BASIC ORTHOPAEDIC SCIENCES - Internet Archive
BASIC ORTHOPAEDIC SCIENCESSECOND EDITION
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BASIC ORTHOPAEDIC SCIENCESSECOND EDITIONMANOJ RAMACHANDRANwith illustrations by Tom Nunn
Dedication (First edition)For Joanna.Everything I do, I do is for you and you only.Dedication (Second edition)As always, for my gorgeous wife Joanna but now also for my threebeautiful children, Isabel, Mia and Zac.
ContentsContributorsPreface to Second EditionPreface to First EditionForeword to First EditionAcknowledgements in the First EditionAbbreviations1 StatisticsManoj Ramachandran, Dan Perry, David Little and Fares Haddad2 GeneticsPeter Calder, Harish Hosalkar and Aresh-Hashemi Nejad3 Skeletal Embryology and limb growthRick Brown, Anish Sangrajka and Deborah Eastwood4 Orthopaedic PharmacologyManoj Ramachandran, Daud Chou and Natasha Rahman5 Inflammation and InfectionVikas Khanduja, Sertazniel SinghKang and Manoj Ramachandran6 Imaging TechniquesManoj Ramachandran, Dennis Kosuge, Navin Ramachandran and AsifSaifuddin7 Orthopaedic OncologyNimal Maruthainar, Rej Bhumbra and Steve Cannon8 Ligament and Tendon
Cheh-Chin Tai, James Hui and Andy Williams9 MeniscusVijai Ranawat, Patrick Schottel, Anil Ranawat and John Skinner10 Articular CartilageTim Waters, Nima Heidari and George Bentley11 NerveMike Fox,Caroline Hing, Sam Heaton and Rolfe Birch12 Skeletal MuscleMike Fox, Steve Key and Simon Lambert13 Basics of BonePeter Bates, Bjarne Moller-Madsen, Ali Noorani and Manoj Ramachandran14 Bone Injury, Healing and GraftingPeter Bates, Andrea Yeo and Manoj Ramachandran15 Intervertebral DiscWill Aston, Alexander Montgomery and Rajiv Bajekal16 Basic Concepts in BiomechanicsManoj Ramachandran and Paul Lee17 Biomaterial BehaviourSubhamoy Chatterjee, Toby Baring and Gordon Blunn18 BiomaterialsSubhamoy Chatterjee, John Stammers and Gordon Blunn19 Biomechanics and Joint Replacement of the HipMark Mullins, Thomas Youm and John Skinner20 Biomechanics and Joint Replacement of the Knee
Alister Hart, Joshua Lee, Richard Carrington and Paul Allen21 Biomechanics of the SpineAmir Ali Narvani, Arun Ranganathan, Brian Hsu and Lester Wilson22 Biomechanics and Joint Replacement of the Shoulder and ElbowMark Falworth, Prakash Jayakumar and Simon Lambert23 Biomechanics of the Hand and WristNicholas Saw, Livio Di Mascio and David Evans24 Biomechanics and Joint Replacement of the Foot and AnkleRohit Madhav, Amit Amin, Deborah Eastwood and Dishan Singh25 Friction, Lubrication, Wear and CorrosionGurdeep Biring, Iain McNamara, Marcus Bankes, Jay Meswania and GordonBlunn26 GaitPramod Achan, Mark Paterson and Fergal Monsell27 ProstheticsManoj Ramachandran, Imad Sedki, Jo Dartnell and Linda Marks28 OrthoticsManoj Ramachandran, Kyle James and Lisa Mitchell29 Inside the Operating TheatreManoj Ramachandran, Steve Key and Alan White30 Basic Science of OsteoarthritisChetan Jayadev and Andrew Price31 Biomechanics of Fracture FixationNick Aresti, Paul Culpan and Peter Bates
AppendixCommon Bone and Joint DisordersPeter Bates, Prakash Jayakumar and Manoj RamachandranIndex
ContributorsPramod AchanConsultant Orthopaedic Surgeon and Clinical DirectorRoyal London HospitalLondon, UKPaul AllenConsultant Orthopaedic SurgeonPrincess Alexandra HospitalEssex, UKAmit AminConsultant Foot and Ankle SurgeonSt George’s University HospitalLondon, UKNick ArestiSpecialty Registrar in Trauma & Orthopaedic SurgeryRoyal London HospitalLondon, UKWill AstonConsultant Orthopaedic Surgeon and Honorary Senior LecturerRoyal National Orthopaedic HospitalMiddlesex, UKRajiv BajekalConsultant Orthopaedic SurgeonBarnet HospitalHerts, UKMarcus Bankes
