Campbell’s Operative Orthopaedics, 14th ed.
List of Techniques
VOLUME I
Surgical Techniques
1.1 Fixation of Tendon to Bone, 14
1.2 Tendon Fixation Into the Intramedullary Canal, 15
1.3 Tendon to Bone Fixation Using Locking Loop Suture, 16
1.4 Tendon to Bone Fixation Using Wire Suture, 16
1.5 Fixation of Osseous Attachment of Tendon to Bone, 17
1.6 Removal of a Tibial Graft, 22
1.7 Removal of Fibular Grafts, 23
1.8 Removal of an Iliac Bone Graft, 26
1.9 Approach to the Interphalangeal Joints, 28
1.10 Medial Approach to the Great Toe Metatarsophalangeal Joint, 28
1.11 Dorsomedial Approach to Great Toe Metatarsophalangeal Joint, 29
1.12 Approach to the Lesser Toe Metatarsophalangeal Joints, 29
1.13 Medial Approach to the Calcaneus, 29
1.14 Lateral Approach to the Calcaneus, 29
1.15 Extended Lateral Approach to the Calcaneus, 29 1.16 Sinus Tarsi Approach, 31
1.17 U–Shaped Approach to the Calcaneus, 31
1.18 Kocher Approach (Curved L) to the Calcaneus, 32
1.19 Anterolateral Approach to Chopart Joint, 33
1.20 Anterior Approach to Expose the Ankle Joint and Both Malleoli, 33
1.21 Kocher Lateral Approach to the Tarsus and Ankle, 34
1.22 Ollier Approach to the Tarsus, 34
1.23 Single-Incision Posterolateral Approach to the Lateral and Posterior Malleoli, 35
1.24 Posterolateral Approach to the Ankle (Gatellier and Chastang), 35
1.25 Anterolateral Approach to the Lateral Dome of the Talus (Tochigi, Amendola, Muir, and Saltzman), 35
1.26 Posterior Approach to the Ankle, 36
1.27 Medial Approach to the Tarsus (Knupp et al.), 37
1.28 Medial Approach to the Ankle (Koenig and Schaefer), 37
1.29 Medial Approach to the Posterior Lip of the Tibia (Colonna and Ralston), 38
1.30 Anterolateral Approach to the Tibia, 39
1.31 Medial Approach to the Tibia (Phemister), 39
1.32 Posterolateral Approach to the Tibial Shaft (Harmon, Modified), 39
1.33 Anterolateral Approach to the Lateral Tibial Plateau (Kandemir and MacLean), 39
1.34 Medial Approach to the Medial Tibial Plateau, 41
1.35 Posteromedial Approach to the Medial Tibial Plateau (Supine), 41
1.36 Posteromedial Approach (Prone) to the Superomedial Tibia (Banks and Laufman), 42
1.37 Posterolateral Approach to the Tibial Plateau (Solomon et al.), 43
1.38 Posterolateral Approach to the Tibial Plateau Without Fibular Osteotomy (Frosch et al.), 44
1.39 Tscherne-Johnson Extensile Approach to the Lateral Tibial Plateau (Johnson et al.), 44
1.40 Anterolateral Approach for Access to Posterolateral Corner (Sun et al.), 45
1.41 Posterolateral Approach to the Fibula (Henry), 46
1.42 Anteromedial Parapatellar Approach (von Langenbeck), 47
1.43 Subvastus (Southern) Anteromedial Approach to the Knee (Erkes, as Described by Hofmann, Plaster, and Murdock), 47
1.44 Anterolateral Approach to the Knee (Kocher), 48
1.45 Posterolateral Approach to the Knee (Henderson), 49
1.46 Posteromedial Approach to the Knee (Henderson), 51
1.47 Medial Approach to the Knee (Cave), 52
1.48 Medial Approach to the Knee (Hoppenfeld and deBoer), 53
1.49 Transverse Approach to the Meniscus, 53
1.50 Lateral Approach to the Knee (Bruser), 55
1.51 Lateral Approach to the Knee (Brown et al.), 56
1.52 Lateral Approach to the Knee (Hoppenfeld and deBoer), 57
1.53 Extensile Approach to the Knee (Fernandez), 58
1.54 Direct Posterior Approach to the Knee (Brackett and Osgood; Putti; Abbott and Carpenter), 58
1.55 Direct Posteromedial Approach to the Knee for Tibial Plateau Fracture (Galla and Lobenhoffer as Described by Fakler et al.), 61
1.56 Direct Posterolateral Approach to the Knee (Minkoff, Jaffe, and Menendez), 62
1.57 Anterolateral Approach to the Femur (Thompson), 62
1.58 Lateral Approach to the Femoral Shaft, 63
1.59 Posterolateral Approach to the Femoral Shaft, 64
1.60 Posterior Approach to the Femur (Bosworth), 64
1.61 Medial Approach to the Posterior Surface of the Femur in the Popliteal Space (Henry), 67
1.62 Lateral Approach to the Posterior Surface of the Femur in the Popliteal Space (Henry), 67
1.63 Lateral Approach to the Proximal Shaft and the Trochanteric Region, 68
1.64 Anterior Iliofemoral Approach to the Hip (Smith-Petersen), 70
1.65 Anterior Approach to the Hip Using a Transverse Incision (Somerville), 71
1.66 Modified Anterolateral Iliofemoral Approach to the Hip (Smith–Petersen), 71
1.67 Lateral Approach to the Hip (Watson-Jones), 73
1.68 Lateral Approach for Extensive Exposure of the Hip (Harris), 73
1.69 Lateral Approach to the Hip Preserving the Gluteus Medius (McFarland and Osborne), 75
1.70 Lateral Transgluteal Approach to the Hip (Hardinge), 77
1.71 Lateral Transgluteal Approach to the Hip (Hay as Described by McLauchlan), 77
1.72 Posterolateral Approach (Gibson), 78
1.73 Posterior Approach to the Hip (Osborne), 80
1.74 Posterior Approach to the Hip (Moore), 82
1.75 Medial Approach to the Hip (Ferguson; Hoppenfeld and DeBoer), 84
1.76 Stoppa Approach (AO Foundation), 85
1.77 Ilioinguinal Approach to the Acetabulum (Letournel and Judet, as Described by Matta), 87
1.78 Iliofemoral Approach to the Acetabulum (Letournel and Judet), 90
1.79 Kocher-Langenbeck Approach (Kocher-Langenbeck; Letournel and Judet), 91
1.80 Modified Gibson Approach (Modified Gibson Approach, Moed), 93 1.81 Extensile Iliofemoral Approach (Letournel and Judet), 94
1.82 Extensile Iliofemoral Approach (Reinert et al.), 94
1.83 Triradiate Extensile Approach to the Acetabulum (Mears and Rubash), 97
1.84 Extensile Approach to the Acetabulum (Carnesale), 99
1.85 Approach to the Ilium, 99
1.86 Approach to the Symphysis Pubis (Pfannenstiel), 100
1.87 Posterior Approach to the Sacroiliac Joint, 102
1.88 Anterior Approach to the Sacroiliac Joint (Avila), 102
1.89 Approach to Both Sacroiliac Joints or Sacrum (Modified from Mears and Rubash), 103
1.90 Approach to the Sternoclavicular Joint, 104
1.91 Approach to the Acromioclavicular Joint and Coracoid Process (Roberts), 104
1.92 Anteromedial Approach to the Shoulder (Thompson; Henry), 105
1.93 Anteromedial/Posteromedial Approach to the Shoulder (Cubbins, Callahan, and Scuderi), 106
1.94 Anterior Axillary Approach to the Shoulder (Leslie and Ryan), 106
1.95 Anterolateral Limited Deltoid-Splitting Approach to the Shoulder, 106
1.96 Extensile Anterolateral Approach to the Shoulder (Gardner et al.), 109
1.97 Transacromial Approach to the Shoulder (Darrach; McLaughlin), 109
1.98 Posterior Deltoid-Splitting Approach to the Shoulder (Wirth et al.), 110
1.99 Posterior Approach to the Shoulder (Modified Judet), 111
1.100 Simplified Posterior Approach to the Shoulder (King, as Described by Brodsky et al.), 111
1.101 Posterior Inverted-U Approach to the Shoulder (Abbott and Lucas), 113
1.102 Anterolateral Approach to the Shaft of the Humerus (Thompson; Henry), 114
1.103 Subbrachial Approach to the Humerus (Boschi et al.), 116
1.104 Posterior Approach to the Proximal Humerus (Berger and Buckwalter), 117
1.105 Posterolateral Approach to the Distal Humeral Shaft (Moran), 118
1.106 Posterolateral Extensile (Cold) Approach to the Distal Humerus (Lewicky, Sheppard, and Ruth), 120
1.107 Posterolateral Approach to the Elbow (Campbell), 121
1.108 Extensile Posterolateral Approach to the Elbow (Wadsworth), 121
1.109 Posterior Approach to the Elbow by Olecranon Osteotomy (MacAusland and Müller), 123
1.110 Extensile Posterior Approach to the Elbow (Bryan and Morrey), 123
1.111 Lateral Approach to the Elbow, 124
1.112 Lateral J–Shaped Approach to the Elbow (Kocher), 126
1.113 Medial Approach with Osteotomy of the Medial Epicondyle (Molesworth; Campbell), 127
1.114 Medial and Lateral Approach to the Elbow, 127
1.115 Global Approach to the Elbow (Patterson, Bain, and Mehta), 127
1.116 Posterolateral Approach to the Radial Head and Neck, 130
1.117 Approach to the Proximal and Middle Thirds of the Posterior Surface of the Radius (Thompson), 131
1.118 Anterolateral Approach to the Proximal Shaft and Elbow Joint (Henry), 132
1.119 Anterior Approach to the Distal Half of the Radius (Henry), 132
1.120 Anterior Approach to the Coronoid Process of the Proximal Ulna (Yang et al.), 134
1.121 Approach to the Proximal Third of the Ulna and the Proximal Fourth of the Radius (Boyd), 135
1.122 Dorsal Approach to the Wrist, 137
1.123 Dorsal Approach to the Wrist, 137
1.124 Volar Approach to the Wrist, 137
1.125 Lateral Approach to the Wrist, 138
1.126 Medial Approach to the Wrist, 138
Arthroplasty of the Hip
3.1 Preoperative Templating for Total Hip Arthroplasty (Capello), 203
3.2 Posterolateral Approach with Posterior Dislocation of the Hip, 207
3.3 Implantation of Cementless Acetabular Component, 210
3.4 Implantation of Cemented Acetabular Component, 212
3.5 Implantation of Cementless Femoral Component, 214
3.6 Implantation of Cemented Femoral Component, 218
3.7 Direct Anterior Approach with Anterior Dislocation of the Hip, 222
3.8 Gluteus Maximus and Tensor Fascia Lata Transfer for Primary Deficiency of the Abductors of the Hip, 269
3.9 Revision After Adverse Local Tissue Reaction, 285
3.10 Transtrochanteric Approach for Revision Total Hip Arthroplasty, 289
3.11 Removal of Cemented Femoral Component, 289
3.12 Removal of Cementless Femoral Component, 290
3.13 Removal of Implants with Extensive Distal Bone Ingrowth (Glassman and Engh), 291
3.14 Extended Trochanteric Osteotomy (Younger et al.), 292
3.15 Removal of a Broken Stem—Proximal Window (Moreland, Marder, and Anspach), 294
3.16 Removal of a Broken Stem—Distal Window, 295
3.17 Removal of Femoral Cement, 295
3.18 Removal of Distal Cement with a High-Speed Burr (Turner et al.), 296
3.19 Removal of Distal Cement with a High-Speed Burr and Cortical Window (Mallory), 298
3.20 Removal of a Loose All-Polyethylene Cup, 299
3.21 Removal of a Metal-Backed, Cemented Acetabular Component, 299
3.22 Cementless Acetabular Component (Mitchell), 301
3.23 Management of Acetabular Cavitary Deficits, 302
3.24 Management of Segmental Acetabular Deficit with Femoral Head Allograft, 307
3.25 Management of Segmental Acetabular Deficit with Metal Augment (Jenkins et al., Modified), 307
3.26 Management of Combined Deficits with Structural Grafting (Sporer et al.), 308
3.27 Acetabular Distraction for Management of Pelvic Discontinuity (Sheth et al.), 310
3.28 Cup-Cage Technique for Management of Pelvic Discontinuity (Abdel et al., Modified), 311
3.29 Management of Pelvic Discontinuity with Allografting and Custom Component (DeBoer et al.), 311
3.30 Management of Femoral Deficit with Modular Femoral Component (Cameron), 316
3.31 Revision with Extensively Porous-Coated Femoral Stem (Mallory and Head), 316
3.32 Management of Proximal Femoral Bone Loss with Modular Tapered Fluted Stem (Kwong et al.), 317
3.33 Management of Proximal Femoral Deficiencies with Impaction Bone Grafting and Cemented Revision Stem (Gie, Modified), 317
3.34 Management of Massive Deficits with Proximal Femoral AllograftProsthesis Composite, 319
3.35 Management of Massive Deficits with Modular Megaprosthesis (Klein et al.), 321
Surface Replacement Hip Arthroplasty
4.1 Hip Resurfacing Technique—Birmingham Hip Replacement, 336 Arthrodesis of the Hip
5.1 Arthrodesis with Cancellous Screw Fixation (Benaroch et al.), 349
5.2 Arthrodesis with Anterior Fixation (Matta et al.), 349
5.3 Arthrodesis with Double-Plate Fixation (Müller et al.), 350
5.4 Arthrodesis with Cobra Plate Fixation (Murrell and Fitch), 351
5.5 Arthrodesis with Hip Compression Screw Fixation (Pagnano and Cabanela), 353
5.6 Arthrodesis in the Absence of the Femoral Head (Abbott, Fischer, and Lucas), 353
Hip Pain in the Young Adult and Hip Preservation Surgery
6.1 Surgical Dislocation of the Hip (Ganz et al.), 367
6.2 Combined Hip Arthroscopy and Limited Open Osteochondroplasty (Clohisy and McClure), 371
6.3 Mini-Open Direct Anterior Approach (Ribas et al.), 373
6.4 Bernese Periacetabular Osteotomy (Matheney et al.), 381
6.5 Rectus-Sparing Modification of Bernese Osteotomy (Novais et al.), 385
6.6 Step-Cut Lengthening of the Iliotibial Band (White et al.), 388
6.7 Core Decompression (Hungerford), 393
6.8 Core Decompression—Percutaneous Technique (Mont et al.), 394
Arthroplasty of the Knee
7.1 Surgical Approach for Primary Total Knee Arthroplasty, 436
7.2 Bone Preparation for Primary Total Knee Arthroplasty, 439
7.3 Pie-Crusting, 444
7.4 Posterior Stabilized Total Knee Arthroplasty In A Varus Knee, 445
7.5 Posterior Cruciate–Retaining Total Knee Arthroplasty of a Varus Knee, 445
7.6 Valgus Deformity Correction, 446
7.7 Flexion Contracture Correction, 447
7.8 Recurvatum Correction, 448
7.9 Posterior Cruciate Ligament Balancing, 448
7.10 Bone Grafting of Peripheral Tibial Defects (Windsor, Insall, and Sculco), 450
7.11 Component Implantation, 453
7.12 Unicondylar Knee Arthroplasty, 455
7.13 Patellofemoral Arthroplasty, 456
7.14 Arthrodesis with an Intramedullary Nail for an Infected Total Knee Arthroplasty, 463
Arthrodesis of the Knee
8.1 Compression Arthrodesis Using External Fixation, 486
8.2 Arthrodesis Using Intramedullary Nail Fixation, 487
8.3 Knee Arthrodesis with Locked Intramedullary Nail After Failed Total Knee Arthroplasty, 489
8.4 Arthrodesis Using Plate Fixation, 490
Soft-Tissue Procedures and Osteotomies About the Knee
9.1 Proximal Release of Quadriceps (Sengupta), 494
9.2 Quadricepsplasty for Posttraumatic Contracture of the Knee (Modified Thompson, Described by Hahn et al.), 494
