Pages, " x 11", Black & White, English, Originally published by Lippincott Williams & Wilkins, See Available Translations. Need a PDF reader. Orthopaedics and Trauma Home · Mobile Rockwood and Green's fractures in adults vol 1 and vol 2 and fractures in children. 3rd Edition ISBN PDF ( KB). Rockwood & Green - Download as PDF File .pdf), Text File .txt) or read online. Wirth MD Professor of Orthopaedics The Charles A. Associate Faculty. Boston .
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Rockwood and Green's Fractures in Adults - 2 Volume Set - edition pdf . Practice of Pediatric Orthopaedics: 2nd (second) Edition Ebook Pdf, Pediatrics, Free. Series: Rockwood, Green, and Wilkins' fractures in adults and children package. the next generation of orthopaedic trauma surgeons who will be determining. PG Moreau, Rockwood and Green's Fractures in Adults. ; 14(1): by Charles A. Rockwood, Jr., David P. Green, Department of Orthopedics (MBC- 77).
Thawrani et al. Several studies have compared the ability to classify fractures involving the growth plate on plain radiographs versus three-dimensional 3-D imaging [ 11 , 19 , 27 ]. These studies do not specifically use interobserver reliability as an endpoint, instead showing that fracture displacement is consistently underappreciated on plain radiographs [ 11 , 19 ], and that 3-D imaging can better elucidate fracture patterns and change the classification of the fracture [ 27 ].
A high rate of interobserver reliability of the classification is important to its clinical utility. Despite a lack of formal validation, the Salter-Harris classification has stood the test of time and is in widespread use.
One may speculate that this prevalence is attributable to its inherent simplicity and being nearly universally known in the orthopaedic community. There are limitations to using a poorly validated classification system and there may be some benefit to perform additional validation studies of the Salter-Harris classification.
Limitations The most significant limitation, as discussed above, is a paucity of studies formally validating the Salter-Harris classification, including interobserver reliability, intraobserver reliability, and accuracy in predicting fracture behavior. This validation is necessary to establish confidence in the classification and its implications.
Lack of validation does not mean the classification is invalid, however, users should be aware of this limitation and use the classification accordingly. Future efforts to improve validation of the Salter-Harris classification could potentially resolve these concerns. It is tempting to equate physeal arrest with prognosis when discussing fractures involving the physis, however, physeal arrest is only one component and is of variable clinical significance depending on remaining growth and the location of the deformity.
Salter and Harris [ 26 ] recognized the complexity of this issue and commented that prognosis was not related to fracture classification alone, but also to the age of the patient, preservation of blood supply, presence of an open fracture, method of reduction, intraarticular displacement, quality of reduction, method and length of immobilization, and, of particular importance, the specific physis involved.
Even if the outcome is limited to the presence of growth arrest alone, many authors agree that the Salter-Harris classification is not a good predictor of prognosis [ 2 , 3 , 7 , 12 , 23 , 29 ]. Initial fracture displacement and accuracy of reduction have been found to be the most important prognostic indicators [ 2 , 12 ]. Multiple studies examining physeal fractures at the distal tibia also have found that fracture displacement and mechanism of injury are the most significant prognostic indicators [ 10 , 25 , 28 ].
In a study of distal radius fractures, Cannata et al. The most commonly reported predictors of physeal arrest appear to be initial fracture displacement, mechanism of injury, and accuracy of reduction. Discussion of the prognostic utility of the Salter-Harris classification highlights another significant limitation, which is lack of anatomic specificity. In their original article, Salter and Harris [ 26 ] recognized important variations in gross anatomy between different physes, however their proposed classification and discussion focused on the microanatomy of the generic physis.
This prevents the classification from becoming overly complex; however, it limits the ability of the classification system to guide treatment or indicate prognosis with any specific fracture. This lack of specificity and comprehensiveness has been the impetus behind several subsequently proposed classification systems.
In , Ogden [ 15 ] proposed a classification scheme that expanded the Salter-Harris classification by adding four additional fracture types and multiple subtypes of each of the five original fracture types.
The classification was meant to be applicable throughout the body, but rarely is used today, likely because of its complexity. In , Peterson [ 17 ] proposed an expanded system based on an impressive epidemiologic study of physeal injuries. A Peterson I injury is a metaphyseal fracture with extension into the physis Fig.