Consultant Orthopaedic SurgeonGuy’s HospitalLondon, UKToby BaringConsultant Shoulder and Elbow SurgeonHomerton University Hospitals NHS TrustLondon, UKPeter BatesConsultant Orthopaedic Surgeon and Honorary Senior LecturerRoyal London HospitalLondon, UKProfessor George BentleyEmeritus Professor and Director, Institute of Orthopaedics and MusculoskeletalSkeletal Science,University College LondonConsultant Orthopaedic Surgeon (retired),Royal National Othopaedic HospitalMiddlesex, UKRej BhumbraConsultant Trauma and Orthopaedic SurgeonRoyal London HospitalLondon, UKProfessor Rolfe BirchConsultant Orthopaedic Surgeon (retired)Royal National Orthopaedic HospitalMiddlesex, UKGurdeep BiringConsultant Orthopaedic SurgeonWycombe HospitalBucks, UKProfessor Gordon Blunn
Professor of Biomedical EngineeringRoyal National Orthopaedic HospitalMiddlesex, UKRichard BrownConsultant Orthopaedic SurgeonCheltenham General HospitalGloucester, UKPeter CalderConsultant Orthopaedic SurgeonRoyal National Orthopaedic HospitalMiddlesex, UKSteve CannonConsultant Orthopaedic Surgeon (retired)Royal National Orthopaedic HospitalMiddlesex, UKRichard CarringtonConsultant Orthopaedic Surgeon and Joint Reconstruction Unit LeadRoyal National Orthopaedic HospitalMiddlesex, UKSubhamoy ChatterjeeConsultant Spinal SurgeonChase Farm HospitalEnfield, UKDaud ChouSpecialty Registrar in Trauma & Orthopaedic SurgeryRoyal London HospitalLondon, UKPaul CulpanConsultant Orthopaedic Surgeon (Lower Limb and Pelvic and AcetabularService)Royal London Hospital
London, UKJo DartnellConsultant Paediatric Orthopaedic SurgeonMaidstone and Tunbridge Wells NHS TrustKent, UKDeborah EastwoodConsultant Paediatric Orthopaedic SurgeonGreat Ormond Street Hospital for Children and Royal NationalOrthopaedic HospitalMiddlesex UKDavid EvansConsultant Hand SurgeonThe Hand ClinicBerks, UKMark FalworthConsultant Orthopaedic SurgeonRoyal National Orthopaedic Hospital Middlesex, UKMichael FoxConsultant Orthopaedic SurgeonRoyal National Orthopaedic HospitalMiddlesex, UKFares HaddadConsultant Orthopaedic SurgeonDivisional Clinical Director - Surgical SpecialtiesUniversity College London HospitalsLondon, UKAlister HartConsultant Orthopaedic Surgeon and Professor of Orthopaedic SurgeryRoyal National Orthopaedic HospitalMiddlesex, UK
Sam HeatonSpecialty Registrar in Trauma & Orthopaedic SurgeryRoyal London HospitalLondon, UKNima HeidariConsultant Foot, Ankle and Limb Reconstruction SurgeonRoyal London HospitalLondon, UKCaroline HingConsultant Orthopaedic SurgeonSt George’s University Hospitals NHS TrustLondon, UKHarish HosalkarAttending Orthopedic Surgeon,Director, Centre for Hip Preservation and Children’s OrthopedicsCalifornia, USABrian HsuConsultant Spinal SurgeonChildren’s Hospital at WestmeadSydney, AustraliaJames HuiHead, Senior Consultant and ProfessorDivision of Paediatric OrthopaedicsDepartment of Orthopaedic SurgeryNational University HospitalSingaporeKyle JamesMedical Director and Orthopaedic SurgeonBeit Cure International Hospital Malawiand Honorary Senior Lecturer, Trauma Sciences MSc ProgrammeQueen Mary University of London, UK
Chetan JayadevSpecialty Registrar in Trauma & Orthopaedic SurgeryRoyal London HospitalLondon, UKPrakash JayakumarSpecialty Registrar in Trauma & Orthopaedic SurgeryRoyal London HospitalLondon, UKSteve KeySpecialty Registrar in Trauma & Orthopaedic SurgeryRoyal London HospitalLondon, UKVikas KhandujaConsultant Orthopaedic Surgeon and Associate LecturerAddenbrookes HospitalCambridge, UKDennis KosugeConsultant Orthopaedic Surgeon PrincessAlexandra Hospital NHS TrustEssex, UKSimon LambertConsultant Shoulder and Elbow SurgeonUniversity College HospitalLondon, UKJoshua LeeConsultant Orthopaedic Surgeon (Lower Limb Service)Royal London HospitalLondon, UKPaul LeeConsultant Orthopaedic Surgeon (Lower Limb Service)Royal London Hospital