9.3 Drainage of Bursa, 499
9.4 Excision of Bursa, 499
9.5 Popliteal Cyst Excision (Hughston, Baker, and Mello), 501
9.6 Medial Gastrocnemius Bursa Excision (Meyerding and Van Demark), 502
9.7 Semimembranosus Bursa Excision, 503
9.8 Semitendinosus Tendon Transfer (Ray, Clancy, and Lemon), 503
9.9 Lateral Closing Wedge Osteotomy (Modified Coventry; Hofmann, Wyatt, and Beck), 513
9.10 Opening Wedge Hemicallotasis (Turi et al.), 518
9.11 Varus Distal Femoral Osteotomy (Coventry), 522
Total Ankle Arthroplasty
10.1 Total Ankle Arthroplasty, 533
10.2 Dome Osteotomy for Correction of Varus Deformity Above the Ankle Deformity (Tan and Myerson), 536
10.3 Medial Tibial Plafondplasty for Varus Deformity at the Ankle Joint (Tan and Myerson), 537
10.4 Reconstruction of Lateral Ankle Ligaments for Chronic Instability as an Adjunct to Total Ankle Arthroplasty (Coetzee), 538
10.5 Tibiotalar Arthrodesis Conversion to Total Ankle Arthroplasty (Pellegrini et al.), 540
10.6 Revision Total Ankle Arthroplasty (Meeker et al.), 555 Ankle Arthrodesis
11.1 Opening Wedge Osteotomy of the Tibia For Varus Deformity and Medial Joint Arthrosis, 564
11.2 Intraarticular Opening Medial Wedge Osteotomy (Plafondplasty) of the Tibia for Intraarticular Varus Arthritis and Instability (Mann, Filippi, and Myerson), 566
11.3 Distraction Arthroplasty of the Ankle, 568
11.4 Mini-Incision Technique, 575
11.5 Transfibular (Transmalleolar) Arthrodesis with Fibular Strut Graft, 576
11.6 Anterior Approach with Plate Fixation, 580
11.7 Lateral Approach with Fibular Sparing (Smith, Chiodo, Singh, Wilson), 580
11.8 Tibiotalocalcaneal Arthrodesis, 581
11.9 Posterior Approach for Arthrodesis of Ankle and Subtalar Joints (Campbell), 584
11.10 Arthrodesis with a Thin-Wire External Fixation, 584
11.11 Tibiotalar Arthrodesis with a Sliding Bone Graft (Blair; Morris et al.), 590
11.12 Tibiotalar or Tibiotalocalcaneal Fusion with Structural Allograft and Internal Fixation for Salvage of Failed Total Ankle Arthroplasty (Berkowitz et al.), 591
11.13 Bone Graft Harvest from the Proximal Tibia (Whitehouse et al.), 593
Shoulder and Elbow Arthroplasty
12.1 Hemiarthroplasty, 608
12.2 Total Shoulder Arthroplasty, 612
12.3 Reverse Total Shoulder Arthroplasty, 617
12.4 Debridement Arthroplasty (Wada et al.), 633
12.5 Interposition Arthroplasty, 637
12.6 Radial Head Arthroplasty, 639
12.7 Coonrad-Morrey Prosthesis, 642
12.8 Elbow Resection Arthroplasty (Campbell), 648
Salvage Operations for the Shoulder and Elbow
13.1 External Fixation (Charnley and Houston), 660
13.2 Plate Fixation (AO Group), 660
13.3 Pelvic Reconstruction Plate (Modification of Richards et al.), 661
13.4 Shoulder Arthrodesis After Failed Prosthetic Shoulder Arthroplasty (Scalise and Iannotti), 662
13.5 Arthroscopic Shoulder Arthrodesis for Brachial Plexus Injury (lenoir), 664
13.6 Elbow Arthrodesis (Staples), 665
13.7 Elbow Arthrodesis (Müller et al.), 666
13.8 Elbow Arthrodesis (Spier), 666
13.9 Latissimus Dorsi Transfer, Open Technique (Gerber et al.), 668
13.10 Latissimus Dorsi Transfer, Arthroscopically Assisted Technique (Castricini et al.), 669
13.11 Lower Trapezius Transfer, Open Technique (Elhassan et al.), 671
13.12 Lower Trapezius Transfer, Arthroscopically Assisted Technique (Elhassan et al.), 672
13.13 Pectoralis Major Transfer (Modification of Resch et al.,), 673
13.14 Latissimus Dorsi Tendon Transfer (Mun et al.), 675
Amputations of the Foot
15.1 Terminal Syme Amputation, 700
15.2 Amputation at the Base of the Proximal Phalanx, 700
15.3 Metatarsophalangeal Joint Disarticulation, 703
15.4 Metatarsophalangeal Joint Disarticulation, 703
15.5 First or Fifth Ray Amputation (Border Ray Amputation), 703
15.6 Central Ray Amputation, 704
15.7 Transmetatarsal Amputation, 707
15.8 Chopart Amputation, 711
15.9 Syme Amputation, 713
15.10 Two-Stage Syme Amputation (Wyss et al.; Malone et al.; Wagner), 717
15.11 Boyd Amputation, 717
Amputations of the Lower Extremity
16.1 Transtibial Amputation, 722
16.2 Transtibial Amputation (Modified Ertl; Taylor and Poka), 723
16.3 Transtibial Amputation Using Long Posterior Skin Flap (Burgess), 725
16.4 Knee Disarticulation (Batch, Spittler, and McFaddin), 726
16.5 Knee Disarticulation (Mazet and Hennessy), 728
16.6 Knee Disarticulation (Kjøble), 728
16.7 Transfemoral (Above-Knee) Amputation of Nonischemic Limbs, 730
16.8 Transfemoral (Above-Knee) Amputation of Nonischemic Limbs (Gottschalk), 731
Amputations of the Hip and Pelvis
17.1 Anatomic Hip Disarticulation (Boyd), 733
17.2 Posterior Flap (Slocum), 735
17.3 Standard Hemipelvectomy, 736
17.4 Anterior Flap Hemipelvectomy, 736
17.5 Conservative Hemipelvectomy, 739
Major Amputations of the Upper Extremity
18.1 Amputation at the Wrist, 743
18.2 Disarticulation of the Wrist, 743
18.3 Distal Forearm (Distal Transradial) Amputation, 744
18.4 Proximal Third of Forearm (Proximal Transradial) Amputation, 745
18.5 Disarticulation of the Elbow, 745
18.6 Supracondylar Area, 746
18.7 Amputation Proximal to the Supracondylar Area, 748
18.8 Amputation Through the Surgical Neck of the Humerus, 748
18.9 Disarticulation of the Shoulder, 750
18.10 Anterior Approach (Berger), 752
18.11 Posterior Approach (Littlewood), 753
18.12 Targeted Muscle Reinnervation After Transhumeral Amputation (O’Shaughnessy et al.), 756
Amputations of the Hand
19.1 Kutler V-Y or Atasoy Triangular Advancement Flaps (Kutler; Fisher), 764
19.2 Atasoy Triangular Advancement Flaps (Atasoy et al.), 766
19.3 Bipedicle Dorsal Flaps, 767
19.4 Adipofascial Turnover Flap, 768
19.5 Thenar Flap, 768
19.6 Local Neurovascular Island Flap, 769
19.7 Island Pedicle Flap, 769
19.8 Retrograde Island Pedicle Flap, 771
19.9 Ulnar Hypothenar Flap, 771
19.10 Index Ray Amputation, 771
19.11 Transposing the Index Ray (Peacock), 774
19.12 Advancement Pedicle Flap for Thumb Injuries, 776
19.13 Phalangization of Fifth Metacarpal, 778
19.14 Krukenberg Reconstruction (Krukenberg; Swanson), 779
19.15 Lengthening of the Metacarpal and Transfer of Local Flap (Gillies and Millard, Modified), 781
19.16 Osteoplastic Reconstruction and Transfer of Neurovascular Island Graft (Verdan), 782
19.17 Riordan Pollicization (Riordan), 784
19.18 Buck-Gramcko Pollicization (Buck-Gramcko), 785
19.19 Foucher Pollicization, 787
Osteomyelitis
21.1 Drainage of Acute Hematogenous Osteomyelitis, 821
21.2 Sequestrectomy and Curettage for Chronic Osteomyelitis, 827
21.3 Open Bone Grafting (Papineau et al.; Archdeacon and Messerschmitt), 828
21.4 Antibiotic Bead Pouch (Henry, Ostermann, and Seligson), 829
21.5 Intramedullary Antibiotic Cement Nail, 829
21.6 Split-Heel Incision (Gaenslen), 834
21.7 Distal Third of the Femur, 835
21.8 Drainage, 835
21.9 Resection of the Metatarsals, 836
21.10 Partial Calcanectomy, 837
21.11 Resection of the Fibula, 837
21.12 Resection of the Iliac Wing (Badgley), 838
Infectious Arthritis
22.1 Surgical Drainage of the Tarsal Joint, 846
22.2 Anterolateral Drainage of the Ankle, 847
22.3 Posterolateral Drainage of the Ankle, 847
22.4 Anteromedial Drainage of the Ankle, 847
22.5 Posteromedial Drainage of the Ankle, 847
22.6 Arthroscopic Drainage of the Knee, 848
22.7 Anterior Drainage of the Knee, 849
22.8 Posterolateral and Posteromedial Drainage of the Knee (Henderson), 849
22.9 Posteromedial Drainage of the Knee (Klein), 850
22.10 Posteromedial and Posterolateral Drainage of the Knee (Kelikian), 850
22.11 Lateral Aspiration of the Hip, 851
22.12 Anterior Aspiration of the Hip, 851
22.13 Medial Aspiration of the Hip, 851
22.14 Posterior Drainage of the Hip (Ober), 852
22.15 Anterior Drainage of the Hip, 852
22.16 Lateral Drainage of the Hip, 852
22.17 Medial Drainage of the Hip (Ludloff), 853
22.18 Arthroscopic Debridement and Partial Synovectomy of the Hip in an Adult, 853
22.19 Resection of the Hip (Girdlestone), 854
22.20 Anterior Drainage of the Shoulder, 856
22.21 Posterior Drainage of the Shoulder, 856
22.22 Medial Drainage of the Elbow, 857
22.23 Lateral Drainage of the Elbow, 857
22.24 Posterior Drainage of the Elbow, 858
22.25 Lateral Drainage of the Wrist, 858
22.26 Medial Drainage of the Wrist, 859
22.27 Dorsal Drainage of the Wrist, 859
22.28 Osteotomy of the Ankle, 859
22.29 Transverse Supracondylar Osteotomy of the Femur, 859
22.30 V-Osteotomy of the Femur (Thompson), 860
22.31 Supracondylar Cuneiform Osteotomy of the Femur, 860
22.32 Supracondylar Controlled Rotational Osteotomy of the Femur, 861
22.33 Intraarticular Osteotomy, 861
22.34 Reconstruction After Hip Sepsis (Harmon), 864
22.35 Transverse Opening Wedge Osteotomy of the Hip, 864
22.36 Transverse Closing Wedge Osteotomy of the Hip, 865
22.37 Brackett Osteotomy of the Hip (Brackett), 865
Tuberculosis and Other Unusual Infections
23.1 Curettage for Tuberculous Lesions in the Foot, 874
23.2 Excision of Metatarsal, 874
23.3 Excision of Cuneiform Bones, 874
23.4 Excision of Navicular, 875
23.5 Excision of Cuboid, 875
23.6 Excision of Calcaneus, 875
23.7 Excision of Talus, 876
23.8 Partial Synovectomy and Curettage (Wilkinson), 877
23.9 Lesions above Acetabulum, 878
23.10 Lesions of the Femoral Neck, 878
23.11 Lesions of the Trochanteric Area (Ahern), 878
23.12 Excision of the Hip Joint, 879
23.13 Excision of Elbow Joint, 880
23.14 Excision of Wrist Joint, 880
General Principles of Tumors
24.1 Resection of the Shoulder Girdle (Marcove, Lewis, and Huvos), 909
24.2 Resection of the Scapula (Das Gupta), 913
24.3 Resection of the Proximal Humerus, 916
24.4 Intercalary Resection of the Humeral Shaft (Lewis), 920
24.5 Resection of the Distal Humerus, 920
24.6 Resection of the Proximal Radius, 920
24.7 Resection of the Proximal Ulna, 921
24.8 Resection of the Distal Radius, 921
24.9 Resection of the Pubis and Ischium (Radley, Liebig, and Brown), 928
24.10 Resection of the Acetabulum, 932
24.11 Resection of the Innominate Bone (Internal Hemipelvectomy) (Karakousis and Vezeridis), 934
24.12 Resection of the Sacroiliac Joint, 934
24.13 Resection of the Sacrum (Stener and Gunterberg), 936
24.14 Resection of the Sacrum (Localio, Francis, and Rossano), 937
24.15 Resection of the Sacrum Through Posterior Approach (MacCarty et al.), 937
24.16 Resection of the Proximal Femur (Lewis and Chekofsky), 938
24.17 Resection of Entire Femur (Lewis), 938
24.18 Intraarticular Resection of the Distal Femur with Endoprosthetic Reconstruction, 943
24.19 Resection of the Proximal Tibia (Malawer), 944
24.20 Resection of the Proximal Fibula (Malawer), 945
24.21 Resection of the Distal Third of the Fibula, 945
24.22 Rotationplasty for a Lesion in the Distal Femur (Kotz and Salzer), 950
24.23 Rotationplasty for a Lesion of the Proximal Femur Without Involvement of the Hip Joint (Winkelmann), 950
24.24 Rotationplasty for a Lesion of the Proximal Femur Involving the Hip Joint (Winkelmann), 952
Operative Orthopaedics, 14th ed.
List of Techniques
VOLUME II
Congenital Anomalies of the Lower Extremity
29.1 Amputation of an Extra Toe (Simple Postaxial Polydactyly), 1081
29.2 Tsuge Ray Reduction (Tsuge), 1082
29.3 Ray Reduction, 1083
29.4 Ray Amputation, 1083
29.5 Simplified Cleft Closure (Wood, Peppers, and Shook), 1087
29.6 Correction of Angulated Toe, 1088
29.7 Arthroplasty of the Fifth Metatarsophalangeal Joint (Butler), 1088
29.8 Creation of Syndactyly of the Great Toe and Second Toe for Hallux Varus (Farmer), 1090
29.9 Dome-Shaped Osteotomies of Metatarsal Bases (Berman and Gartland), 1092
29.10 Cuneiform and Cuboid Osteotomies (McHale and Lenhart), 1095
29.11 Anterior Tibial Tendon Transfer, 1100
29.12 Transverse Circumferential (Cincinnati) Incision (Crawford, Marxen, and Osterfeld), 1102
29.13 Extensile Posteromedial and Posterolateral Release (McKay, Modified), 1103
29.14 Achilles Tendon Lengthening and Posterior Capsulotomy (Selective Approach), 1106
29.15 First Metatarsal Osteotomy and Tendon Transfer for Dorsal Bunion, 1108
29.16 Osteotomy of the Calcaneus for Persistent Varus Deformity of the Heel (Dwyer, Modified), 1109
29.17 Medial Release with Osteotomy of the Distal Calcaneus (Lichtblau), 1109
29.18 Selective Joint-Sparing Osteotomies for Residual Cavovarus Deformity (Mubrak and Van Valin), 1110
29.19 Triple Arthrodesis, 1112
29.20 Talectomy (Trumble et al.), 1112
29.21 Open Reduction and Realignment of Talonavicular and Subtalar Joints (Kumar, Cowell, and Ramsey), 1115
29.22 Open Reduction and Extraarticular Subtalar Fusion (Grice- Green), 1116
29.23 Tibiofibular Synostosis (Langenskiöld), 1120
29.24 Insertion of Williams Intramedullary Rod and Bone Grafting (Anderson et al.), 1123
29.25 One-Stage or Two-Stage Release of Circumferential Constricting Band (Greene), 1126
29.26 Capsular Release and Quadriceps Lengthening for Correction of Congenital Knee Dislocation (Curtis and Fisher), 1127
29.27 Lateral Release and Medial Plication (Beaty; Modified from Gao et al. and Langenskiöld), 1129
29.28 Distal Fibulotalar Arthrodesis, 1136
29.29 Proximal Tibiofibular Synostosis, 1137
29.30 Varus Supramalleolar Osteotomy of the Ankle (Wiltse), 1139
29.31 Knee Fusion for Proximal Femoral Focal Deficiency (King), 1145
29.32 Rotationplasty (Van Nes), 1148
29.33 Syme Amputation, 1150
29.34 Boyd Amputation, 1152
29.35 Physeal Exposure Around the Knee (Abbott and Gill, Modified), 1160
29.36 Percutaneous Epiphysiodesis (Canale et al.), 1161
29.37 Percutaneous Transepiphyseal Screw Epiphysiodesis (Métaizeau et al.), 1162