A Peterson Type VI injury represents the loss of part of the physis. Peterson and Burkhart [ 18 ] also removed the Salter-Harris Type V fracture variant, questioning its existence; however, the omission of the Salter-Harris Type V fracture generally is not accepted. The fracture line is marked by arrows and can be seen crossing the metaphysis, and also extending into the physis.
Conclusions and Uses The Salter-Harris classification continues to be relevant and serve an important purpose in orthopaedics despite substantial limitations.
It is not a comprehensive system for classifying physeal injuries, guiding treatment, or determining prognosis. These limitation may be inherent to a classification that is intended to be generically applied to physeal fractures and does not attempt to account for anatomic variation between physes or unique clinical considerations of fractures in different locations. The Salter-Harris classification does provide a foundation to help clinicians understand how pediatric fractures relate to the anatomy and architecture of an open physis.
Additionally, the generic nature of the classification allows it to be extremely simple and widely applied. The Salter-Harris classification has become part of the language used in orthopaedics, is nearly universally understood, and is used by orthopaedic practitioners, greatly facilitating communication. This is where the classification derives much of its utility.
It may be more appropriate to think of the Salter-Harris classification as descriptive terminology with general clinical implications than a specific fracture classification that is expected to dictate treatment and prognosis. A thorough understanding of the scope of pediatric trauma and anatomy is necessary to guide treatment decisions and understand expected outcomes.
Aitken AP. The end results of the fractured distal tibial epiphysis. J Bone Joint Surg Am. Google Scholar 2.
Predicting the outcome of physeal fractures of the distal femur. J Pediatr Orthop. Fractures involving the distal femoral epiphyseal growth line. South Med J. Stress changes of the distal radial growth plate: a radiographic survey and review of the literature. Am J Sports Med. Physeal fractures of the distal radius and ulna: long-term prognosis.
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Prognosis of epiphyseal separation: an experimental study. J Bone Joint Surg Br. PubMed Google Scholar 7.
Traumatic injuries of the distal femoral physis: retrospective study on cases. Foucher JT. De la divulsion des epiphyses. Cong Med France. Google Scholar 9.
Cartilaginous path of physeal fracture-separations: evaluation with MR imaging—an experimental study with histologic correlation in rabbits. Physeal fractures of the distal tibia: predictive factors of premature physeal closure and growth arrest.
Salter-Harris type III fractures of the distal femur: plain radiographs can be deceptive. Fractures of the distal femoral epiphyses: factors influencing prognosis: a review of thirty-four cases. PubMed Google Scholar Statistical analysis of the incidence of physeal injuries. Biomechanical and histological correlations in growth plate failure. Ogden JA. Injury to the growth mechanisms of the immature skeleton. Skeletal Radiol. Peterson HA. Physeal fractures: Part 2. Two previously unclassified types.
Physeal fractures: Part 3.
Compression injury of the epiphyseal growth plate: fact or fiction? Acute fracture of the distal tibial physis: role of gradient-echo MR imaging versus plain film examination. Poland J. Traumatic Separation of the Epiphyses. Google Scholar Please verify that you are not a robot.
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Rockwood and Green's fractures in adults Author: Rockwood, Green, and Wilkins' fractures in adults and children package. In this edition there are two more chapters and 61 new authors drawn from three continents and eleven different countries In addition, many of the new authors represent the next generation of orthopaedic trauma surgeons who will be determining the direction of trauma management over the next two or three decades"--Publisher's description.
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Document, Internet resource Document Type: A two volume guide on fracture treatment. It offers up-to-the-minute research and recommendations from more than 80 leading orthopaedic experts from around the world.
It is an essential resource on fractures for every orthopaedic surgeon or resident. Reviews Editorial reviews. Publisher Synopsis ' indispensable part of most residents' training''the key go-to reference on fractures''While there are other books are dedicated to trauma and fractures, they all simply fight for second position behind the time-tested and valued Rockwood and Green'' Must download for all orthopedic and medical libraries.
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Classifications In Brief: Salter-Harris Classification of Pediatric Physeal Fractures
Fractures, Bone. Linked Data More info about Linked Data. Primary Entity http: MediaObject , schema: Book , schema: Intangible ;. Click link to access " ;. Court-Brown " ;. Heckman " ;. McKee " ;. McQueen " ;. Ricci " ;. InformationResource , genont:Bucholz MD Professor and Chairman. Scott Levin MD.
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Understand the treatment options for supracondylar fractures, their indications, and their potential complications. Peterson HA. Physeal fractures of the distal tibia: predictive factors of premature physeal closure and growth arrest.
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