London, UKDavid LittleSenior Staff SpecialistDepartment of OrthopaedicsThe Children’s Hospital at Westmead, AustraliaConjoint Professor Paediatrics and Child Health University of Sydney, AustraliaRohit MadhavConsultant Orthopaedic SurgeonLondon Orthopaedic Surgeons LtdThe Princess Grace HospitalLondon, UKLinda MarksConsultant in Rehabilitation Medicine (retired)Royal National Orthopaedic HospitalMiddlesex, UKNimal MaruthainarConsultant Orthopaedic SurgeonRoyal Free HospitalLondon, UKLivio diMascioConsultant in Upper Limb and Hand SurgeryRoyal London HospitalLondon, UKIain McNamaraConsultant Orthopaedic Surgeon and Honorary ProfessorThe Norfolk and Norwich UniversityHospitals NHS TrustNorwich, UKJay MeswaniaDepartment of Biomechanical EngineeringRoyal National Orthopaedic Hospital
Middlesex, UKLisa MitchellClinical Specialist OrthotistGreat Ormond Street Hospital for ChildrenLondon, UKBjarne Moller-MadsenConsultant and Professor Department of Children’s OrthopaedicsAarhus University Hospital NBGDenmarkFergal MonsellConsultant Paediatric Orthopaedic SurgeonBristol Royal Hospital for ChildrenBristol, UKAlexander MontgomeryConsultant SpinalOrthopaedic SurgeonRoyal London HospitalLondon, UKMark MullinsConsultant Orthopaedic SurgeonMorriston HospitalSwansea, UKAmir Ali NarvaniConsultant Orthopaedic SurgeonAshford and St Peter’s HospitalsNHS TrustSurrey, UKAresh-Hashemi NejadConsultant Orthopaedic SurgeonRoyal National Orthopaedic HospitalMiddlesex, UK
Ali NooraniConsultant Orthopaedic and Trauma Surgeon (Upper Limb Service)Royal London HospitalLondon, UKTom NunnConsultant Trauma and Orthopaedics SurgeonRoyal Alexandra HospitalGlasgow, UKNatasha RahmanConsultant Orthopaedic SurgeonRoyal Sussex County HospitalBrighton, UKManoj RamachandranConsultant Orthopaedic Surgeon and Honorary ReaderRoyal London HospitalLondon, UKNavin RamachandranConsultant Radiologist and Honorary Senior LecturerUniversity College London Hospitals NHS TrustLondon, UKAnil RanawatAssociate Attending Orthopedic Surgeon and Associate Professor of OrthopedicSurgeryHospital for Special SurgeryNew York, USAVijai RanawatSenior Medical PractitionerDepartment of OrthopaedicsThe Repatriation General HospitalAdelaide, AustraliaArun Ranganathan
Consultant Orthopaedic and Spinal SurgeonRoyal London HospitalLondon, UKMark PatersonConsultant Paediatric Orthopaedic Surgeon (ex)Royal London HospitalLondon, UKDan PerrySenior Lecturer in OrthopaedicSurgery and Honorary Consultant Orthopaedic SurgeonAlder Hey Children’s NHS TrustLiverpool, UKAndrew PriceConsultant Orthopaedic Surgeon and ProfessorNuffield Orthopaedic CentreOxford, UKAsif SaifuddinConsultant RadiologistRoyal National Orthopaedic HospitalMiddlesex UKAnish SangrajkaConsultant Paediatric Orthopaedic SurgeonThe Norfolk and Norwich University Hospitals NHS TrustNorwich, UKNicholas SawConsultant Orthopaedic SurgeonPrincess Alexandra HospitalEssex, UKPatrick SchottelOrthopedic Surgeon and Assistant ProfessorThe University of Vermont Medical Center
Vermont, USAImad SedkiConsultant in Rehabilitation MedicineRoyal National Orthopaedic HospitalMiddlesex, UKDishan SinghConsultant Orthopaedic SurgeonRoyal National Orthopaedic HospitalMiddlesex, UKSertazniel SinghKangConsultant Trauma & OrthopaedicSurgeon and Associate LecturerCambridge University Hospitals NHSFoundation TrustCambridge, UKJohn SkinnerConsultant Orthopaedic SurgeonRoyal National Orthopaedic HospitalMiddlesex, UKJohn StammersSpecialty Registrar in Trauma & Orthopaedic Surgery Royal London HospitalLondon, UKCheh-Chin TaiHip & Knee Orthopaedic SurgeonDepartment of Orthopaedic SurgeryUniversity of MalayaMalaysiaTim WatersConsultant Orthopaedic Surgeon, Clinical Director for Trauma & OrthopaedicsWest Hertfordshire Hospitals NHS TrustHerts, UK
