. Physeal Injuries 3242GS Kulkarni

337. Fractures of the Shaft of the Radius and 3253Ulna in ChildrenN Ashok

338. Fractures Around the Elbow in Children 3265K Sharath Rao

339. Fractures of the Distal Forearm, 3284Fractures and Dislocations of theHand in ChildrenVK Aithal

340. Fractures of the Humeral Shaft in 3289ChildrenRB Senoy

341. Fractures and Dislocations of the 3293Shoulder in ChildrenRB Senoy

342. Fractures and Dislocations of the 3300Spine in ChildrenRB Senoy

343. Fractures of the Pelvis in Children 3308GS Kulkarni, SA Ranjalkar

344. Pediatric Femoral Neck Fracture 3313Anil Arora

345. Femoral Shaft Fractures in Children 3337S Gill, MS Dhillon

346. Fractures and Dislocations of the Knee 3343Premal Naik

347. Fractures of the Tibia and Fibula in 3353ChildrenSK Rao

348. Fractures and Dislocations of the 3361Foot in ChildrenN Ashok

349. Birth Trauma 3367K Sriram

350. The Battered Baby Syndrome 3375(Child Abuse)K Sriram

Section 39Pediatric Orthopedics: GeneralA Johar, V Madhuri

351. General Considerations in Pediatric 3381OrthopedicsGS Kulkarni351.1 Clinical Examination in 3381

Pediatric OrthopedicsGS Kulkarni

351.2 Nuclear Medicine Bone 3384Imaging in PediatricsI Gordon

352. Gait Analysis 3388Ruta Kulkarni352.1 Normal Gait 3388352.2 Abnormal Gait 3393

353. Anesthetic Considerations in Pediatric 3398OrthopedicsSandeep Diwan, Laxmi Vas

354. Genetics in Pediatric Orthopedics 3403Rujuta Mehta

355. Congenital Anomalies 3414TK Shanmugsundaram, Rujuta Mehta

356. Osteogenesis Imperfecta 3425GS Kulkarni

357. Dysplasias of Bone 3430GS Kulkarni

358. Hematooncological Problems in 3435ChildrenBR Agarwal, ZE Currimbhoy

359. Caffey’s Disease (Infantile Cortical 3451Hyperostosis)S Kulkarni, SA Ranjalkar

360. Myopathies 3452SV Khadilkar

361. Arthrogryposis Multiplex Congenita 3457N De Mazumdar, Premal Naik

Contents xxxix

362. Cerebral Palsy 3463AK Purohit362.1 General Considerations 3463362.2 Neurosurgical Approach for 3551

Spasticity363. Spinal Dysraphism 3558

Dhiren Ganjwala364. Miscellaneous Neurologic Disorders 3568

GS Kulkarni364.1 Spinal Muscular Atrophy 3568

V Kulkarni364.2 Motor Neuron Disease 3569

(Progressive Muscular Atrophy)V Kulkarni

364.3 Hereditary Motor Sensory 3569NeuropathiesRM Kulkarni

364.4 Congenital Absence of Pain 3571(Analgia)R Kulkarni

364.5. Friedreich Ataxia 3572S Kulkarni

364.6 Syringomyelia 3572RM Kulkarni

365. Scoliosis and Kyphosis 3573Deformities of SpineK Sriram

366. Developmental Dysplasia of the Hip 3593Allaric Aroojis

367. Congenital Short Femur Syndrome 3603(Proximal Focal Femoral Deficiency)GS Kulkarni

368. Perthes Disease 3613GS Kulkarni

369. Slipped Capital Femoral Epiphysis 3628Sanjiv Sabharwal

370. Developmental Coxa Vara 3633N De Mazumdar

371. Septic Arthritis in Infants and Children 3638GS Kulkarni

372. Transient Synovitis of the Hip 3645Premal Naik

373. Idiopathic Chondrolysis of the Hip 3647Premal Naik

374. Angular Deformities in Lower Limb 3650in ChildrenGS Kulkarni