29.38 Tension Plate Epiphysiodesis, 1164
29.39 Proximal Femoral Metaphyseal Shortening (Wagner), 1165
29.40 Distal Femoral Metaphyseal Shortening (Wagner), 1165
29.41 Proximal Tibial Metaphyseal Shortening (Wagner), 1166
29.42 Tibial Diaphyseal Shortening (Broughton, Olney, and Menelaus), 1166
29.43 Closed Femoral Diaphyseal Shortening (Winquist, Hansen, and Pearson), 1166
29.44 Transiliac Lengthening (Millis and Hall), 1168
29.45 Tibial Lengthening (DeBastiani et al.), 1170
29.46 Tibial Lengthening (Ilizarov, Modified), 1171
29.47 Tibial Lengthening Over Intramedullary Nail (PRECICE Intramedullary Lengthening System, Ellipse Technologies, Irvine, CA); (Herzenberg, Standard, Green), 1174
29.48 Femoral Lengthening (DeBastiani et al.), 1175
29.49 Femoral Lengthening (Ilizarov, Modified), 1175
29.50 Femoral Lengthening Over Intramedullary Nail (PRECICE); (Standard, Herzenberg, and Green), 1179
Congenital and Developmental Abnormalities of the Hip and Pelvis
30.1 Arthrography of the Hip in DDH, 1193
30.2 Application of a Hip Spica Cast (Kumar), 1195
30.3 Anterior Approach (Beaty; After Somerville), 1197
30.4 Medial Approach (Ludloff), 1199
30.5 Trochanteric Advancement (Lloyd-Roberts and Swann), 1202
30.6 Varus Derotational Osteotomy of the Femur In Hip Dysplasia, with Pediatric Hip Screw Fixation, 1203
30.7 Primary Femoral Shortening, 1206
30.8 Innominate Osteotomy Including Open Reduction (Salter), 1209
30.9 Pericapsular Osteotomy of the Ilium (Pemberton), 1211
30.10 Triple Innominate Osteotomy (Steel), 1214
30.11 Transiliac (Dega) Osteotomy (Grudziak and Ward), 1216
30.12 Slotted Acetabular Augmentation (Staheli), 1219
30.13 Chiari Osteotomy, 1222
30.14 Valgus Osteotomy for Developmental Coxa Vara, 1225
30.15 Bilateral Anterior Iliac Osteotomies (Sponseller, Gearhart, and Jeffs), 1227
Congenital Anomalies of the Trunk and Upper Extremity
31.1 Woodward Operation, 1232
31.2 Morcellation of the Clavicle, 1233
31.3 Unipolar Release, 1236
31.4 Bipolar Release (Ferkel et al.), 1237
31.5 Open Reduction and Iliac Bone Grafting for Congenital Pseudarthrosis of the Clavicle, 1239
31.6 Radial and Ulnar Osteotomies for Correction of Congenital Radioulnar Synostosis (Two-Stage) (Lin et al.), 1243
Osteochondrosis or Epiphysitis and Other Miscellaneous Affections
32.1 Innominate Osteotomy for Legg-Calvé-Perthes Disease (Canale et al.), 1250
32.2 Lateral Shelf Procedure (Labral Support) for Legg-Calvé-Perthes Disease (Willett et al.), 1252
32.3 Varus Derotational Osteotomy of the Proximal Femur for Legg-Calvé-Perthes Disease (Stricker), 1253
32.4 Reversed or Closing Wedge Technique for Legg-Calvé-Perthes Disease, 1256
32.5 Arthrodiastasis for Legg-Calvé-Perthes Disease (Segev et al.), 1257
32.6 Osteochondroplasty Surgical Dislocation of the Hip (Ganz), 1258
32.7 Trochanteric Advancement for Trochanteric Overgrowth (Wagner), 1261
32.8 Trochanteric Advancement for Trochanteric Overgrowth (MacNicol and Makris), 1262
32.9 Greater Trochanteric Epiphysiodesis for Trochanteric Overgrowth, 1263
32.10 Tibial Tuberosity and Ossicle Excision (Pihlajamäki et al.), 1267
32.11 Excision of Ununited Tibial Tuberosity for Osgood-Schlatter Disease (Ferciot and Thomson), 1268
32.12 Arthroscopic Ossicle and Tibial Tuberosity Debridement for Osgood-Schlatter Disease, 1269
32.13 Extraarticular Drilling for Stable Osteochondritis Dissecans of the Knee (Donaldson and Wojtys), 1270
32.14 Reconstruction of the Articular Surface with Osteochondral Plug Grafts for Osteochondrosis of the Capitellum (Takahara et al.), 1276
32.15 Metaphyseal Osteotomy for Tibia Vara (Rab), 1281
32.16 Chevron Osteotomy for Tibia Vara (Greene), 1282
32.17 Epiphyseal and Metaphyseal Osteotomy for Tibia Vara (Ingram, Canale, Beaty), 1283
32.18 Intraepiphyseal Osteotomy for Tibia Vara (Siffert, Støren, Johnson et al.), 1285
32.19 Hemielevation of the Epiphysis Osteotomy with Leg Lengthening Using an Ilizarov Frame for Tibia Vara (Jones et al., Hefny et al.), 1285
32.20 Synovectomy of the Knee In Hemophilia, 1293
32.21 Synoviorthesis for Treatment of Hemophilic Arthropathy, 1293
32.22 Open Ankle Synovectomy in Hemophilia (Greene), 1293
32.23 Fassier-Duval Telescoping Rod, Femur (Open Osteotomy), 1297
32.24 Tibial Lengthening Over an Intramedullary Nail with External Fixation in Dwarfism (Park et al.), 1305
32.25 Bony Bridge Resection for Physeal Arrest (Langenskiöld), 1306
32.26 Bony Bridge Resection and Angulation Osteotomy for Physeal Arrest (Ingram), 1306
32.27 Peripheral and Linear Physeal Bar Resection for Physeal Arrest (Birch et al.), 1308
32.28 Central Physeal Bar Resection for Physeal Arrest (Peterson), 1308
Cerebral Palsy
33.1 Adductor Tenotomy and Release, 1328
33.2 Iliopsoas Recession, 1329
33.3 Iliopsoas Release at the Lesser Trochanter, 1329
33.4 Combined One-Stage Correction of Spastic Dislocated Hip, 1333
33.5 Proximal Femoral Resection, 1336
33.6 Redirectional Osteotomy (McHale Procedure for Neglected Hip Dislocation), (McHale et al.), 1337
33.7 Hip Arthrodesis, 1337
33.8 Fractional Lengthening of Hamstring Tendons, 1339
33.9 Distal Femoral Extension Osteotomy and Patellar Tendon Advancement (Stout et al.), 1341
33.10 Rectus Femoris Transfer (Gage et al.), 1343
33.11 Z-Plasty Lengthening of the Achilles Tendon, 1346
33.12 Percutaneous Lengthening of the Achilles Tendon, 1347
33.13 Gastrocnemius-Soleus Lengthening, 1348
33.14 Musculotendinous Recession of the Posterior Tibial Tendon, 1349
33.15 Split Posterior Tibial Tendon Transfer, 1350
33.16 Split Anterior Tibial Tendon Transfer (Hoffer et al.), 1351
33.17 Lateral Closing-Wedge Calcaneal Osteotomy (Dwyer), 1353
33.18 Medial Displacement Calcaneal Osteotomy, 1354
33.19 Hindfoot Arthrodesis, 1355
33.20 Release of Elbow Flexion Contracture, 1359
33.21 Correction of Talipes Equinovarus, 1362
33.22 Release of Internal Rotation Contracture of the Shoulder, 1363
33.23 Fractional Lengthening of Pectoralis Major, Latissimus Dorsi, Teres Major, 1364
Paralytic Disorders
34.1 Posterior Transfer of Anterior Tibial Tendon (Drennan), 1374
34.2 Subtalar Arthrodesis (Grice and Green), 1376
34.3 Subtalar Arthrodesis (Dennyson and Fulford), 1377
34.4 Triple Arthrodesis, 1378
34.5 Correction of Cavus Deformity, 1380
34.6 Lambrinudi Arthrodesis (Lambrinudi), 1380
34.7 Anterior Transfer of Posterior Tibial Tendon (Barr), 1382
34.8 Anterior Transfer of Posterior Tibial Tendon (Ober), 1382
34.9 Split Transfer of Anterior Tibial Tendon, 1383
34.10 Peroneal Tendon Transfer, 1384
34.11 Peroneus Longus, Flexor Digitorum Longus, or Flexor or Extensor Hallucis Longus Tendon Transfer (Fried and Hendel), 1385
34.12 Tenodesis of the Achilles Tendon (Westin), 1386
34.13 Posterior Transfer of Peroneus Longus, Peroneus Brevis, and Posterior Tibial Tendons, 1387
34.14 Posterior Transfer of Posterior Tibial, Peroneus Longus, and Flexor Hallucis Longus Tendons (Green and Grice), 1388
34.15 Transfer of Biceps Femoris and Semitendinosus Tendons, 1389
34.16 Osteotomy of the Tibia for Genu Recurvatum (Irwin), 1391
34.17 Triple Tenodesis for Genu Recurvatum (Perry, O’Brien, and Hodgson), 1392
34.18 Complete Release of Hip Flexion, Abduction, and External Rotation Contracture (Ober; Yount), 1394
34.19 Complete Release of Muscles from Iliac Wing and Transfer of Crest of Ilium (Campbell), 1395
34.20 Posterior Transfer of the Iliopsoas for Paralysis of the Gluteus Medius and Maximus Muscles (Sharrard), 1396
34.21 Trapezius Transfer for Paralysis of Deltoid (Bateman), 1401
34.22 Trapezius Transfer for Paralysis of Deltoid (Saha), 1402
34.23 Transfer of Deltoid Origin for Partial Paralysis (Harmon), 1402
34.24 Transfer of Latissimus Dorsi or Teres Major or Both for Paralysis of Subscapularis or Infraspinatus (Saha), 1403
34.25 Flexorplasty (Bunnell), 1404
34.26 Anterior Transfer of the Triceps (Bunnell), 1405
34.27 Transfer of the Pectoralis Major Tendon (Brooks and Seddon), 1405
34.28 Transfer of the Latissimus Dorsi Muscle (Hovnanian), 1406
34.29 Rerouting of Biceps Tendon for Supination Deformities of Forearm (Zancolli), 1408
34.30 V-O Procedure, 1416
34.31 Anterolateral Release, 1418
34.32 Transfer of the Anterior Tibial Tendon to the Calcaneus, 1418
34.33 Screw Epiphysiodesis, 1422
34.34 Supramalleolar Varus Derotation Osteotomy, 1422
34.35 Radical Flexor Release, 1424
34.36 Anterior Hip Release, 1426
34.37 Fascial Release, 1427
34.38 Adductor Release, 1427
34.39 Transfer of Adductors, External Oblique, and Tensor Fasciae Latae (Phillips and Lindseth), 1428
34.40 Proximal Femoral Resection and Interposition Arthroplasty (Baxter and D’Astous), 1429
34.41 Pelvic Osteotomy (Lindseth), 1430
34.42 Correction of Knee Flexion Contracture with Circular-Frame External Fixation (Van Bosse et al.), 1436
34.43 Correction of Knee Flexion Contracture with Anterior Stapling (Palocaren et al.), 1438
34.44 Reorientational Proximal Femoral Osteotomy for Hip Contractures in Arthrogryposis (Van Bosse), 1439
34.45 Posterior Elbow Capsulotomy with Triceps Lengthening for Elbow Extension Contracture (Van Heest et al.), 1442
34.46 Posterior Release of Elbow Extension Contracture and Triceps Tendon Transfer (Tachdjian), 1442
34.47 Dorsal Closing Wedge Osteotomy of the Wrist (Van Heest and Rodriguez, Ezaki, and Carter), 1443
34.48 Anterior Shoulder Release (Fairbank, Sever), 1449
34.49 Rotational Osteotomy of the Humerus (Rogers), 1449
34.50 Derotational Osteotomy with Plate and Screw Fixation (Abzug et al.), 1450
34.51 Glenoid Anteversion Osteotomy and Tendon Transfer (Dodwell et al.), 1450
34.52 Release of the Internal Rotation Contracture and Transfer of the Latissimus Dorsi and Teres Major (Sever-L’Episcopo, Green), 1451
34.53 Arthroscopic Release and Transfer of the Latissimus Dorsi (Pearl et al.), 1455
Neuromuscular Disorders
35.1 Open Muscle Biopsy, 1463
35.2 Percutaneous Muscle Biopsy (Mubarak, Chambers, and Wenger), 1463
35.3 Percutaneous Release of Hip Flexion and Abduction Contractures and Achilles Tendon Contracture (Green), 1467
35.4 Transfer of the Posterior Tibial Tendon to the Dorsum of the Foot (Greene), 1467
35.5 Transfer of the Posterior Tibial Tendon to the Dorsum of the Base of the Second Metatarsal (Mubarak), 1469
35.6 Scapulothoracic Fusion (Diab et al.), 1472
35.7 Plantar Fasciotomy, Osteotomies, and Arthrodesis for CharcotMarie-Tooth Disease (Faldini et al.), 1477
35.8 Radical Plantar-Medial Release and Dorsal Closing Wedge Osteotomy (Coleman), 1481
35.9 Transfer of the Extensor Hallucis Longus Tendon for Claw Toe Deformity (Jones), 1481
35.10 Transfer of the Extensor Tendons to the Middle Cuneiform (Hibbs), 1482
35.11 Stepwise Joint-Sparing Foot Osteotomies (Mubarak and Van Valin), 1482
Fractures and Dislocations in Children
36.1 Closed Reduction and Percutaneous Pinning (or Screw Fixation) of Proximal Humerus, 1501
36.2 Closed Reduction and Intramedullary Nailing of Proximal Humerus, 1501
36.3 Closed/Open Reduction and Intramedullary Nailing of Humeral Shaft, 1502
36.4 Closed Reduction and Percutaneous Pinning of Supracondylar Fractures (Two Lateral Pins), 1504
36.5 Anterior Approach, 1507
36.6 Lateral Closing Wedge Osteotomy for Cubitus Varus, 1509
36.7 Open Reduction and Internal Fixation of Lateral Condylar Fracture, 1512
36.8 Osteotomy for Established Cubitus Valgus Secondary to Nonunion or Growth Arrest, 1513
36.9 Open Reduction and Internal Fixation of Medial Condylar Fracture, 1515
36.10 Open Reduction and Internal Fixation for Displaced or Entrapped Medial Epicondyle, 1518
36.11 Closed and Open Reduction of Radial Neck Fractures, 1526
36.12 Percutaneous Reduction and Pinning, 1527
36.13 Closed Intramedullary Nailing, 1527
36.14 Overcorrection Osteotomy and Ligamentous Repair or Reconstruction (Shah and Waters), 1535
36.15 Intramedullary Forearm Nailing, 1538
36.16 Closed Reduction and Percutaneous Pinning of Fractures of the Distal Radius, 1540
36.17 Open Reduction and Internal Fixation of Physeal Fractures of Phalanges and Metacarpals, 1543
36.18 Closed Reduction and Internal Fixation, 1561
36.19 Open Reduction and Internal Fixation (Weber et al.; Boitzy), 1561
36.20 Valgus Subtrochanteric Osteotomy for Acquired Coxa Vara or Nonunion, 1561
36.21 Modified Pauwels Intertrochanteric Osteotomy for Acquired Coxa Vara or Nonunion (Magu et al.), 1564
36.22 Determining the Entry Point for Cannulated Screw Fixation of a Slipped Epiphysis (Canale et al.), 1569
36.23 Determining the Entry Point for Cannulated Screw Fixation of a Slipped Epiphysis (Morrissy), 1570
36.24 Positional Reduction and Fixation for SCFE (Chen, Schoenecker, Dobbs, et al.), 1572
36.25 Subcapital Realignment of the Epiphysis (Modified Dunn) for SCFE (Leunig, Slongo, and Ganz), 1573
36.26 Compensatory Basilar Osteotomy of the Femoral Neck (Kramer et al.), 1575
36.27 Extracapsular Base-of-Neck Osteotomy (Abraham et al.), 1576
36.28 Intertrochanteric Osteotomy (Imhäuser), 1578
36.29 Spica Cast Application, 1586
36.30 Flexible Intramedullary Nail Fixation, 1589
36.31 Closed or Open Reduction, 1595
36.32 Reconstruction of the Patellofemoral and Patellotibial Ligaments with a Semitendinosus Tendon Graft (Nietosvaara et al.), 1598
36.33 3-In-1 Procedure for Recurrent Dislocation of the Patella: Lateral Release, Vastus Medialis Obliquus Muscle Advancement, and Transfer of the Medial Third of the Patellar Tendon to the Medial Collateral Ligament (Oliva et al.), 1599