Alan WhiteConsultant Orthopaedic SurgeonSouthend University HospitalWestcliff-on-Sea, UKAndrew WilliamsConsultant Orthopaedic SurgeonChelsea and Westminster Hospital NHS TrustLondon, UKLester WilsonConsultant Spinal SurgeonRoyal National Orthopaedic HospitalMiddlesex, UKAndrea YeoConsultant Paediatric Orthopaedic SurgeonSt George’s University Hospital NHS TrustLondon, UKThomas YoumClinical Assistant Professor and Director of Hip ArthroscopyNYU Hospital for Joint DiseasesNew York, USA
Preface to the second editionI am extremely proud to be able to bring you, the reader, the second edition ofthe Basic Orthopaedic Sciences book. It has been another labour of love but thistime, I have had constant and incredible help from Tom Nunn who has kept megoing through this process but has also signficantly enhanced the book with hisamazing illustrations. Thanks Tom!I’ve tried to correct any and all the mistakes from the first edition but if anycreep through, do let me know. There are new chapters and updated conceptsthroughout and I hope this book continues to be as comprehensive as the firstwas.You may have noticed that the title of the second edition has been shortened toBasic Orthopaedic Sciences. This is for two reasons. The first is that all the newcontributors (each chapter has had at least one new contributor added whose jobwas to refresh the text, approaching it with new eyes) came from institutionsaround the world, which made this book a truly global effort. Therefore, Iwanted to stay away from a title that implied parochialism. Secondly, I havebeen a Consultant Orthopaedic Surgeon for more than ten years now, primarilyat the Royal London and Barts and The London Children’s Hospitals, BartsHealth NHS Trust in London, England and although the concepts for the secondedition matured during my time here, I still wanted to keep the title general andnot allied to any particular institution.Finally, I want to thank all the contributors, new and old, for making this bookwhat it has become and I hope you, the reader, find it helpful for building thesolid foundations of your orthopaedic knowledge and practice.Manoj Ramachandranmanojorthopod@gmail.comLondon 2017
The first edition of this book is legendary, the sacred text of orthopaedic basicscience. I am convinced it is the reason I, and many like me, passed theFRCS(Tr&Orth).In the preface to that edition, as here, Manoj suggests the reader send anyfeedback they may have in order that he may improve upon the edition. This isnot mere editorial rhetoric. He means it. In 2009 I met Manoj at what was thenthe pre-exam revision course based upon his book. I gave my “feedback” on thediagrams, and a few emails and years later, I found myself entrusted withreconceptualising and producing pretty much every image in the book.I am not a formally trained illustrator, I am an orthopaedic surgeon just likemany of you. I do however know the importance of a good diagram and have anenthusiasm for them and the role they have in the learning process. The Englishidiom “a picture paints a thousand words” may often be over used, but here I feelit is entirely appropriate. Drawings have three main uses as I see it: to aid in theunderstanding of a concept, to help in the recollection of that information, and toallow one to relay that same information quickly and easily when needed (to anexaminer for example). The diagrams I have produced will hopefully deliver onthe first two and I would implore you to not shy away from using them for thethird.I hope you enjoy this book as much as I have enjoyed helping produce it, and dosend your feedback. Who knows, in another few years, it could be you sittinghere writing an entry for a future edition!Tom Nunntom@nunngeo.comGlasgow 2017