375. Toe Walking 3658GS Kulkarni

Section 40MicrosurgerySameer Kumta

376. Microvascular Surgery 3663Sameer Kumta

Section 41

ArthroplastyON Nagi, Arun Mullaji

377. Total Hip Arthroplasty 3675JA Pachore, HR Jhunjhunwala377.1 Cemented Hip Arthroplasty 3675

An OverviewJA Pachore, HR Jhunjhunwala

377.2 Total Hip Arthroplasty: 3702An Overview of UncementedTHA and Recent AdvancesVS Vaidya, Prashant P Deshmane

377.3 Surface Replacement of 3706Hip JointSKS Marya

377.4 Revision Total Hip Surgery 3719P Suryanarayan

377.5 Bipolar Hip Arthroplasty 3728Baldev Dudhani

378. Total Knee Arthroplasty 3739Arun Mullaji378.1 Part I: General Considerations 3739

ON Nagi, RK SenPart II: Knee Arthroplasty 3752EW Abel, DI Rowley

378.2 Indications and 3772Contraindications: TKRSushrut Babhulkar, Kaustubh Shinde

378.3 Preoperative Evaluation of 3775Total Knee ReplacementAV Guruva Reddy

378.4 Knee Replacement— 3780Prosthesis DesignsSachin Tapasvi, Dynanesh Patil,Rohit Chodankar

378.5 Complications of Total Knee 3788ArthroplastyAnirudh Page, Arun Mullaji

378.6 Soft Tissue Balancing in TKR 3794Harish Bhende

xl Textbook of Orthopedics and Trauma (Volume 1)

378.7 Correction of Varus and Valgus 3798Deformity During Total KneeArthroplastyAmit Sharma, Arun Mullaji

378.8. Long-Term Results of 3802Total Knee ArthroplastyParag Sancheti

378.9 Unicompartmental Knee 3809ArthroplastyA Mullaji, Raj Kanna

378.10. Principles of Revision 3812TKR for Aseptic LooseningHemant Wakankar

378.11 Part I: Approaches for 3814Revision KneeArthroplasty SurgeryKhalid Alquwayee, Fares S HaddadBassam A Masri, Donald S GarbuzClive P DuncanPart II: Selecting A Surgical 3823Exposure for Revision HipArthroplastyNelson Greidanrius, John Antoniou,Paramjeet Gill, Wayne Paprosky

378.12. Infected TKR 3828Vikram Shah, Saurabh Goyal

378.13. Results of Revision Total Knee 3833ArthroplastyA Rajgopal

379. Shoulder Arthroplasty 3837SK Marya

380. Total Elbow Arthroplasty 3855DP Baksi

381. Ankle Arthroplasty 3862Rajeev Limaye

Section 42ArthrodesisS Kumar

382. Shoulder Arthrodesis 3667S Kumar, IK Dhammi

383. Hip Arthrodesis 3873AK Jain, IK Dhammi

384. Knee Arthrodesis 3880IK Dhammi

385. Ankle Arthrodesis 3885S Kumar, AK Jain

Section 43AmputationsAS Rao, Ramchandar Siwach

386. Amputations 3891AS Rao, R Siwach

Section 44Rehabilitation—Prosthetic and OrthoticBD Athani, Nagesh Naik, Ashok Indalkar, Deep Prabhu

387. Prosthetics and Orthotics: Introduction 3919RK Srivastava, NP Naik

388. Upper Extremity Prostheses 3923SK Jain

389. Rehabilitation of Adult Upper 3931Limb AmputeeNP Naik

390. Lower Limb Prosthesis 3934AK Agrawal

391. Upper Limb Orthoses 3955S Rastogi, T Ragurams

392. Lower Limb Orthoses 3962NP Naik

393. Physical Therapy and Therapeutic 3972ExercisesNP Naik

394. Orthopedic Rehabilitation 3987NP Naik

395. Rehabilitation of Spinal Cord Injury 3992HC Goyal

396. Disability Process and Disability 4005EvaluationSS Yadav, SP Gupta, A Arora