36.34 Open Reduction and Internal Fixation of Sleeve Fracture (Houghton and Ackroyd), 1600
36.35 Open Reduction and Internal Fixation of Tibial Eminence Fracture, 1602
36.36 Arthroscopic Reduction of Tibial Eminence Fracture and Internal Fixation with Bioabsorbable Nails (Liljeros et al.), 1603
36.37 Open Reduction and Internal Fixation, 1606
36.38 Open Reduction and Removal of Interposed Tissue (Weber et al.), 1611
36.39 Elastic Stable Intramedullary Nailing of Tibial Fracture (O’Brien et al.), 1614
36.40 Open Reduction and Internal Fixation, 1617
36.41 Open Reduction and Internal Fixation, 1618
36.42 Excision of Osteochondral Fragment of the Talus, 1625
36.43 Open Reduction and Internal Fixation of Cuboid Compression (Nutcracker) Fracture (Ceroni et al.), 1629
Anatomic Approaches to the Spine
37.1 Anterior Transoral Approach (Spetzler), 1648
37.2 Anterior Retropharyngeal Approach (McAfee et al.), 1649
37.3 Subtotal Maxillectomy (Cocke et al.), 1651
37.4 Extended Maxillotomy, 1652
37.5 Anterior Approach, C3 to C7 (Southwick and Robinson), 1653
37.6 Anterolateral Approach, C2 to C7 (Bruneau et al., Chibbaro et al.), 1655
37.7 Low Anterior Cervical Approach, 1657
37.8 High Transthoracic Approach, 1657
37.9 Transsternal Approach, 1657
37.10 Modified Anterior Approach to Cervicothoracic Junction (Darling et al.), 1658
37.11 Anterior Approach to the Cervicothoracic Junction Without Sternotomy (Pointillart et al.), 1659
37.12 Anterior Approach to the Thoracic Spine, 1661
37.13 Video-Assisted Thoracic Surgery (Mack et al.), 1661
37.14 Anterior Approach to the Thoracolumbar Junction, 1663
37.15 Minimally Invasive Approach to the Thoracolumbar Junction, 1663
37.16 Anterior Retroperitoneal Approach, L1 to L5, 1664
37.17 Percutaneous Lateral Approach, L1 to L4-5 (Ozgur et al.), 1667
37.18 Anterior Transperitoneal Approach, L5 to S1, 1669
37.19 Oblique Approach for Lumbar Interbody Fusion, L1-L5 and L5-S1 (Mehren et al.), 1670
37.20 Video-Assisted Lumbar Surgery (Onimus et al.), 1673
37.21 Posterior Approach to the Cervical Spine, Occiput to C2, 1673
37.22 Posterior Approach to the Cervical Spine, C3 to C7, 1674
37.23 Posterior Approach to the Thoracic Spine, T1 to T12, 1675
37.24 Costotransversectomy, 1676
37.25 Posterior Approach to the Lumbar Spine, L1 to L5, 1677
37.26 Paraspinal Approach to Lumbar Spine (Wiltse and Spencer), 1677
37.27 Posterior Approach to the Lumbosacral Spine, L1 to Sacrum (Wagoner), 1677
37.28 Posterior Approach to the Sacrum and Sacroiliac Joint (Ebraheim et al.), 1679
Degenerative Disorders of the Cervical Spine
38.1 Interlaminar Cervical Epidural Injection, 1688
38.2 Cervical Medial Branch Block Injection, 1689
38.3 Cervical Discography (Falco), 1690
38.4 Removal of Posterolateral Herniations by Posterior Approach (Posterior Cervical Foraminotomy), 1695
38.5 Minimally Invasive Posterior Cervical Foraminotomy with Tubular Distractors (Gala, O’Toole, Voyadzis, and Fessler), 1697
38.6 Full-Endoscopic Posterior Cervical Foraminotomy (Ruetten et al.), 1697
38.7 Tissue-Sparing Posterior Cervical Fusion (Mccormack and Dhawan), 1699
38.8 Smith-Robinson Anterior Cervical Fusion (Smith-Robinson et al.), 1703
38.9 Anterior Occipitocervical Arthrodesis by Extrapharyngeal Exposure (De Andrade and MacNab), 1705
38.10 Fibular Strut Graft in Cervical Spine Arthrodesis with Corpectomy (Whitecloud and Larocca), 1705
Degenerative Disorders of the Thoracic and Lumbar Spine
39.1 Myelography, 1724
39.2 Interlaminar Thoracic Epidural Injection, 1728
39.3 Interlaminar Lumbar Epidural Injection, 1729
39.4 Transforaminal Lumbar and Sacral Epidural Injection, 1730
39.5 Caudal Sacral Epidural Injection, 1730
39.6 Lumbar Intraarticular Injection, 1732
39.7 Lumbar Medial Branch Block Injection, 1732
39.8 Sacroiliac Joint Injection, 1734
39.9 Lumbar Discography (Falco), 1735
39.10 Thoracic Discography (Falco), 1736
39.11 Thoracic Costotransversectomy, 1738
39.12 Thoracic Discectomy—Anterior Approach, 1738
39.13 Thorascopic Thoracic Discectomy (Rosenthal et al.), 1740
39.14 Minimally Invasive Thoracic Discectomy, 1740
39.15 Transforaminal Endoscopic Thoracic Discectomy, 1741
39.16 Microscopic Lumbar Discectomy, 1747
39.17 Transforaminal Endoscopic Lumbar Discectomy, 1750
39.18 Interlaminar Endoscopic Lumbar Discectomy, 1750
39.19 Dural Repair Augmented with Fibrin Glue, 1754
39.20 Repeat Lumbar Disc Excision, 1755
39.21 Transthoracic Approach to the Thoracic Spine, 1756
39.22 Anterior Interbody Fusion of the Lumbar Spine (Goldner et al.), 1757
39.23 Percutaneous Anterior Lumbar Arthrodesis—Lateral Approach to L1 to L4-5, 1758
39.24 Hibbs Fusion (Hibbs, as Described by Howarth), 1759
39.25 Posterolateral Lumbar Fusion (Watkins), 1760
39.26 Intertransverse Lumbar Fusion (Adkins), 1761
39.27 Minimally Invasive Transforaminal Lumbar Interbody Fusion (Gardock), 1762
39.28 Pseudarthrosis Repair (Ralston and Thompson), 1764
39.29 Midline Decompression (Neural Arch Resection), 1780
39.30 Spinous Process Osteotomy (Decompression) (Weiner et al.), 1781
39.31 Microdecompression (McCulloch), 1782
39.32 Pedicle Subtraction Osteotomy (Bridwell et al.), 1792
39.33 Coccygeal Injection, 1795
Spondylolisthesis
40.1 Repair of Pars Interarticularis Defect with V-Rod Technique (Gillet and Petit), 1810
40.2 In Situ Posterolateral Instrumented Fusion: Wiltse and Spencer Approach, 1815
40.3 Posterior Instrumented Fusion with Interbody Fusion (PLIF and TLIF), 1815
40.4 L5-S1 Anterior Lumbar Interbody Fusion, 1818
40.5 Lumbar Decompression, 1823
40.6 Lumbar Decompression and Posterolateral Fusion with or without Instrumentation, 1824
40.7 Lumbar Decompression and Combined Posterolateral and Interbody Fusion (TLIF or PLIF), 1825
Fractures, Dislocations, and Fracture-Dislocations of the Spine
41.1 Stretch Test, 1838
41.2 Application of Gardner-Wells Tongs, 1843
41.3 Closed Reduction of the Cervical Spine, 1843
41.4 Halo Vest Application, 1848
41.5 Occipitocervical Fusion Using Modular Plate and Rod Construct, Segmental Fixation with Occipital Plating, C1 Lateral Mass Screw, C2 Isthmic (Pars) Screws, and Lateral Mass Fixation, 1851
41.6 Occipitocervical Fusion Using Wires and Bone Graft (Wertheim and Bohlman), 1853
41.7 Posterior Primary Osteosynthesis of C1 (Shatsky et al.), 1856
41.8 Anterior Odontoid Screw Fixation (Etter), 1858
41.9 Posterior C1-C2 Fusion Using Rod and Screw Construct with C1 Lateral Mass Screws (Harms), 1859
41.10 Posterior C1-C2 Fusion with C2 Translaminar Screws (Wright), 1862
41.11 Posterior C1-C2 Transarticular Screws (Magerl and Seemann), 1863
41.12 Posterior C1-C2 Fusion Using the Modified Gallie Posterior Wiring Technique (Gallie, Modified), 1863
41.13 Posterior C1-C2 Wiring (Brooks and Jenkins), 1864
41.14 Anterior Cervical Discectomy and Fusion with Plating, 1873
41.15 Cervical Corpectomy and Reconstruction with Plating, 1875
41.16 Lateral Mass Screw and Rod Fixation (Magerl), 1877
41.17 Thoracic and Lumbar Segmental Fixation with Pedicle Screws, 1888
41.18 Anterior Plating, 1891
41.19 Lumbopelvic Fixation (Triangular Osteosynthesis) (Shildhauer), 1895
Infections and Tumors of the Spine
42.1 Drainage of Retropharyngeal Abscess Through Posterior Triangle of the Neck, 1934
42.2 Anterior Cervical Approach to Drainage of Retropharyngeal Abscess, 1934
42.3 Costotransversectomy for Drainage of Dorsal Spine Abscess, 1935
42.4 Drainage of Paravertebral Abscess, 1935
42.5 Drainage Through the Petit Triangle, 1936
42.6 Drainage by Lateral Incision, 1936
42.7 Drainage by Anterior Incision, 1937
42.8 Coccygectomy for Drainage of a Pelvic Abscess (Lougheed and White), 1937
42.9 Radical Debridement and Arthrodesis (Roaf et al.), 1937
42.10 Anterior Excision of Spinal Tumor, 1949
42.11 Costotransversectomy for Intralesional Excision of Spinal Tumor, 1950
42.12 Transpedicular Intralesional Excision for Tumor of the Spine, 1950
Pediatric Cervical Spine
43.1 Posterior Atlantoaxial Fusion (Gallie), 1961
43.2 Posterior Atlantoaxial Fusion Using Laminar Wiring (Brooks and Jenkins), 1963
43.3 Translaminar Screw Fixation of C2, 1963
43.4 Occipitocervical Fusion, 1964
43.5 Occipitocervical Fusion Passing Wires Through Table of Skull (Wertheim and Bohlman), 1966
43.6 Occipitocervical Fusion Without Internal Fixation (Koop et al.), 1966
43.7 Occipitocervical Fusion Using Crossed Wiring (Dormans et al.), 1967
43.8 Occipitocervical Fusion Using Contoured Rod and Segmental Rod Fixation, 1969
43.9 Occipitocervical Fusion Using a Contoured Occipital Plate, Screw, and Rod Fixation, 1970
43.10 Transoral Approach (Fang and Ong), 1970
43.11 Transoral Mandible-Splitting and Tongue-Splitting Approach (Hall, Denis, and Murray), 1971
43.12 Lateral Retropharyngeal Approach (Whitesides and Kelly), 1972
43.13 Anterior Retropharyngeal Approach (McAfee et al.), 1974
43.14 Application of Halo Device (Mubarak et al.), 1976
43.15 Posterior Fusion of C3-7, 1985
43.16 Posterior Fusion of C3 to C7 Using 16-Gauge Wire and Threaded Kirschner Wires (Hall), 1985
43.17 Posterior Fusion with Lateral Mass Screw Fixation (Roy- Camille), 1986
43.18 Posterior Fusion with Lateral Mass Screw and Rod Fixation, 1986
43.19 Rib Resection (Bonola), 1987
43.20 Posterior Spinal Fusion for Cervical Kyphosis Through a Lateral Approach (Sakaura et al.), 1992
43.21 Sternal-Splitting Approach to the Cervicothoracic Junction (Mulpuri et al.), 1994
Scoliosis and Kyphosis
44.1 Casting for Idiopathic Scoliosis, 2002
44.2 Dual Growing Rod Instrumentation Without Fusion, 2007
44.3 Shilla Guided Growth System (McCarthy et al.), 2008
44.4 Growing Rod Attachment Using Rib Anchors (Sankar and Skaggs), 2010
44.5 Anterior Vertebral Tethering, 2012
44.6 Posterior Surgeries for Idiopathic Scoliosis, 2025
44.7 Facet Fusion (Moe), 2027
44.8 Facet Fusion (Hall), 2027
44.9 Autogenous Iliac Crest Bone Graft, 2028
44.10 Thoracic Pedicle Screw Insertion Techniques, 2035
44.11 Pedicle Hook Implantation, 2039
44.12 Transverse Process Hook Implantation, 2040
44.13 Laminar Hook Implantation, 2040
44.14 Sublaminar Wires, 2040
44.15 Instrumentation Sequence in Typical Lenke 1A Curve, 2043
44.16 Deformity Correction by Direct Vertebral Rotation, 2044
44.17 Halo-Gravity Traction (Sponseller and Takenaga), 2046
44.18 Temporary Distraction Rod (Buchowski et al.), 2048
44.19 Anterior Release (Letko et al.), 2050
44.20 Osteotomy in Complex Spinal Deformity (Ponte Osteotomy), 2050
44.21 Posterior Thoracic Vertebral Column Resection (Powers et al.), 2051
44.22 Osteotomy of the Ribs (Mann et al.), 2058
44.23 Thoracoabdominal Approach, 2059
44.24 Lumbar Extraperitoneal Approach, 2059
44.25 Disc Excision, 2060
44.26 Anterior Instrumentation of a Thoracolumbar Curve, 2060
44.27 Video-Assisted Thoracoscopic Discectomy (Crawford), 2065
44.28 Thoracoscopic Vertebral Body Instrumentation for Vertebral Body Tether (Picetti), 2067
44.29 Luque Rod Instrumentation and Sublaminar Wires Without Pelvic Fixation, 2074
44.30 Sacropelvic Fixation (McCarthy), 2075
44.31 Galveston Sacropelvic Fixation (Allen and Ferguson), 2076
44.32 Unit Rod Instrumentation with Pelvic Fixation, 2078
44.33 Iliac Fixation with Iliac Screws, 2079
44.34 Iliac and Lumbosacral Fixation with Sacral-Alar-Iliac Screws, 2081
44.35 Transpedicular Convex Anterior Hemiepiphysiodesis and Posterior Arthrodesis (King), 2098
44.36 Convex Anterior and Posterior Hemiepiphysiodeses and Fusion (Winter), 2099
44.37 Hemivertebra Excision: Anteroposterior Approach (Hedequist and Emans), 2102
44.38 Hemivertebra Excision: Lateral-Posterior Approach (Li et al.), 2105
44.39 Hemivertebra Excision: Posterior Approach (Hedequist, Emans, Proctor), 2105
44.40 Transpedicular Eggshell Osteotomies with Frameless Stereotactic Guidance (Mikles et al.), 2107
44.41 Expansion Thoracoplasty (Campbell), 2110
44.42 Anterior Release and Fusion, 2120
44.43 Posterior Multiple Hook and Screw Segmental Instrumentation (Crandall), 2120
44.44 Posterior Column Shortening Procedure for Scheuermann Kyphosis (Ponte et al.), 2122
44.45 Anterior Osteotomy and Fusion (Winter et al.), 2129
44.46 Anterior Cord Decompression and Fusion (Winter and Lonstein), 2129
44.47 Anterior Vascular Rib Bone Grafting (Bradford), 2130
44.48 Circumferential Decompression and Cantilever Bending (Chang et al.), 2132
44.49 Posterior Hemivertebra Resection with Transpedicular Instrumentation (Ruf and Harms), 2133
44.50 Spondylolysis Repair (Kakiuchi), 2142
44.51 Modified Scott Repair Technique (Van Dam), 2143
44.52 Intralaminar Screw Fixation of Pars Defect (Buck Screw Technique), 2144
44.53 Spondylolysis Repair with U-Rod or V-Rod (Sumita et al.), 2144
44.54 Posterolateral Fusion and Pedicle Screw Fixation (Lenke and Bridwell), 2147
44.55 Instrumented Reduction (Crandall), 2147
44.56 Reduction and Interbody Fusion (Smith et al.), 2150
44.57 One-Stage Decompression and Posterolateral Interbody Fusion (Bohlman and Cook), 2153
44.58 Uninstrumented Circumferential In Situ Fusion (Helenius et al.), 2154
44.59 L5 Vertebrectomy (Gaines), 2156
44.60 Posterior Instrumentation and Fusion, 2160
44.61 Vertebral Excision and Reduction of Kyphosis (Lindseth and Selzer), 2163
44.62 Open Biopsy of Thoracic Vertebra (Michele and Krueger), 2173
Campbell’s Operative Orthopaedics, 14th ed.