Preface to the first editionHow many times have you heard a colleague say, “I once knew everything aboutarticular cartilage/hip biomechanics/statistics (substitute any orthopaedic basicscience topic here) but I seem to have forgotten the exact details. Anyway,you’re the one sitting the exam, not me!” Oh, how trainees love to hear thosedulcet tones of encouragement I like to think that learning orthopaedic basic sciences is somewhat similar tolearning anatomy at medical school. It is certainly better to have learnt once thannot at all. Equally, it is better to have understood concepts than to havecommitted facts to rote memory. Having spouted all these wise words though, Istill feel that there is an awful lot to learn in orthopaedic basic sciences. The aimof this book is to tease out the pertinent points that are relevant both to examsituations and day-to-day clinical practice. Although originally conceived withpostgraduate orthopaedic exams in mind, the final text has evolved into a primerin basic sciences for all health professionals with an interest in orthopaedics,mainly as a result of the input from all the contributors.This first edition has drawn from and expanded on the popular “Stanmore BasicSciences course” run at the Royal National Orthopaedic Hospital in Middlesex,UK. The book’s scope and focus were determined by feedback from candidateson the course and from field-testing at its various stages of development (whichmakes it sound much more impressive than it really was!). Ideas such as boldhighlighting of key words and concepts, and the use of only five key referencesfor further reading, were added along the way. Diagrams have been kept simplefor ease of reproduction as and when required. Although the book is notexhaustive, and indeed does not claim to be, a working knowledge of the textshould serve the readers well in their journey through the quagmire that is basicsciences.Finally, a personal note. I wanted to put together a text that doesn’t insult thereader by aiming too low and omitting key information. Equally, aiming too high(as some books do) would be disastrous. I’ve settled for a happy medium. I urge
you, the reader, having read this book, to rest safe in the knowledge that you areat the higher end of the orthopaedic basic science Gaussian curve. And from thisvantage position, from where you can attack any exam-related or basic sciencequery, I urge you to send me feedback so I can improve upon this edition andperhaps even invite you onto the panel of authors on the next one.Now all you have to do is start by learning how exactly a Gaussian curve isdefined Manoj Ramachandranmanojorthopod@gmail.comLondon 2006
Foreword to the first editionKnowledge of basic science is an essential platform on which to build anunderstanding of orthopaedics. It is necessary for day-to-day clinical work,research, publications and examinations. This book has been developed to coverthe major areas of basic science required by orthopaedic surgeons and all thoseassociated with musculoskeletal function and dysfunction.Although it would be impossible to cover every facet of basic science, thesections are wideranging, from statistics to biomechanics and frompharmacology to gait analysis. Sections on all the musculoskeletal tissues havebeen included, together with sections on the functions of all the joints. Relevantareas of biomaterials, friction and lubrication, together with the basic tools ofresearch, including statistics, have also been included in a form that provides theessence of knowledge required of the trainee.The majority of the chapters have a junior and senior author. Each senior authorhas an expertise in the area covered, while the junior author has provided thefocus required for postgraduate orthopaedic examinations. Each section is wellorganized and easy to read and contains a wealth of information essential to thereader. The viva questions are useful in assessing the reader’s understanding ofthe section with an added essential reading section for the examinationcandidate.Basic Orthopaedic Sciences: The Stanmore Guide has been ably edited byManoj Ramachandran, Paediatric and Young Adult Fellow on the StanmoreRotation, who is to be congratulated in bringing together such a disparate groupof topics, along with the contributors for making many difficult topics sounderstandable.I am sure this book will become a necessary addition to any library for thoserequiring information on orthopaedic basic sciences in a concise and readableform.George SE Dowd MD MCh(Orth) FRCS
Consultant Orthopaedic Surgeon (ex),Royal Free Hospital, London, UK
Acknowledgements in the first editionI’d like to start by thanking all the authors for putting up with my constantnagging about deadlines. I hope you all think it was worth the effort. The seniorreviewers did a great job too. I must single out Dishan Singh as the book’scatalyst during its embryonic stages. The conversations we had back in 2002 arethe reason why this book even came into being. In addition, Deborah Eastwoodworked tirelessly (as always!) in the latter stages of the book’s development toensure that deadlines were met and people were chased up.I’d also like to thank and congratulate the team at Hodder Arnold for making thisbook happen. Finally, I must thank everyone in my personal life for putting upwith me during my multiple projects. My deepest gratitude though goes to mywife, Joanna.
Abbreviations5-ASA5-aminosalicylic acidA&EAccident & EmergencyAAatlantoaxial, abduction/adductionAAOSAmerican Academy of Orthopedic SurgeonsAbDMabductor digiti minimiABSamniotic band syndromeACalternating currentAChacetylcholineAChRacetylecholine receptorACIautologous chondrocyte implantationACLanterior cruciate ligamentACRAmerican College of RheumatologyADAMTa disintegrin and metalloproteinaseADIatlantodens intervalAERapical ectodermal ridgeAFOankle–foot orthosisALannular ligamentALCLaccessory lateral collateral ligamentALVALaseptic lymphocyte vasculitisassociated lesionsAMLacute myeloid leukaemia(c)AMP(cyclic) adenosine monophosphateANAantinuclear antibodyANOVAanalysis of one-way varianceAOFASAmerican Orthopaedic Foot and Ankle SocietyAOLanterior oblique ligamentAPadductor pollicis, anteroposteriorAPBabductor pollicis brevisAPLabductor pollicis longusAPTTactivated partial thromboplastin time