List of Techniques
VOLUME III
Knee Injuries
45.1 Open Meniscal Repair, 2222
45.2 Arthroscopic Partial Meniscectomy and Decompression of Meniscal Cyst, 2226
45.3 Excision of Meniscal Cyst, 2227
45.4 Repair of Medial Compartment Disruptions, 2244
45.5 Reconstruction of Medial Compartment (Slocum), 2252
45.6 Repair of Posteromedial Corner, 2256
45.7 Reconstruction of Posteromedial Corner (Hughston), 2257
45.8 Reconstruction of the Anterolateral Ligament, 2260
45.9 Repair of Lateral Compartment Disruptions, 2260
45.10 Reconstruction of the Posterolateral Structures for Mild-toModerate Posterolateral Instability (Hughston and Jacobson), 2267
45.11 Reconstruction of the Popliteal Tendon Using the Iliotibial Band for Posterolateral Instability (Müller), 2270
45.12 Rerouting of the Biceps Tendon to the Femoral Epicondyle for Posterolateral Instability (Clancy), 2273
45.13 Anatomic Posterolateral Knee Reconstruction for Grade III Posterolateral Injury (LaPrade et al.), 2275
45.14 Posterolateral Corner Reconstruction with a Single Allograft Fibular Sling (Yang et al.), 2276
45.15 Allograft Reconstruction of the Lateral Collateral Ligament (Noyes), 2277
45.16 Reconstruction of Posterolateral Structures with Semitendinosus Tendon (Larson), 2279
45.17 Valgus Tibial Osteotomy and Posterolateral Reconstruction, 2280
45.18 Repair of Bony Tibial Avulsions of Anterior Cruciate Ligament, 2287
45.19 Extraarticular Procedures (Iliotibial Band Tenodesis) (MacIntosh), 2289
45.20 Extraarticular Procedures (Iliotibial Band Tenodesis) (MacIntosh, Modified by Losee), 2289
45.21 Extraarticular Procedures (Iliotibial Band Tenodesis) (Andrews), 2290
45.22 Anterior Cruciate Ligament Reconstruction with Bone–Patellar Tendon-Bone Graft (Clancy, Modified), 2296
45.23 Anterior Cruciate Ligament Reconstruction with Hamstrings (with Proximal Release of Hamstrings), 2301
45.24 Repair of Bony Avulsion, 2316
45.25 Reconstruction of Posterior Cruciate Ligament with Patellar Tendon Graft (Clancy), 2319
45.26 Reconstruction of Posterior Cruciate Ligament with Patellar Tendon Graft (Sallay and McCarroll), 2321
45.27 Reconstruction of Posterior Cruciate Ligament with Bone-Patellar Tendon-Bone or Achilles Tendon-Bone Grafts (Berg), 2326
45.28 Reconstruction of Posterior Cruciate Ligament with Bone-Patellar Tendon-Bone or Achilles Tendon-Bone Grafts (Burks and Schaffer), 2327
45.29 Subperiosteal Release of the Lateral Quadriceps Mechanism (Ogata), 2348
45.30 Advancement of the Tibial Tuberosity (Maquet), 2351
45.31 Patellectomy (Soto-Hall), 2352
45.32 Thompson Quadricepsplasty (Thompson), 2353
45.33 Mini-Invasive Quadricepsplasty (Wang, Zhao, He), 2353
45.34 Posterior Capsulotomy (Putti, Modified), 2356
45.35 Posterior Capsulotomy (Yount), 2356
Shoulder and Elbow Injuries
46.1 Open Anterior Acromioplasty, 2388
46.2 Open Repair of Rotator Cuff Tears, 2392
46.3 Latissimus Dorsi Transfer (Gerber et al.), 2397
46.4 Decompression and Debridement of Massive Rotator Cuff Tears (Rockwood et al.), 2398
46.5 Closed Manipulation, 2402
46.6 Posterior Surgical Approach for Quadrilateral Space Syndrome (Cahill and Palmer), 2406
46.7 Posterior Surgical Approach for Suprascapular Nerve Entrapment (Post and Mayer), 2407
46.8 Suprascapular Notch Decompression, 2408
46.9 Spinoglenoid Notch Decompression, 2408
46.10 Removal of a Ganglion from the Inferior Branch of the Suprascapular Nerve (Thompson et al.), 2409
46.11 Correction of Tennis Elbow (Nirschl, Modified), 2412
46.12 Correction of Medial Epicondylitis (Nirschl), 2413
46.13 Anterior and Posterior Release of Elbow Contracture (Morrey), 2416
46.14 Excision of Heterotopic Ossification (Morrey and Harter), 2418
Recurrent Dislocations
47.1 Medial Quadriceps Tendon-Femoral Ligament Reconstruction (Phillips), 2432
47.2 Distal Realignment, 2434
47.3 Fulkerson Osteotomy, 2435
47.4 Trochleoplasty, 2435
47.5 Modified Bankart Repair (Montgomery and Jobe), 2448
47.6 Anterior Stabilization with Associated Glenoid Deficiency (Laterjet Procedure) (Walch and Boileau), 2450
47.7 Reconstruction of Anterior Glenoid Using Iliac Crest Bone Autograft (Warner et al.), 2453
47.8 Capsular Shift (Neer and Foster), 2454
47.9 Neer Inferior Capsular Shift Procedure Through a Posterior Approach (Neer and Foster), 2457
47.10 Tibone and Bradley Technique (Tibone and Bradley), 2459
47.11 Capsular Shift Reconstruction with Posterior Glenoid Osteotomy (Rockwood), 2460
47.12 McLaughlin Procedure (McLaughlin), 2461
47.13 Ulnar Collateral Ligament Reconstruction—Modified Jobe Technique, 2467
47.14 Ulnar Collateral Ligament Reconstruction—Andrews et al Technique, 2468
47.15 Ulnar Collateral Ligament Reconstruction (Altchek et al.), 2470
47.16 Ulnar Collateral Ligament Repair With an Internal Brace (Dugas et al.), 2472
47.17 Lateral Ulnar Collateral Ligament Reconstruction for Posterolateral Rotatory Instability (Nestor, Morrey, and O’Driscoll), 2473
Traumatic Disorders
48.1 Fasciotomy for Acute Compartment Syndrome of the Thigh (Tarlow et al.), 2482
48.2 Single-Incision Fasciotomy for Lower Leg Compartment Syndrome (Davey et al.), 2483
48.3 Double-Incision Fasciotomy for Lower Leg Compartment Syndrome (Mubarak and Hargens), 2484
48.4 Double Mini-Incision Fasciotomy for Chronic Anterior Compartment Syndrome (Mouhsine et al.), 2487
48.5 Single-Incision Fasciotomy for Chronic Anterior and Lateral Compartment Syndrome (Fronek et al.), 2487
48.6 Double-Incision Fasciotomy for Chronic Posterior Compartment Syndrome (Rorabeck), 2489
48.7 Open Repair of Acute Achilles Tendon Rupture, 2493
48.8 Open Repair of Achilles Tendon Rupture—Krackow et al., 2494
48.9 Open Repair of Achilles Tendon Rupture—Lindholm, 2494
48.10 Repair of Acute Achilles Tendon Rupture Using Plantaris Tendon (Lynn), 2495
48.11 Dynamic Loop Suture Technique for Acute Achilles Tendon Rupture (Teuffer), 2495
48.12 Minimally Invasive and Percutaneous Repair of Acute Achilles Tendon Rupture (Ma and Griffith), 2496
48.13 Percutaneous Achilles Tendon Repair (Hsu, Berlet, Anderson), 2497
48.14 Transfer of the Peroneus Brevis Tendon for Neglected Achilles Tendon Ruptures (Maffulli et al.), 2500
48.15 Direct Repair of Neglected Achilles Tendon Ruptures, 2502
48.16 Repair of Neglected Achilles Tendon Ruptures Using Peroneus Brevis and Plantaris Tendons (White and Kraynick; Teuffer, Modified), 2502
48.17 Repair of Neglected Achilles Tendon Ruptures Using Gastrocnemius-Soleus Turn-Down Graft (Bosworth), 2503
48.18 V-Y Repair of Neglected Achilles Tendon Ruptures (Abraham and Pankovich), 2503
48.19 Repair of Neglected Achilles Tendon Ruptures Using Flexor Hallucis Longus Tendon Transfer (Wapner et al.), 2504
48.20 Tenotomy and Repair for Chronic Patellar Tendinosis, 2507
48.21 Fixation of Patellar Stress Fracture, 2507
48.22 Suture Repair of Patellar Tendon Rupture, 2509
48.23 Suture Anchor Repair of Patellar Tendon Rupture (DeBerardino and Owens), 2510
48.24 Achilles Tendon Allograft for Chronic Patellar Tendon Rupture, 2511
48.25 Hamstring (Semitendinosus and Gracilis) Autograft Augmentation for Chronic Patellar Tendon Rupture (Ecker, Lotke, and Glazer), 2513
48.26 Hamstring Autograft Augmentation for Chronic Patellar Tendon Rupture (Mandelbaum et al.), 2514
48.27 Repair of Acute Rupture of the Tendon of the Quadriceps Femoris Muscle, 2514
48.28 Repair of Proximal Hamstring Avulsion (Birmingham et al.), 2518
48.29 Open Repair of Proximal Hamstring Avulsion (Bowman et al.), 2519
48.30 Endoscopic Repair of Proximal Hamstring Avulsion (Bowman et al.), 2519
48.31 Repair of Proximal Biceps Tendon Rupture, 2521
48.32 Subpectoral Biceps Tenodesis (Mazzoca et al.), 2521
48.33 Two-Incision Technique for Repair of the Distal Biceps Tendon (Boyd and Anderson), 2524
48.34 Single-Incision Technique for Repair of the Distal Biceps Tendon, 2525
48.35 Double-Row Repair of the Distal Triceps Tendon, 2526
48.36 Repair of the Superior Peroneal Retinaculum, 2529
48.37 Fibular Groove Deepening with Tissue Transfer (Periosteal Flap) for Recurrent Peroneal Tendon Dislocation (Zoellner and Clancy), 2529
48.38 Indirect (Impaction) Fibular Groove Deepening for Peroneal Tendon Dislocation (Shawen and Anderson), 2530
48.39 Achilles Tendon Augmentation of Superior Peroneal Retinaculum Repair (Jones), 2531
48.40 Treatment of Biceps Brachii Tendon Displacement, 2532
Arthroscopy of the Foot and Ankle
50.1 Arthroscopic Examination And Debridement of the Ankle Joint, 2553
50.2 Posterior Debridement For Ankle Impingement, 2558
50.3 Posterior Arthroscopic Subtalar Arthrodesis (Devos-bevernage et al.), 2562
50.4 Subtalar Arthroscopy, 2564
50.5 First Metatarsophalangeal Joint Arthroscopy, 2565
50.6 Tendoscopic Recession of the Gastrocnemius Tendon, 2568 Arthroscopy of the Lower Extremity
51.1 Resection of Bucket-Handle Tear, 2585
51.2 Removal of Posterior Horn Tear, 2586
51.3 Treatment of Partial Depth Meniscal Tears, 2587
51.4 Partial Excision of the Discoid Meniscus, 2588
51.5 Inside-To-Outside Technique, 2590
51.6 Outside-To-Inside Technique, 2592
51.7 Lateral Meniscal Suturing, 2593
51.8 Outside-In Repair of Complete Radial Tear of the Lateral Meniscus (Steiner et al.), 2594
51.9 Transtibial Pull-out Repair of Radial or Meniscal Root Tear (Phillips), 2597
51.10 Meniscal Replacement, 2599
51.11 Removal of Loose Bodies, 2601
51.12 Resection of Plica, 2603
51.13 Arthroscopic Drilling of an Intact Lesion of the Femoral Condyle, 2605
51.14 Arthroscopic Screw Fixation for Osteochondritis Dissecans Lesions In the Medial Femoral Condyle, 2605
51.15 Osteochondral Autograft Transfer, 2606
51.16 Anatomic Single-Bundle Endoscopic Anterior Cruciate Ligament Reconstruction Using Bone–Patellar Tendon–Bone Graft, 2610
51.17 Two-Incision Technique for Anterior Cruciate Ligament Reconstruction Using Bone–Patellar Tendon–Bone Graft, 2616
51.18 Endoscopic Quadruple Hamstring Graft, 2618
51.19 All-Inside Quadruple Hamstring Graft Anterior Cruciate Ligament Reconstruction, 2619
51.20 Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction (Karlsson et al.), 2620
51.21 Transepiphyseal Replacement of Anterior Cruciate Ligament Using Quadruple Hamstring Grafts (Anderson), 2623
51.22 Physeal-Sparing Reconstruction of the Anterior Cruciate Ligament (Kocher, Garg, and Micheli), 2625
51.23 Partial Transepiphyseal ACL Reconstruction In Skeletally Immature Athletes (Azar and Miller), 2626
51.24 Anterior Cruciate and Anterolateral Ligament Reconstruction (Phillips), 2627
51.25 Single-Tunnel Posterior Cruciate Ligament Reconstruction (Phillips), 2631
51.26 Double-Tunnel Posterior Cruciate Ligament Reconstruction (Laprade et al.), 2633
51.27 Lateral Retinacular Release, 2637
51.28 Synovectomy, 2638
51.29 Drainage and Debridement in Pyarthrosis, 2638
51.30 Arthroscopically Assisted Fracture Reduction and Percutaneous Fixation (Caspari et al.), 2639
51.31 Arthroscopic Lysis and Excision of Adhesions (Sprague), 2639
51.32 Supine Position Arthroscopy (Byrd), 2642
51.33 Lateral Position Arthroscopy (Glick et al.), 2645
51.34 Arthroscopic Repair of Labral Tears (Kelly et al.), 2649
51.35 Arthroscopic Treatment of Pincer Impingement (Larson), 2652
51.36 Arthroscopic Treatment of Cam Impingement (Mauro et al.), 2652
51.37 Arthroscopic Labral Reconstruction (Matsuda), 2653
51.38 Repair of the Adductor Tendon (Byrd), 2655
51.39 Treatment of External Snapping Hip (Ilizaliturri et al), 2655
51.40 Psoas Release at the Lesser Trochanter, 2656
51.41 Psoas Release at the Joint Level (Wettstein et al.), 2656
Arthroscopy of the Upper Extremity
52.1 Establishing a Posterior Portal, 2667
52.2 Antegrade Method, 2668
52.3 Retrograde Method, 2668
52.4 Establishing the Superior Portal (Neviaser), 2669
52.5 Arthroscopic Removal of Loose Body, 2671
52.6 Arthroscopic Fixation of Type Ii Slap Lesions (Modified from Burkhart, Morgan, and Kibler), 2673
52.7 Biceps Tendon Release, 2678
52.8 Arthroscopic Biceps Tenodesis: Percutaneous Intraarticular Transtendon Technique (Sekiya et al.), 2680
52.9 Arthroscopic “Loop ‘n’ Tack” Tenodesis (Duerr et al.), 2680
52.10 Biceps Tenodesis: Arthroscopic or Mini-Open Technique with Screw Fixation (Romeo et al. Modified), 2682
52.11 Arthroscopic Bankart Repair Technique, 2684
52.12 Posterior Shoulder Stabilization (Kim et al.), 2692
52.13 Capsular Shift, 2694
52.14 Arthroscopic Repair of Posterior Humeral Avulsion of the Glenohumeral Ligament, 2695
52.15 Remplissage (Purchase et al. [Wolf] Technique), 2695
52.16 Transosseous Bony Bankart Repair (Driscoll, Burns, and Snyder), 2697
52.17 Arthroscopic Subacromial Decompression and Acromioplasty, 2700
52.18 Chock-Block Method for Acromioplasty, 2702
52.19 Debridement of Partial-Thickness Rotator Cuff Tears, 2703
52.20 Repair of Delamination and Localized, Articular-Side PartialThickness Cuff Tears, 2704
52.21 Transtendinous Repair of A Partial Articular-Side Supraspinatus Tendon Avulsion Lesion, 2704
52.22 Rotator Cuff Repair, 2713
52.23 Repair of Large or Massive Contracted Tears Using the Interval Slide Technique (Tauro et al.), 2716
52.24 Superior Capsule Reconstruction, 2717
52.25 Subscapularis Tendon Repair (Burkhart and Tehrany), 2721
52.26 Arthroscopic Resection of the Distal End of the Clavicle (Mumford Procedure) (Tolin and Snyder), 2724
52.27 Superior Approach (Flatow et al.), 2726
52.28 Arthroscopically Assisted AC Joint Reconstruction, 2726
52.29 Release of Calcific Tendinitis, 2727
52.30 Capsular Release (Scarlat and Harryman), 2730
52.31 Suprascapular Nerve Release (Lafosse, Tomasi, and Corbett), 2731
52.32 Scapulothoracic Bursectomy, 2733
52.33 Arthroscopic Elbow Examination, 2739
52.34 Arthroscopic Treatment of Osteochondritis Dissecans, 2744
52.35 Osteochondral Autograft Transfer (Yamamoto et al.), 2744
52.36 Removal of Olecranon Tip and Osteophytes, 2746
52.37 Resection of Thickened Pathologic Synovial Plica, 2747
52.38 Arthroscopy for Arthrofibrosis (Phillips and Strasburger), 2747
52.39 Arthroscopic Tennis Elbow Release (Baker and Cummings), 2749
52.40 Arthroscopic Bursectomy (Baker and Cummings), 2750
General Principles of Fracture Treatment
53.1 Percutaneous Drainage of a Morel-Lavallée Lesion (Tseng and Tornetta), 2771
53.2 Irrigation and Debridement of Open Wounds, 2774
53.3 Harvest of Femoral or Tibial Bone Graft with the RIA Instrumentation, 2779
53.4 Screw Fixation, 2790
53.5 ASIF Cancellous Screw Technique, 2791
53.6 Pin Insertion, 2804
Fractures of the Lower Extremity
54.1 Fixation of the Lateral Malleolus, 2818
54.2 Fixation of the Medial Malleolus, 2819
54.3 Repair of the Deltoid Ligament and Internal Fixation of the Lateral Malleolus, 2821
54.4 Reduction and Fixation of Posterior Malleolar Fracture, 2823
54.5 Reduction and Fixation of Anterior Tibial Margin Fractures, 2824
54.6 Stabilization of Unstable Ankle Fracture-Dislocation (Childress), 2826
54.7 Staged Minimally Invasive Open Reduction and Internal Fixation, 2831
54.8 Posterolateral Approach to Pilon Fractures, 2832
54.9 Spanning External Fixation of Tibial Pilon Fracture (Bonar and Marsh), 2835
54.10 Definitive Ring External Fixation of Tibial Pilon Fractures (Watson), 2837
54.11 Intramedullary Nailing of Tibial Shaft Fractures, 2848
54.12 External Fixation for Tibial Shaft Fractures, 2854
54.13 Ilizarov External Fixation for Tibial Shaft Fractures, 2857
54.14 Open Reduction and Fixation of a Lateral Tibial Plateau Fracture, 2869
54.15 Posteromedial Exposure, 2871
54.16 Open Reduction and Internal Fixation of Bicondylar Injuries, 2872
54.17 Circular External Fixation (Watson), 2872
54.18 Common Approach and Technique for Patellar Fractures, 2876
54.19 Circumferential Wire Loop Fixation (Martin), 2876
54.20 Tension Band Wiring Fixation, 2877
54.21 Partial Patellectomy, 2879
54.22 Partial Patellectomy Using Figure-of-Eight Load-Sharing Wire or Cable (Perry et al.), 2879
54.23 Total Patellectomy, 2880
54.24 Fracture Fixation of the Medial Condyle, 2884
54.25 Fracture Fixation of the Posterior Part of the Medial Condyle, 2885
54.26 Swashbuckler Approach to the Distal Femur (Starr et al.), 2886
54.27 Submuscular Minimally Invasive Locking Condylar Plate Application, 2887
54.28 Double Plate Fixation (Chapman and Henley), 2888
54.29 Antegrade Femoral Nailing, 2895
54.30 Retrograde Femoral Nailing, 2901
54.31 Extraction of an Unbroken Antegrade Femoral Nail, 2904
54.32 Extraction of a Broken Femoral Antegrade Nail, 2904 Fractures and Dislocations of the Hip
55.1 Fixation of Femoral Neck Fracture with Cannulated Screws, 2912
55.2 Open Reduction and Internal Fixation (Modified Smith-Petersen), 2914