ARDSacute respiratory distress syndromeASankylosing spondylitisASAAmerican Society of AnesthesiologistsASTMAmerican Standard Testing and MaterialsATPadenosine triphosphateBCGbacillus Calmette–GuèrinBCPbacteria-carrying particlesBMDbone mineral densityBMIbody mass indexBMLbone marrow oedema-like lesionBMPbone morphogenetic proteinBOABritish Orthopaedic AssociationBRbrachioradialisBRUbone remodelling unitCAcommunity acquiredCASCrk-associated substrateCCPcitrullinated cyclic peptideCFUcolony-forming unitsCIconfidence intervalCIAcarpal instability adaptiveCICcarpal instability complexCIDcarpal instability dissociativeCINDcarpal instability non-dissociativeCKDchronic kidney diseaseCMAPcompound muscle action potentialCMCcarpometacarpalCMGPcartilage matrix glycoproteinCMPcartilage matrix proteinCNcranial nerveCNScentral nervous systemCOMPcartilage oligometric matrix proteinCOPDchronic obstructive pulmonary diseaseCORcentre of rotationCOXcyclo-oxygenasecoxibcyclo-oxygenase-2 inhibitorCPONC-flanking peptide of neuropeptide Y
CROWCharcot restraint orthotic walkerCRPC-reactive proteinCSchondroitin sulphateCSFcerebrospinal fluidCTcomputed tomographyCTEVcongenital talipes equinovarusCTScarpal tunnel syndromeCTXcarboxy-terminalDAFdecay accelerating factorDAFOdynamic ankle–foot orthosisDAMPdistal-anterior and medial proximalDBMdemineralized bone matrixDCOdamage control orthopaedicsDDHdevelopmental dysplasia of the hipDDPdirect dynamic problemsDEXAdual energy X-ray absorptiometryDHFRdihydrofolate reductaseDIMSDigital Image Management SystemDIOdorsal interosseousDIPdistal interphalangealDISIdorsal intercalated segmental instabilityDMARDdisease modifying antirheumatoid drugDMDDuchenne’s muscular dystrophyDMOADdisease-modifying osteoarthritis drugDMPTdimethyl-p-toluidineDNAdeoxyribonucleic acidDOFdegrees of freedomDOMSdelayed onset muscle sorenessDRdigital radiographyDRUJdistal radioulnar jointDTIdirect thrombin inhibitorDVTdeep vein thrombosisECGelectrocardiographyECMextracellular matrixECRBextensor carpi radialis brevisECRLextensor carpi radialis longus
ECUextensor carpi ulnarisEDCextensor digitorum communisEDSEhlers–Danlos’ syndromeEGFepidermal growth factorEHDelastohydrodynamicEIPextensor indicisEMelectromagnetic fieldEMGelectromyographyEPBextensor pollicis brevisEPLextensor pollicis longusESRerythrocyte sedimentation rateFBCfull blood countFCRflexor carpi radialisFCUflexor carpi ulnarisFDAFood and Drug AdministrationFDGfluorodeoxyglucoseFDPflexor digitorum profundusFDSflexor digitorum superficialisF/Eflexion/extensionFGFfibroblast growth factorFGFRfibroblast growth factor receptorFNfalse negativeFPfalse positiveFPBflexor pollicis brevisFPLflexor pollicis longusFPPfarnesyl pyrophosphateFRfluoroscopic receptorGABAgamma aminobutyric acidGAGglycosaminoglycanG-CSFgranulocyte colony-stimulating factorGCTgiant-cell tumourGFRglomerular filtration rateGHJglenohumeral ge colony-stimulating factorGnRHgonadotrophin releasing hormone
GRAFOground reaction ankle–foot orthosisGRFground reaction forceHAhospital acquired/hyaluronic acidHDhydrodynamicHEPAhigh-efficiency particulate airHGPRThypoxanthine–guanine phosphoribosyltransferaseHIPhot isostatic press(ing)HITheparin-induced thrombocytopeniaHIVhuman immunodeficiency virusHKAFOhip–knee–ankle–foot orthosisHLAhuman leucocyte antigenHMOhereditary multiple osteochondromatosisHRheart rateHRThormone replacement therapyICinitial contactIDPinverse dynamic problemsIFSSHInternational Federation of Societies Surgery of the HandIgimmunoglobulinIGFinsulin-like growth factorIGHLinferior glenohumeral ligamentIIimage ronINRinternational normalized ratioIPinterphalangealIRMERIonizing Radiation (Medical Exposure) RegulationsISOInternational Standards OrganizationISWinitial swingITAPintraosseous trans-cutaneous amputation prosthesisITUIntensive Therapy UnitJRFjoint reaction forceKSkeratan sulphateLCLlateral collateral ligamentLFAlow friction arthroplastyLIAlocal infiltration analgesia