55.3 Fluoroscopically Guided Capsulotomy of the Hip, 2918
55.4 Screw–Side Plate Fixation of Intertrochanteric Femoral Fractures, 2925
55.5 Intramedullary Nailing of Intertrochanteric Femoral Fractures, 2929
55.6 Intramedullary Nailing of Intertrochanteric Femoral Fractures With Integrated Proximal Interlocking Screws (Intertan), 2933
55.7 Intramedullary Nailing in Reconstruction Mode, 2935
55.8 Fixation of Subtrochanteric Femoral Fracture with a Proximal Femoral Locking Plate, 2938
55.9 Fixation of Subtrochanteric Femoral Fracture with a Blade Plate, 2940
55.10 Open Reduction of Posterior Hip Dislocation Through a Posterior Approach, 2948
Fractures of the Acetabulum and Pelvis
56.1 Anterior Intra-Pelvic Approach, 2973
56.2 Fixation of Comminuted Posterior Wall Fracture with or without a Transverse Component, 2988
56.3 Anterior Approach for Total Hip Arthroplasty for Fractures Involving Primarily the Anterior Wall and Column (Beaulé et al.), 2988
56.4 Gluteal Pillar External Fixation, 3008
56.5 Supra-Acetabular External Fixation, 3008
56.6 Anterior Subcutaneous Internal Fixation (Vaidya et al.), 3010
56.7 Pelvic Clamps (Ganz et al.), 3011
56.8 Open Reduction and Internal Fixation of the Pubic Symphysis, 3015
56.9 Internal Fixation: Posterior Approach and Fixation of Sacral Fractures and Sacroiliac Dislocations (Prone) (Matta and Saucedo), 3016
56.10 Percutaneous Iliosacral Screw Fixation of Sacroiliac Disruptions and Sacral Fractures (Supine), 3017
56.11 Anterior Approach and Stabilization of the Sacroiliac Joint (Simpson et al.), 3019
Fractures of the Shoulder, Arm, and Forearm
57.1 Open Reduction and Internal Fixation of Clavicular Fractures (Collinge et al., Modified), 3034
57.2 Intramedullary Fixation with a Headed, Distally Threaded Pin (Rockwood Clavicle Pin), 3036
57.3 Distal Clavicular Fracture Repair with Coracoclavicular Ligament Reconstruction and Cortical Button Fixation (Yagnik et al.), 3039
57.4 Intramedullary Nailing of a Proximal Humeral Fracture, 3053
57.5 Open Reduction and Internal Fixation of Proximal Humeral Fractures, 3054
57.6 Anterolateral Acromial Approach for Internal Fixation of Proximal Humeral Fracture (Gardner et al.; Mackenzie), 3055
57.7 Open Reduction and Internal Fixation of the Humeral Shaft Through a Modified Posterior Approach (Triceps-Reflecting), 3062
57.8 Minimally Invasive Plate Osteosynthesis (Apivatthakakul et al.; Tetsworth et al.), 3064
57.9 Antegrade Intramedullary Nailing of Humeral Shaft Fractures, 3067
57.10 Open Reduction and Internal Fixation of the Distal Humerus with Olecranon Osteotomy, 3076
57.11 Open Reduction and Internal Fixation of Radial Head Fracture, 3081
57.12 Stabilization of “Terrible Triad” Elbow Fracture-Dislocation (McKee et al.), 3084
57.13 Internal Joint Stabilization for Elbow Instability (Orbay et al.), 3088
57.14 Open Reduction and Internal Fixation of Olecranon Fracture, 3093
57.15 Open Reduction and Internal Fixation of Both-Bone Forearm Fractures, 3097
57.16 Closed Reduction and Percutaneous Pinning of Distal Radial Fracture (Glickel et al.), 3103
57.17 External Fixation of Fracture of the Distal Radius, 3105
57.18 Volar Plate Fixation of Fracture of the Distal Radius (Chung), 3108
57.19 Distraction Plate Fixation (Burke and Singer as Modified by Ruch et al.), 3111
Malunited Fractures
58.1 Correction of Metatarsal Angulation, 3129
58.2 Correction of Tarsal Malunion, 3129
58.3 Posterior Subtalar Arthrodesis (Gallie), 3131
58.4 Distraction Arthrodesis (Carr et al.), 3132
58.5 Resection of Lateral Prominence of Calcaneus (Kashiwagi, Modified), 3133
58.6 Correction of Calcaneal Malunion Through Extensile Lateral Approach (Clare et al.), 3134
58.7 Correction of Valgus Malunion of Extraarticular Calcaneal Fracture (Aly), 3136
58.8 Osteotomy for Bimalleolar Fracture, 3138
58.9 Correction of Diastasis of the Tibia and Fibula, 3139
58.10 Supramalleolar Osteotomy, 3139
58.11 Oblique Tibial Osteotomy (Sanders et al.), 3142
58.12 Clamshell Osteotomy (Russell et al.), 3145
58.13 Subcondylar Osteotomy and Wedge Graft for Malunion of Lateral Condyle, 3149
58.14 Osteotomy and Internal Fixation of the Lateral Condyle, 3149
58.15 Open Reduction and Internal Fixation, 3150
58.16 Osteotomy for Femoral Malunion, 3152
58.17 Osteotomy for Femoral Malunion in Children, 3155
58.18 Correction of Cervicotrochanteric Malunion, 3157
58.19 Osteotomy and Reorientation of Scapular Neck (Cole et al.), 3160
58.20 Osteotomy and Plate Fixation, 3161
58.21 Osteotomy and Elastic Intramedullary Nailing of Midshaft Clavicular Fracture (Smekal et al.), 3164
58.22 Closing Wedge Valgus Osteotomy for Varus Malunion of Proximal Humerus (Benegas et al., Modified), 3168
58.23 Correction of Proximal Third Humeral Malunion, 3169
58.24 Correction of Radial Neck Malunion (Inhofe and Moneim, Modified), 3170
58.25 Osteotomy and Fixation of Monteggia Fracture Malunion, 3170
58.26 Resection of Proximal Part of Radial Shaft (Kamineni et al.), 3172
58.27 Osteotomy and Plating for Forearm Malunion (Trousdale and Linscheid, Modified), 3173
58.28 Correction of Forearm Malunion with Distal Radioulnar Joint Instability (Trousdale and Linscheid, Modified), 3174
58.29 Drill Osteoclasis (Blackburn et al.), 3174
58.30 Opening Wedge Metaphyseal Osteotomy with Bone Grafting And Internal Fixation with Plate and Screws (Fernandez), 3179
58.31 Volar Osteotomy (Shea et al.), 3180
58.32 Intramedullary Fixation, 3182
58.33 External Fixation (Melendez), 3183
58.34 Osteotomy for Intraarticular Malunion (Marx and Axelrod), 3184
58.35 Radiolunate Arthrodesis (Saffar), 3185
58.36 Ulnar Shortening Osteotomy (Milch), 3186
58.37 Resection of the Distal Ulna (Darrach), 3187
Delayed Union and Nonunion of Fractures
59.1 Decortication, 3199
59.2 Fibular Autograft (Nonvascularized), 3200
59.3 Intramedullary Fibular Strut Allograft (Humerus) (Willis et al.), 3200
59.4 Resection of the Distal Fragment of the Medial Malleolus, 3210
59.5 Sliding Graft, 3210
59.6 Bone Graft of Medial Malleolar Nonunion (Banks), 3211
59.7 Posterolateral Bone Grafting, 3212
59.8 Anterior Central Bone Grafting, 3212
59.9 Percutaneous Bone Marrow Injection (Connolly et al., Brinker et al.), 3213
59.10 Tibial Exchange Nailing, 3214
59.11 Plate Fixation and Bone Grafting of the Clavicle, 3222
Acute Dislocations
60.1 Open Reduction and Repair of Patellar Dislocation, 3230
60.2 Grafting of the Medial Patellar Retinaculum, 3231
60.3 Open Reduction and Repair of the Extensor Mechanism, 3231
60.4 Open Reduction of Hip Dislocation, 3236
60.5 Anatomic Reconstruction of the Conoid and Trapezoid Ligaments (Mazzocca et al.), 3240
60.6 Open Reduction of Radial Head Dislocation, 3242
Old Unreduced Dislocations
61.1 Ligamentous Reconstruction for Old Unreduced Dislocation of the Proximal Tibiofibular Joint, 3247
61.2 Open Reduction for Old Unreduced Dislocation of the Knee, 3247
61.3 Open Reduction for Old Unreduced Dislocation of the Patella, 3249
61.4 Intertrochanteric Osteotomy for Chronic Anterior Dislocation of the Hip (Aggarwal and Singh), 3249
61.5 Traction and Abduction for Chronic Posterior Hip Dislocation (Gupta and Shravat), 3250
61.6 Resection or Stabilization of the Medial End of the Clavicle for Old Anterior Sternoclavicular Joint Dislocation, 3251
61.7 Stabilization of Old Posterior Sternoclavicular Joint Dislocation (Wang et al.), 3252
61.8 Resection of the Lateral End of the Clavicle for Chronic Acromioclavicular Joint Dislocation (Mumford; Gurd), 3253
61.9 Reconstruction of the Superior Acromioclavicular Ligament for Chronic Acromioclavicular Joint Dislocation (Neviaser), 3254
61.10 Transfer of the Coracoacromial Ligament for Chronic Acromioclavicular Joint Dislocation (Rockwood), 3255
61.11 Arthroscopic Transfer of the Coracoacromial Ligament for Chronic Acromioclavicular Joint Dislocation (Boileau et al.), 3256
61.12 Open Reduction of Chronic Anterior Shoulder Dislocations (Rowe and Zarins), 3261
61.13 Open Reduction of Chronic Posterior Shoulder Dislocation from a Superior Approach (Rowe and Zarins), 3262
61.14 Open Reduction of Chronic Posterior Shoulder Dislocation Through an Anteromedial Approach (McLaughlin), 3263
61.15 Deltopectoral Approach for Chronic Posterior Shoulder Dislocation (Keppler et al.), 3264
61.16 Open Reduction and V-Y Lengthening of Triceps Muscles for Chronic Elbow Dislocation (Speed), 3266
Campbell’s Operative Orthopaedics, 14th ed.
List of Techniques
VOLUME IV
Peripheral Nerve Injuries
62.1 Epineurial Neurorrhaphy, 3292
62.2 Perineurial (Fascicular) Neurorrhaphy, 3292
62.3 Interfascicular Nerve Grafting (Millesi, Modified), 3293
62.4 Transfer of the Ulnar Nerve Fascicles to Nerve of the Biceps Muscle (Oberlin et al.), 3295
62.5 Double Fascicular Transfer from Ulnar and Median Nerves to Nerve of the Brachialis Branches (MacKinnon and Colbert), 3296
62.6 Neurotization of the Suprascapular Nerve with the Spinal Accessory Nerve (MacKinnon and Colbert), 3297
62.7 Neurotization of the Axillary Nerve with Radial Nerve (MacKinnon and Colbert), 3298
62.8 Posterior Approach for Division of the Transverse Scapular Ligament (Swafford and Lichtman), 3300
62.9 Approach to the Axillary Nerve, 3301
62.10 Approach to the Musculocutaneous Nerve, 3302
62.11 Approach to the Radial Nerve, 3303
62.12 Approach to the Ulnar Nerve, 3306
62.13 Nerve Transfer for Ulnar Nerve Reconstruction (MacKinnon and Novak), 3308
62.14 Approach to the Median Nerve, 3309
62.15 Approach to the Femoral Nerve, 3312
62.16 Approach to the Sciatic Nerve, 3314
62.17 Approach to the Common, Superficial, and Deep Peroneal Nerves, 3316
62.18 Approach to the Tibial Nerve Deep to the Soleus Muscle, 3318
Microsurgery
63.1 Microvascular Anastomosis (End-to-End), 3325
63.2 Microvascular End-to-Side Anastomosis, 3326
63.3 Microvascular Vein Grafting, 3327
63.4 Preparation for Replantation, 3334
63.5 Vessel Repair in Replantation, 3337
63.6 Nerve Repair for Replantation, 3338
63.7 Reoperation, 3340
63.8 Pocket Technique for Microvascular Anastomosis (Arata et al.), 3341
63.9 Dissection for Free Groin Flap, 3347
63.10 Dissection for Anterolateral Thigh Flap (Javaid and Cormack), 3349
63.11 Dissection for Scapular and Parascapular Flap (Gilbert; Urbaniak et al.), 3350
63.12 Dissection for Lateral Arm Flap, 3351
63.13 Dissection for Latissimus Dorsi Transfer, 3354
63.14 Dissection for Serratus Anterior Flap, 3356
63.15 Dissection for Tensor Fasciae Latae Muscle Flap, 3357
63.16 Dissection for Gracilis Muscle Transfer, 3359
63.17 Dissection for Rectus Abdominis Transfer, 3360
63.18 Transfer of Functioning Muscle (Forearm Preparation), 3361
63.19 Posterior Approach for Harvesting Fibular Graft (Taylor), 3365
63.20 Lateral Approach for Harvesting Fibular Graft (Gilbert; Tamai et al.; Weiland), 3365
63.21 Distal Tibiofibular Fusion to Prevent Progressive Valgus Deformity, 3368
63.22 Free Iliac Crest Bone Graft (Taylor, Townsend, and Corlett; Daniel; Weiland et al.), 3369
63.23 Harvesting of Medial Femoral Condyle Corticoperiosteal Free Flap, 3369
63.24 Medial Femoral Condyle Corticoperiosteal Free Flap for Scaphoid Arthroplasty (Higgins and Burger), 3370
63.25 Dorsalis Pedis Free Tissue Transfer, 3374
63.26 Neurovascular Free Flap Transfer First Web Space, 3377
63.27 Great Toe Wraparound Flap Transfer (Morrison et al., Urbaniak et al., Steichen), 3378
63.28 Single-Stage Great Toe Transfer (Buncke, Modified), 3382
63.29 Trimmed-Toe Transfer (Wei et al.), 3384
63.30 Second or Third Toe Transplantation, 3386
Basic Surgical Technique and Postoperative Care
64.1 Midlateral Finger Incision, 3405
64.2 Z-Plasty, 3409
Acute Hand Injuries
65.1 Applying Split-Thickness Grafts, 3424
65.2 Applying Full-Thickness Grafts, 3425
65.3 Applying Cross Finger Flaps, 3427
65.4 Applying a Radial Forearm Graft (Foucher et al.), 3430
65.5 Applying a Posterior Interosseous Flap (Zancolli and Angrigiani; Chen et al.), 3433
65.6 Applying a Random Pattern Abdominal Pedicle Flap, 3435
65.7 Groin Pedicle Flap, 3436
65.8 Hypogastric (Superficial Epigastric) Flap, 3438
65.9 Applying a Filleted Graft, 3439
Flexor and Extensor Tendon Injuries
66.1 Modified Kessler-Tajima Suture (Strickland, 1995), 3447
66.2 Flexor Tendon Repair Using Six-Strand Repair (Adelaide Technique) (Savage), 3448
66.3 Four- or Six-Strand Repair (Chung, Modified Tsuge), 3449
66.4 Multiple Looped Suture Tendon Repair (Tang et al.), 3449
66.5 Six-Strand Double-Loop Suture Repair (Lim and Tsai), 3449
66.6 Eight-Strand Repair (Winters and Gelberman), 3450
66.7 End-to-Side Repair, 3451
66.8 Roll Stitch, 3452
66.9 Pull-Out Technique for Tendon Attachment, 3452
66.10 Repair in Zones I and Ii, 3458
66.11 Repair in Zones III, IV, and V, 3461
66.12 Profundus Advancement (Wagner), 3467
66.13 Reconstruction of Finger Flexors: Single-Stage Tendon Graft, 3468
66.14 Reconstruction of Flexor Tendon Pulleys, 3473
66.15 Stage 1: Excision of Tendon and Scar and Reconstruction of Flexor Pulley, 3475
66.16 Stage 2: Rod Removal and Tendon Graft Insertion, 3477
66.17 Flexor Tendon Graft, 3478
66.18 Two-Stage Flexor Tendon Graft for Flexor Pollicis Longus (Hunter), 3478
66.19 Transfer of Ring Finger Flexor Sublimis to Flexor Pollicis Longus, 3479
66.20 Flexor Tenolysis After Repair and Grafting, 3480
66.21 Freeing of Adherent Tendon (Howard), 3480
66.22 Tenodesis, 3481
66.23 Chronic Mallet Finger (Secondary Repair), 3484
66.24 Chronic Mallet Finger (Secondary Repair) (Fowler), 3485
66.25 Tendon Transfer for Correction of Old Mallet Finger Deformity (Milford), 3486
66.26 Tendon Graft for Correction of Old Mallet Finger Deformity, 3486
66.27 Repair of Central Slip of the Extensor Expansion Causing Boutonniere Deformity, 3487
66.28 Reconstruction of the Extensor Mechanism for Chronic Boutonniere Deformity (Littler, Modified), 3488
66.29 Repair of Traumatic Dislocation of the Extensor Tendon, 3491 Fractures, Dislocations, and Ligamentous Injuries of the Hand and Wrist
67.1 Closed Pinning (Wagner), 3503
67.2 Open Reduction (Wagner), 3504
67.3 Corrective Osteotomy, 3505
67.4 Open Reduction and Internal Fixation (Foster and Hastings), 3506
67.5 Open Reduction and Internal Fixation (Buchler et al.), 3507
67.6 Ligament Reconstruction for Recurrent Dislocation (Eaton and Littler), 3508
67.7 Open Reduction—Volar Approach, 3511
67.8 Repair by Suture, 3515
67.9 Anatomic Graft Reconstructions (Glickel), 3516
67.10 Jobe Four-Limb Reconstruction, 3516
67.11 Open Reduction (Kaplan), 3522
67.12 Open Reduction—Dorsal Approach (Becton et al.), 3522
67.13 Open Reduction and Fixation of Metacarpal Shaft Fracture, 3525
67.14 Percutaneous Pinning of Metacarpal Shaft Fracture, 3525
67.15 Percutaneous Pinning of a Metacarpal Shaft Fracture, 3525
67.16 Open Reduction and Plate Fixation, 3526
67.17 Open Reduction and Screw Fixation, 3527
67.18 Open Reduction (Pratt), 3530
Another random document with no related content on Scribd:
escape, or the countryside resent the appeal to the law, which induced Peter Knowles to desire to shift upon Haines the active responsibility of giving information: his jealousy in love might be considered a motive adequate to bring upon him all the retributions of the recoil of the scheme if aimed amiss.
Knowles watched the young man narrowly and with a glittering eye as, with a trembling hand and a look averse, Haines began to untie the cord which held the package together.
“He killed the man, Owen, ez sure ez ye air livin’, an’ flunged his bones in the quicklime, an’ now he flunged in his clothes,” Knowles was saying as the bundle gave loose in the handling.
Drawing back with a sense of suffocation as a cloud of minute particles of quicklime rose from the folds of the material, Owen Haines nevertheless recognized upon the instant the garments which the juggler himself had worn when he first came to the Cove, the unaccustomed fashion of which had riveted the young mountaineer’s attention for the time at the “show” at the church-house.
With a certain complex duality of emotion, he experienced a sense of dismay to note how his heart sank with the extinguishment of his hope that the man might prove a criminal and that this discovery might rid the country of him. How ill he had wished him! Not only that the fierce blast of the law might consume him, but, reaching back into the past, that he might have wrought evil enough to justify it and make the retribution sure! With a pang as of sustaining loss he gasped, “Why, these hyar gyarmints air his own wear. I hev viewed him in ’em many a time whenst he fust kem ter the Cove!”
Knowles glared at him in startled doubt, and slowly turned over one of the pointed russet shoes. “He hed ’em on the night he gin the show in the Cove,” said Haines.
“I seen him that night,” said Knowles conclusively. “He hed on no sech cur’ous clothes ez them, else I’d hev remarked ’em, sure!”
“Ye ’lowed ’twar night an’ by the flicker o’ the fire, an’ ye war in a cornsider’ble o’ a jigget ’bout’n yer lime.”
“Naw, sir! naw, sir! he hed on no sech coat ez that, ennyhow,” protested Knowles. Then, with rising anger, “Ye air a pore shoat fur sense, Owen Haines! Ef they air his gyarmints, what’s the reason he hid ’em so secret an’ whar the quicklime would deestroy ’em; bein’ so partic’lar ter ax o’ me ef ’twould burn boots an’ clothes an’ bone, —bone, too?”
“I dunno,” said Haines, at a loss, and turning the black-and-red blazer vaguely in his hands.
“I do; them folks over ter New Helveshy wears sech fool gear ez these,” Knowles insisted, from his superior knowledge, for in the interest of his lime-trade he had visited New Helvetia more than once,—a rare trip for a denizen of Etowah Cove.
“Thar ain’t nobody missin’ at New Helveshy!” Haines argued, against his lingering hope.
“How do you-uns know?” exclaimed Knowles hurriedly, and with a certain alert alarm in his face. “Somebody comin’ ez never got thar! Somebody goin’ ez never got away!” He had risen excitedly to his feet. What ghastly secret might be hidden beneath the residue of quicklime in that dark cavern, the responsibility possibly to be laid at his door!
Owen Haines, looking up at him with childlike eyes, was slowly studying his face,—a fierce face, with the savagery of his cowardice as predatory an element as the wantonness of his malice.
“These hyar air his clothes,” Haines reiterated; “I ’members ’em well. This hyar split buttonhole at the throat”—
“That’s whar he clutched the murdered one,” declared Knowles tumultuously.
—“an’ these water-marks on these hyar shoes,—they hed been soaked,—an’ this hyar leather belt, whar two p’ints hed been teched through with a knife-blade, stiddier them round holes, ter draw the belt up tighter ’n it war made ter be wore,—I could swar ter ’em,— an’ this hyar”—
Knowles looked down at him in angry doubt. “Shucks,” he interrupted, “ye besotted idjit! I dunno what ailed me ter kem ter you-uns. I ’lowed ye war so beset ter do—yer—Marster’s—work!” with a mocking whine. “But ye ain’t. Ye seek yer own chance! The Lord tied yer tongue with a purpose, an’ he wasted no brains on a critter ez he didn’t ’low ter hev gabblin’ round the throne. Ye see ter it ye say nuthin’ bout’n this, else jestice’ll take arter you-uns, too, an’ ye won’t be much abler ter talk ter the court o’ law ’n the court o’ the Lawd.” He wagged his head vehemently at the young man, while kneeling to make up anew the bundle of garments, until the scorching vapor compelled him to turn aside. When he arose, he stood erect for one doubtful instant. Then, satisfied by the reflection that for the sake of his own antagonism toward the juggler the jealous and discarded lover would do naught to frustrate the vengeance that menaced Royce, he turned suddenly, and, with the bundle swaying as before on the end of the stick, started without a word along the path by which he had come, leaving Owen Haines gazing after him till he disappeared amongst the leaves.
How long Haines sat there staring at the vanishing point of that bosky perspective he could hardly have said. When he leaped to his feet, it was with a repentant sense of the waste of time and the need of haste. His long, lank, slouching figure seemed incompatible with any but the most languid rate of progression; and indeed it was not his habit to get over the ground at the pace which he now set for himself. This was hardly slackened through the several miles he traversed until he reached the schoolhouse, which he found silent and empty. After a wild-eyed and hurried survey, he set forth anew, tired, breathless, his shoulders bent, his head thrust forward, his gait unequal; for he was not of the stalwart physique common amongst the youth of the Cove. He reached the Sims cabin, panting, anxiouseyed, and hardly remembering his grievances against Phemie when he saw her in the passage. She looked at him askance over her shoulder as she rose in silent disdain to go indoors.
“I ain’t kem hyar ter plague you-uns, Phemie,” he called out, divining her interpretation of his motive. “I want ter speak ter that thar
juggler-man,”— he could not bring himself to mention the name.
She paused a moment, and he perceived in surprise that her proud and scornful face bore no tokens of happiness. Her lips had learned a pathetic droop; her eyelids were heavy, and the long lashes lifted barely to the level of her glance. The words in a low voice, “He ain’t hyar,” were as if wrung from her by the necessity of the moment, so unwilling they seemed, and she entered the house as Mrs. Sims flustered out of the opposite door.
“Laws-a-massy, Owen Haines,” she exclaimed, “ye better lef’ be that thar juggler-man, ez ye calls him! He could throw you-uns over his shoulder. Ye’ll git inter trouble, meddlin’. Phemie be plumb delighted with her ch’ice, an’ a gal hev got a right ter make a ch’ice wunst in her life, ennyhows.”
He sought now and again to stem the tide of her words, but only when a breathless wheeze silenced her he found opportunity to protest that he meant no harm to the juggler, and he held no grudge against Euphemia; that he was the bearer of intelligence important to the juggler, and she would do her guest a favor to disclose his whereabouts.
There were several added creases—they could hardly be called wrinkles—in Mrs. Sims’s face of late, and a certain fine network of lines had been drawn about her eyes. She was anxious, troubled, irritated, all at once, and entertained her own views touching the admission of the fact of the juggler’s frequent and lengthened absence from his beloved. Euphemia’s fascinations for him were evidently on the wane, and although he was gentle and considerate and almost humble when he was at the house, he seemed listless and melancholy, and had grown silent and unobservant, and they had all marked the change.
“We-uns kin hardly git shet o’ the boy,” said Mrs. Sims easily, lying in an able-bodied fashion. “But I do b’lieve ter-day ez he hev tuk heart o’ grace an’ gone a-huntin’.”
Owen Haines’s countenance fell. Of what avail to follow at haphazard in the vastness of the mountain wilderness? There was naught for him to do but return to his work, and wait till nightfall might bring home the man he sought. Meantime, the sheriff was as near as ’Possum Cross-Roads, only twelve miles down the valley. Peter Knowles would probably give the information which he had tried to depute to the supplanted lover. Haines did not doubt now the juggler’s innocence, but he appreciated the cruel ingenuity of perverse circumstances, and he had felt the venom of malice. Thus it was that he had sought to warn the man of the discovery which Peter Knowles had made, and of the very serious construction he was disposed to place upon the facts.
XIII.
WHEN this crisis supervened, Lucien Royce was at New Helvetia Springs, at the bowling-alley. His resolution that the beautiful girl, whom he had learned to adore at a distance, should never see him again in a guise so unworthy of him, of his true position in life, and of his antecedents, collapsed one day in an incident which was a satiric comment upon its importance. He met her unexpectedly in the mountain woods, within a few miles of the Cove, one of a joyous young equestrian party, and riding like the wind. The plainness of the black habit, the hat, the high close white collar, seemed to embellish her beauty, in that no adornments frivolously diverted the attention from the perfection of its detail. The flush on her cheek, the light in her eye, the lissome grace of her slender figure, all attested a breezy delight in the swift motion; her smile shone down upon him like the sudden revelation of a star in the midst of a closing cloud, when he sprang forward and handed her the whip which she had dropped at the moment of passing, before the cavalier at her side could dismount to recover it. A polite inclination of the head, a murmur of thanks, a broadside of those absolutely unrecognizing eyes, and she was gone. She evidently had no remembrance of him. His alert intuition could have detected it in her face if she had. For her he had no existence. He thought, as he walked on into the silence and the wilderness, of his resolution and his self-denial, and he laughed bitterly at the futility of the one and the pangs of the other. He need never wince to be so lowly placed, so mean, so humble, for she never thought of him. He need not fear to go near her, to haunt, like the ghost he was, her ways in life, for she would never look at him, she would never realize that he was near; for most people are thus insensible of spectral influences.
When he sat for the first time on a bench against the wall, by the door of the bowling-alley, with two or three mountaineers whose lethargic curiosity—their venison or peaches having been sold—was excited in a degree by the spectacle of the game of tenpins, he had much ado to control the agitation that beset him, the pangs of humiliation. But after this day he came often, availing himself of the special courtesy observed by the players in providing a bench for the mountaineers, as spectators, who were indeed never intrusive or out of place, and generally of most listless and uninterested attitude toward the freaks and frivolities of New Helvetia. This attention seemed a gracious and kindly condescension, and flattered a conscious sentiment of noblesse oblige. There were other spectators, of better quality, on the opposite side of the long low building,—the elders among the sojourners at New Helvetia Springs, while down the centre, between the two alleys, were the benches on which the players were ranged.
She was sometimes among these, always graceful and girlish, with a look of innocence in her eyes like some sweet child’s, and wearing her youth and beauty like a crown, with that unique touch of dignity suggestive of a splendid future development, and that these days, lovely though they might be, were not destined to be her best. One might have pitied the hot envy he felt toward the youths who handed her the balls and applauded her play, and hung about near her, and chatted in the intervals,—so foolish, so hopeless, so bitter it was. Sometimes he heard her responses: little of note, the talk of a girl of his day and world, but animated with a sort of individuality, a something like herself,—or did he fancy it was like no one else? He had met his fate too late; this was the one woman in all the world for him. She could have made of him anything she would. His heart stirred with a vague impulse of reminiscent ambitions that might have been facts had she come earlier. He loved her, and he felt that never before had he loved. The slight spurious evanescent emotion, evoked from idleness or folly or caprice, in sundry remembered episodes of his old world, or evolved in the desert of his loneliness for Euphemia,—how vain, how unreal, how ephemeral, how
unjustified! But she who would have been the supreme power in his life had come at last—and had come too late. How truly he reasoned he knew well, as he sat in his humble garb amongst his uncouth associates on the segregated bench, and heard the thunder of the balls and the swift steps of the lightly passing figures at the head of the alley; but surely he should not have been capable of an added pang when he discerned, with a sense almost as impersonal as if he were indeed the immaterial essence he claimed to be, her fate in the identity of a lately arrived guest. This was a man of middle height and slender, about thirty-five years of age, with a slight bald spot on the top of his well-shaped head. He had a keen narrow face, an inexpressive calm manner, and was evidently a personage of weight in the world of men, sustaining a high social and financial consideration. He did not take part in the game. He leaned against a pillar near her, and bent over her, and talked to her in the intervals of her play. He had apparently little affinity for youthful amusements, and spent much of his time with her parents. His mission here was most undisguised, and it seemed to the poor juggler that the fortunate suitor was but a personified conventionality, whom no woman could truly love, and who could truly love no woman.
When once Royce had acquired the sense of invisibility, he put no curb on his poor and humble cravings to see her, to hear the sound of her voice albeit she spoke only to others. Every day found him on the mountaineers’ bench at the bowling-alley, sometimes alone, sometimes in grotesque company, the ridicule, he knew, of the young and thoughtless; and he had no care if he were ridiculed too. Sometimes she came, and he was drearily happy. Frequently she was absent, and in dull despair he sat and dreamed of her till the game was done. He grew to love the inanimate things she touched, the dress she wore; he even loved best that which she wore most often, and his heart lightened whenever he recognized it, as if the sight of it were some boon of fate, and their common preference for it a bond of sympathy. Once she came in late from a walk in the woods, wearing white, with a purple cluster of the wild verbena at her bosom. There was a blossom lying upon the floor after the
people were all gone. He saw it as it slipped down, and he waited, and then, in the absolute solitude, with a furtive gesture he picked it up, and after that he always wore it, folded in a bit of paper, over his heart.
In the midst of this absorbing emotion Lucien Royce did not feel the pangs of supplantation till the fact had been repeatedly driven home. When, returning from New Helvetia, he would find Jack Ormsby sitting on the steps of the cabin porch, talking to Euphemia, he welcomed as a relief the opportunity to betake himself and his bitter brooding thoughts down to the bank of the river, where he was wont to walk to and fro under the white stars, heedless of the joyous voices floating down to him, deaf to all save the inflections of a voice in his memory. He began gradually to note with a dull surprise Euphemia’s scant, overlooking glance when her eyes must needs turn toward him; her indifferent manner,—even averse, it might seem; her disaffected languor save when Jack Ormsby’s shadow fell athwart the door. In some sort Royce had grown obtuse to all except the sentiment that enthralled him. Under normal circumstances he would have detected instantly the flimsy pretense with which she sought to stimulate his jealousy, to restore his allegiance, to sustain her pride. She had not dreamed that her hold upon his heart, gained only by reason of his loneliness and despair and the distastefulness of his surroundings, had slackened the instant a deep and real love took possession of him. She had not divined this hopeless, silent love—from afar, from infinite lengths of despair!—for another. She only knew that somehow he had grown oblivious of her, and was much absent from her. This touched her pride, her fatal pride! And thus she played off Jack Ormsby against him as best she might, and held her head very high.
The sense of desertion inflicted upon him only a dull pain. He said listlessly to himself, his pride untouched, that she had not really loved him, that she had been merely fascinated for a time by the novelty of the “readin’s,” and now she cared for them and him no more. He recalled the readiness with which she had forsworn her earlier lover, when his conscience had conflicted with her pride, and
this seeming fickleness was accented anew in the later change. Royce tacitly acquiesced in it, no longer struggling as he had done at first with a sense of loyalty to her, but giving himself up to his hopeless dream, precious even in its conscious futility.
How long this quiescent state might have proved more pleasure than pain it is hard to say. There suddenly came into its melancholy serenities a wild tumult of uncertainty, a mad project, a patent possibility that set his brain on fire and his heart plunging. He argued within himself with some doubting, denying, forbidding instinct of self-immolation, as it seemed, that had somehow attained full control of him in these days—that in one sense he was fully the equal of Miss Fordyce, as well born, as well bred, as she, as carefully trained in all the essentials that regulate polite society. She would sustain no derogation if he could contrive an entrance to her social circle, and meet her there as an equal. He had overheard in the fragmentary gossip mention of people in New Orleans, familiars of her circle, to whom he was well known. He did not doubt that his father’s name and standing would be instantly recognized by her father, Judge Archibald Fordyce,—the sojourners at New Helvetia were identifiable to him now,—or indeed by any man of consequence of that gentleman’s acquaintance. Under normal circumstances the formality of an introduction would be a matter of course. If she had chanced to spend a winter in St. Louis, Royce would doubtless have danced with her on a dozen different occasions; he wondered blankly if he would then have adequately valued the privilege! He felt now that he would give his life for a touch of her hand, a look of her eyes fixed upon him observingly; how the utter neutrality of her glance hurt him! He would give his soul for the bliss of one waltz. He trembled as he realized how possible, how easily and obviously practicable, this had become.
For the tableaux and fancy-dress ball had been so relished by the more juvenile element of New Helvetia that the successor of that festivity was already projected. This was to be a grotesquerie in calico costumes and masks, chiefly of facetious characters. The masks were deemed essential by the small designers of the
entertainment, since the secret of the various disguises had not been carefully kept, and these vizards were ingenuously relied on to protect the incognito of certain personages garbed, with the aid of sympathetic elders, as Dolly Varden, Tilly Slowboy (with a rag-doll baby furnished with a head proof against banging on door-frames or elbows), Sir John Falstaff, three feet high, Robinson Crusoe, and similar celebrities. The whole affair was esteemed a tedious superfluity by the youths of twenty and a few years upward, already a trifle blasé, who sometimes lingered and talked and smoked in the bowling-alley after the game was finished and the ladies had gone. It was from overhearing this chat that Royce learned that although the majority of the young fellows, tired with one effort of devising costumes, had declined to go in calico and in character, still, in deference to the style of the entertainment and the importunity of the children who had projected it, they had agreed to attend in mask. Their out-of-door attire of knickerbockers and flannel shirts and blazers ought to be deemed, they thought, shabby enough to appease the “tacky” requirements of the juvenile managers, who were pleased to call their burlesque masquerade a “tacky party.”
Then it was that Royce realized his opportunity. The knickerbockers and flannel shirt, the red-and-black blazer and russet shoes, in which he had entered Etowah Cove, now stowed away in the roof-room of Tubal Cain Sims’s house, were not more the worse for wear than much of such attire at New Helvetia Springs after a few weeks of mountain rambles. Ten minutes in the barbershop of the hotel, at a late hour when it would be deserted by its ordinary patrons, would put him in trim for the occasion, and doubtless its functionaries who had never seen him would fancy him in this dress a newly arrived guest of the hotel or of some of the New Helvetia summer cottagers. He had even a prevision of the free and casual gesture with which he would hand an attendant a quarter of a dollar and send across the road to the store for a mask. And then—and then—he could feel already the rhythm of the waltz music beating in every pulse; he breathed even now the breeze quickening in the motion of the dance, endowed with the sweetness of the zephyrs of the seventh
heaven. It was she—she alone—whom he would care to approach; the rest, they were as naught! One touch of her hand, the rapture of one waltz, and he would be ready to throw himself over the bluff; for he would have attained the uttermost happiness that earth could bestow upon him now.
And suddenly he was ready to throw himself over the bluff that he should even have dreamed this dream. For all that his pulses still beat to the throb of that mute strain, that his eyes were alight with an unrealized joy, that the half quiver, half smile of a visionary expectation lingered at his lips, the red rush of indignant humiliation covered his face and tingled to the very tips of his fingers. He was far on the road between the Cove and the Springs, and he paused in the solitude that he might analyze this thing, and see where he stood and whither he was tending. He, of all men in the world, an intruder, a partaker of pleasures designed exclusively for others! He to wear a mask where he might not dare to show his face! He to scheme to secure from her,—from her!—through false pretenses, under the mistake that he was another, a notice, a word, chance phrases, the touch of her confiding hand, the ecstasy of a waltz! He had no words for himself!