LIPUSlow-intensity pulsed ultrasoundLLlumbar lordosisLMlateral meniscusLMWHlow-molecular weight heparinLRloading responseLTLlunotriquetral ligamentLUCLlateral ulnar collateral ligamentMACImatrix-induced autologous chondrocyte implantationMCImid-carpal instabilityMCLmedial collateral ligamentMCPmetacarpophalangeal, monocyte chemoattractant proteinM-CSFmonocyte colony-stimulating factorMDRmulti-drug resistantMEDmultiple endocrine neoplasiaMEHDmicro-elastohydrodynamicMENmultiple endocrine neoplasiaMGHLmiddle glenohumeral ligamentMIPmacrophage inflammatory proteinMIPOminimally invasive plate osteosynthesisMMmedial meniscusMMPmatrix metalloproteinaseMMTVmouse mammary tumour virusMOFSmultiple organ failure syndromeMPFLmedial patellofemoral ligamentMPSmucopolysaccharidosesMRmagnetic resonanceMRCMedical Research CouncilMRImagnetic resonance imagingMRSAmethicillin-resistant Staphylococcus aureusMSmid-stanceMSCmesenchymal stem lMUAPmotor unit action potentialMWmolecular weight
NACN-acetyl
Consultant Paediatric Orthopaedic Surgeon Maidstone and Tunbridge Wells NHS Trust Kent, UK Deborah Eastwood Consultant Paediatric Orthopaedic Surgeon Great Ormond Street Hospital for Children and Royal National Orthopaedic Hospital Middlesex UK David Evans Consultant Hand Surgeon The Hand Clinic Berks, UK Mark Falworth Consultant Orthopaedic .
Veterans Review and Veterans Review and Appeal Board “Your right to be heard” ORTHOPAEDIC HANDBOOK Prepared by: Stanish Orthopaedic Inc. Professor of Orthopaedic Surgery, Dalhousie University Director, Orthopaedic and Sport Medicine Clinic of Nova Scotia Hali
Orthopaedic Specialist Certification Candidate Guide 6 intervention. Option B Applicants must submit evidence of successful completion of an APTA-accredited postprofessional Orthopaedic clinical residency completed within the last 10 years that has a curriculum plan reflective of the Description of Specialty Practice: Orthopaedic Physical Therapy.
2 ORTHOPAEDIC INSIGHTS For referrals, please call 216.445.0096 or 800.223.2273, ext.50096 Dear Colleague, Welcome to the Fall 2012 issue of Orthopaedic Insights from Cleveland Clinic’s Department of Orthopaedic Surgery. We bring y
Oct 04, 2017 · The Canadian Orthopaedic Nurses Association Association Canadienne des Infirmières et Infirmiers en Orthopédie RAPID REVIEWS For Orthopaedic Nurses The Rapid Reviews have been revised with permission from the Orthopaedic Specialty Preparation Pro
LAWRENCE V. GULOTTA, MD Associate Professor of Orthopedic Surgery Weill Cornell Medical College Assistant Attending Orthopaedic Surgeon Hospital for Special Surgery New York, New York PATRICK ST. PIERRE, MD Director, Sports Medicine and Orthopaedic Research Desert Orthopaedic Center Ran
fracture clinic held Monday-Friday at RAH and IRH Emergency referral of all orthopaedic cases should be made to the orthopaedic FY2 at RAH and the on call orthopaedic registrar at IRH. Paediatric fractures requiring emergency orthopaedic discussion and assessment should be discussed with senior doctors. .
Orthopaedic Surgery program is the top-ranked program in Texas. . In addition to lectures from orthopaedic faculty and other departments at UTSW, visiting professors from other medical centers around the country offer a diverse, evidenced-based per-spective on modern orthopaedics. This is followed by presentations of select surgical cases that
Grade 2 ELA Week of April 13-17, 2020 Day Skill Instructions Monday . There was a city park very close to their apartment. The park was really big. Maybe part of it could be turned into a park for dogs. Then Oscar s puppy would have a place to run! 4 Now Oscar needed to turn his idea into a plan. Oscar worked very hard. He wrote letters to newspapers. He wrote to the mayor about his idea for .