He was an exile and penniless. He had no identity. He could reveal himself only to be falsely suspected of a vile robbery in a position of great trust; any lapse of caution would consign him to years of unjust imprisonment in a felon’s cell. He was the very sport of a cruel fate. He had naught left of all the lavish earthly endowments with which he had begun life save his own estimate of his own sense of honor. But this was still precious to him. Bereft as he was, he was still a gentleman at heart. He claimed that,—he demanded of himself his own recognition as such. Never again, he determined, as he began to walk slowly along the road once more, never again should expert sophistries tempt him. He would not argue his equality with her, his birth, his education, the social position of his people. It was enough to reflect that if she knew all she would shrink from him. He would not again seek refuge in the impossibility that his identity could be discovered as a guest at the ball. He would not plead as a
set-off against the deception how innocent its intention, how transient, how venial a thing it was. And lest in his loneliness,—for since the atmosphere of his old world had once more inflated his lungs he was as isolated in the Sims household, he found its air as hard to breathe, as if he were in an exhausted receiver,—in his despair, in the hardship of his lot, in the deep misery of the first true, earnest, and utterly hopeless love of his life, some fever of wild enterprise should rise like a delirium in his brain, and confuse his sense of right and wrong, and palsy his capacity for resistance, and counsel disguise, and destroy his reverent appreciation of what was due to her, he would put it beyond his power ever to masquerade in the likeness of his own self and the status of his own true position in the world; he would render it necessary that he should always appear before her in the absolutely false and contemptible rôle of a country boor, an uncouth, unlettered clown.
At the paradox of this conclusion he burst into a grim laugh; then— for he would no longer meddle with these subtle distinctions of right and wrong, where, in the metamorphoses of deduction, the false became true, and interchangeably the true was false—he began to run, and in the strong vivacity of his pride in his physical prowess he was able to reflect that better time was seldom made by an amateur, unless for a short spurt, than the pace he kept all the way to the Sims cabin. He would not let himself think while in the roof-room he rolled the jaunty suit into a bundle. He set his teeth and breathed hard as he recognized a certain pleasure which his finger-tips derived from the very touch of the soft, fine texture of the cloth, and realized how tenuous was the quality of his resolution, how quick he must needs be to carry into effect the conclusions of his sober judgment, lest he waver anew. He was out again and a mile away before he began to debate the disposition which it would be best to make of the bundle under his arm. He recalled with a momentary regret Mrs. Sims’s kitchen fire, over which doubtless Euphemia was now bending, busy with the johnny-cake for the evening meal. He dismissed the thought on the instant. The feminine ideas of economy would never suffer the destruction of so much good all-
wool gear, whatever its rescue might cost in the future. Moreover, it would be inexplicable. He could get a spade and bury the bundle,— and dig it up, too, the next time this mad, unworthy temptation should assail him. He could throw it into the river,—and fish it out again.
Suddenly he remembered the lime-kiln. The greater portion of its product had been used long ago, but the residue still lay unslaked in the dry cavern, and more than once, in passing, he had noted the great boulder rolled to the aperture and securely closing it against the entrance of air and moisture. The place was in the immediate vicinity, and somehow, although he had been here often since, the predominant impression in his mind, when he reached the jutting promontory of rock and gazed down at the sea of foliage in the Cove, that surely had once known the ebb and flow of tides other than the spring bourgeonings and the autumn desiccations, was the reminiscence of that early time in Etowah Cove when he had stood here in the white glare from the lime-kiln and watched that strange anamorphosis of the lime-burner’s face through the shimmering medium of the uprising heat. He seemed to see it again,—all unaware that now, in its normal proportions, that face looked down upon him from the height of the cliff above, although its fright, its surprise, its crafty intimations, its malevolence, distorted it hardly less than the strange effects of the writhing currents of heat and air in that dark night so long ago.
The young man hesitated once more. He had a certain conscientious reverence for property and order; it was with a distinct wrench of volition that he would destroy aught of even small value. But as he seated himself on the ledge, shaking out the natty black-and-red blazer, he recognized the melody that was mechanically murmuring through his lips,—again, still again, the measures of a waltz, that waltz through whose enchanted rhythms he had fancied that he and she might dreamily drift together. He sprang to his feet in a panic. With one mighty effort he flung the great boulder aside. Hastily he dropped the garments with the shoes, belt, and long blue hose, into the cavern, and with a staff stirred the depths of the lime till it rose
above them. More than once he was fain to step back from the scorching air and the smarting white powder that came in puffs from the interior.
“That’s enough,” he muttered mockingly after a moment, as he stood with his muscles relaxed, sick with the sentiment of the renunciation of the world which the demolition of the sophisticated garb included in its significance. “I cannot undertake to dance with any fine lady in this toggery now; she’d think I had come straight from hell. And,” with a swift change of countenance, “so I have!—so I have!”
Then, with his habitual carefulness where any commercial interest, however small, was concerned, he roused himself, wrenched the great boulder back into its place, noting here and there a crevice, and filling it with smaller stones and earth that no air might gain admission; and, with one final close scrutiny of the entrance, he took his way into the dense laurel and the gathering dusk, all unaware of the peering, suspicious, frightened face and angry eyes that watched him from the summit of the cliff above.
The discipline of life had certain subduing effects on Lucien Royce. He felt very much tamed when next he took a seat upon the bench placed aside in the corner of the bowling-alley, to affect to watch the game, but in truth to give his humble despair what added pain it might deem pleasure and clutch as solace, by the sight of her smiles won by happier men, the sound of her voice, the meagre realities of the day to supplement the lavish and fantastic visions of his dreams. He had reached the point where expectation fails. He looked only for the eventless routine of the alley,—the hour of amusement for the others, the lingering separation, the silence of the deserted building, and the living on the recollection of a glance of the eye, a turn of the head, a displaced tendril of hair, softly curling, until to-morrow, or the next day, or the next, should give him the precious privilege of making such observations for the sustenance of his soul through another interval of absence. Suddenly, his heart, dully beating on through these dreary days, began to throb wildly, and he gazed with
quickening interest at the scene before him: the long narrow shell of a building with the frequent windows where the green leaves looked in, the brown unplastered walls, the dark rafters rising into the shadowy roof, and the crossing of the great beams into which records of phenomenal successions of ten strikes had been cut by the vaunting winners of matches, with their names and the dates of the event, the year of the Lord methodically affixed, as if these deeds were such as were to be cherished by posterity. Down the smooth and shining alley a ball was rolling. Miss Gertrude Fordyce, wearing a sheer green-and-white dress of simple lawn and a broad hat trimmed with ferns, was standing at the head of the alley, about to receive her second ball from the hands of a blond young cavalier in white flannels. Royce had seen him often since the morning when he had observed him giving his valuable advice as to the erection of the stage in the ballroom, and knew that he was Millden Seymour, just admitted to the bar, with a reputation for talent, an intelligent face, and a smooth and polished bonhomieof manner; he was given to witty sayings, and was a little too intent upon the one he was exploiting at this moment to notice that the pins at the further end of the alley had not been set up, the hotel functionary detailed for that duty not having arrived. Miss Fordyce hesitated, with the ball in her hand, in momentary embarrassment, the color in her cheeks and a laugh in her eyes.
Royce sprang up, and running lightly down by the side of the alley placed the pins in readiness to receive her second ball; then stood soberly aside, his hat in his hand, as if to watch the execution of the missile.
“How very polite!” said one of the chaperons over her knitting to another. “I often notice that young man. He seems to take so much interest in the game.”
This trifling dévoir, however, which Royce had not hesitated to offer to a lady, savored of servility in its appropriation by a man. Nevertheless, he was far too discreet, too well aware of what was due to Miss Fordyce, to allow the attention to seem a personal
tribute from him. He silently cursed his officiousness, notwithstanding, as he bent down to set the tenpins in place for the second player, who happened to be the smart young cavalier. Only with an effort Royce conserved his blithe air and a certain amiable alacrity as through a round or two of the game he continued to set up the pins; but when the flustered and hurried bell-boy whose duty he had performed came panting in, Royce could have broken the recreant’s head with right good will, and would not restrain a tendency to relapse into his old gait and pose, which had no savor of meekness, as he sauntered up the side of the alley to his former seat beside the mountaineers, who had gazed stolidly at his performance.
Royce noted that one or two of the more athletic of the young men had followed his movements with attention. “Confound you!” he said to himself irritably. “I am man enough to throw you over that beam, and you are hardly so stupid as to fail to know it.”
Miss Fordyce had not turned her eyes toward him,—no more, he said to himself, than if he had been the side of the wall. And notwithstanding the insignia of civilization thrust out of sight into the quicklime and the significance of their destruction, and the flagellant anguish of the discipline of hopelessness and humiliation, he felt this as a burning injustice and grief, and the next instant asked himself in disdain what could such a man gain if she should look at him in his lowly and humble estate?
Royce brooded gloomily upon these ideas during the rest of the game; and when the crowd had departed, and he had risen to take leave of the scene that he lived by, he noticed, with only the sense that his way was blocked, several of the young men lingering about the door. They had been glancing at him, and as one of them,—it was Seymour,—in a very propitiatory manner, approached him, he became suddenly aware that they had been discussing the appropriateness of offering him a gratuity for setting up the tenpins in the heat and dust while they played. Seymour was holding out their joint contributions in his hand; but his affability was petrified
upon his countenance as his mild eyes caught the fiery glance which Royce flung at the group, and marked the furious flush which suffused neck and face and ears as he realized their intention. It was a moment of mutual embarrassment. They meant no offense, and he knew it. Had he been what he seemed, it would have been shabby in the last degree to accept such timely offices with no tender of remuneration. Royce’s ready tact served to slacken the tension.
“Here,” he said abruptly, but despite his easy manner his voice trembled, “let me show you something.”
He took a silver quarter of a dollar from the handful of small change still mechanically extended, and, turning to a table which held a tray with glasses, he played the trick with the goblet and the bit of money that had interested the captain of the ill-fated steamboat on the night when Lucien Royce perished so miserably to the world. It was with a good-natured feigning of interest that the young men pressed round, at first, all willing to aid the salving of the honest pride which their offering had evidently so lacerated. But this gave way to an excitement that had rarely been paralleled at New Helvetia Springs, as feat succeeded feat. The juggler was soon eager to get away, having served his purpose of eluding their bounty, but this was more difficult than he had anticipated. He feared troublesome questions, but beyond a “Say, how in thunder did you learn all this?” there were none; and the laconic response, “From a traveling fellow,” seemed to allay their curiosity.
After a little he forgot their ill-starred benevolence; his spirits expanded in this youthful society, the tone of which was native to him, and from which he had long been an outcast. He began to reflect subacutely that the idea of a fugitive from justice would not occur to men of their social position so readily as to the mountaineers, who were of a more restricted field of speculation and limited knowledge of the world. He might seem to these summer sojourners, perhaps, a man educated beyond his prospects in life and his station, and ashamed of both; such types are not altogether
unknown. Or perhaps he might be rusticating in this humble fashion, being a person of small means, or a man with some malady, attracted here like others in search of health, but of a lower grade of society. “For they tell me,” he said satirically to himself, “that such people have lungs and livers like the best of us!” He might be a native touched by some unhallowed ambition, and, having tried his luck in the outer world, flung back upon his despised beginnings and out of a job. He might be the schoolmaster in the Cove, of a vastly higher grade than the native product, doubtless, but these young fellows were uninterested and unobservant, and hardly likely to evolve accurate distinctions. He felt sure that the idea of crime would occur to these gay butterflies the most remotely of all the possible solutions of the anomalies of his presence and his garb. He began to give himself up unconsciously to the mild pleasure of their association; their chatter, incongruously enough, revived his energies and solaced his feelings like some suave balm. But he experienced a quick repulsion and a start of secret terror when two or three, having consulted apart for a few moments, joined the group again, and called upon him to admire their “cheek,” as they phrased it, in the proposition they were about to make,—no less than that he should consent to perform some of his wonderful feats of sleight of hand at an entertainment which they proposed to give at New Helvetia. They explained to him, as if he had not grievous cause to know already, that the young ladies had devised a series of tableaux followed by a ball; that the children had scored a stunning success in a “tacky party;” that the married people had preëmpted the not very original idea of a fête champêtre, and to preclude any unmannerly jumping of their claim had fixed the date, wind and weather permitting, and had formally bidden the guests, all the summer birds at New Helvetia Springs. And now it devolved upon the young men to do their part toward whiling away time for the general pleasure,— a task for which, oddly enough, they were not so well equipped as one might imagine. They were going to give a dramatic entertainment upon the stage which had been erected for the tableaux in the ballroom, and which still stood, it being cheaper, the proprietor had remarked, to leave it there than to erect it anew; for
no one could be sure when the young people would want it again. There would be college songs first, glees and so forth, and they made much of the prestige of a banjo-player in their ranks. Some acrobatic feats by the more athletic youths were contemplated, but much uneasiness was felt because a budding littérateur—this was again Mr. Seymour—was giving token of a total breakdown in a farce he was writing for the occasion, entitled “The New Woman,” which, although beginning with aplomb and brilliancy, showed no signs of reaching a conclusion,—a flattering tribute to the permanence of the subject. Mr. Seymour might not have it completed by the date fixed. The skill of this amateur prestidigitator would serve to fill the breach if the playwright should not be ready; and even if inspiration should smile upon him and bring him in at the finish, the jugglery would enliven the long waits while the scenes were being prepared and the costumes changed.
Royce, with a sudden accession of prudence, refused plumply; a sentiment of recoil possessed him. He felt the pressure of the surprise and the uncertainty like a positive pain as he sat perched on the high window-sill, and gazed out into the blank unresponsiveness of the undergrowth of the forest, wilting in the heat of a hazy noon. The young men forbore to urge him; that delicate point of offering money, obviously so very nettling to his pride, which seemed altogether a superfluous luxury for a man in his position, hampered them. He might, however, be in the habit of giving exhibitions for pay; for aught they knew, the discussion of the honorarium was in order. But they had been schooled by the incident of the morning; even the quarter of a dollar which had lent itself to the nimble gyrations of legerdemain had found its way by some unimagined art of jugglery into the pocket of its owner, and Millden Seymour, who had a bland proclivity to smooth rough places and enjoy a refined peace of mind, was swearing by all his gods that it should stay there until more appropriately elicited.
An odd thing it was, Royce was feeling, that without a moment’s hesitation he should accept the box receipts of the “show” in the Cove, on which he had subsisted for weeks, and yet in his uttermost
necessity he could not have brooked appearing as a juggler before the sojourners at New Helvetia Springs for his own benefit. The one audience represented the general public, he supposed, and was far from him. The other he felt as his own status, his set; and he could as soon have handed around the hat, after one of the snug little bachelor dinners he used to be so fond of giving in St. Louis, as ask remuneration for his assistance in this amateur entertainment of the young butterflies at New Helvetia.
He burst into abrupt and sardonic laughter as he divined their line of cogitation, and realized how little they could imagine the incongruities of his responsive mental processes. In the quick change from a pondering gravity to this repellent gayety there was something of the atmosphere of a rude rebuff, and a certain dignity and distance informed the manner of the few who still lounged about with their cigars. Royce hastened to nullify this. They had shown much courtesy to one of his low degree, and although he knew—from experience, poor fellow—that it was prompted not so much by a perception of his deserts as by a realization of their own, it being the conduct and sentiment which graced them and which they owed to persons of their condition, he had no wish to be rude, even though it might seem that he owed a man in his position nothing.
“Oh, I’ll help you,” he said hastily, “though we shall have to rig up some sort of properties. But I don’t need much.”
The talk fell upon these immediately, and he forthwith perceived that he was in for it. And why not? he asked himself. How did it endanger him, or why should he shun it? All the Cove and the countryside for twenty miles around knew of his feats of sleight of hand; and since accident had revealed his knack to this little coterie of well-bred and well-placed young men, why should he grudge the exhibition to the few scores of ladies and children at New Helvetia, to aid the little diversion of the evening? His scruples could have no force now, for this would bring him—the social pariah!—no nearer to them than when he sat by the tenpin-alley and humbly watched his betters
play. The episode of the jugglery, once past, would be an old story and bereft of interest. He would have had his little day, basking in the sun of the applause of his superiors, and would sink back to his humble obscurity at the side of the bowling-alley. Should he show any disposition to presume upon the situation, he realized that they well understood the art of repressing a forward inferior. The entertainment contemplated no subsequent social festivities. The programme, made out with many an interlineation, had been calculated to occupy all the time until eleven o’clock; and Royce, looking at it with the accustomed eye of a manager of private theatricals, felt himself no prophet to discern that midnight would find the exhausted audience still seated, enjoying that royal good measure of amusement always meted out by bounteous amateurs. Throughout the evening he would be immured with the other young men in the close little pens which served for dressing and green rooms,—for all the actors in the farce were to be men,—save for the fraction of time when his jugglery would necessitate his presence on the stage. True, Miss Fordyce, should she patronize the entertainment, might then have to look at him somewhat more discerningly than she would look at the wall, perhaps! It could surely do her no harm. She had seen worse men, he protested, with eager self-assertion. She owed him that much,—one glance, one moment’s cognition of his existence. It was not much to ask. He had made a great sacrifice for her sake, and all unknown to her. He had had regard to her estimate of her dignity and held it dear. He had done her reverence from the depths of his heart, regardless that it cost him his last hope.
The powers of the air were gradually changing at New Helvetia Springs. The light of the days had grown dull and gray. Masses of white vapor gathered in the valley, rising, and rising, and filling all its depths and slopes, as if it were the channel of some great river, till only the long level line of the summit of the opposite range showed above the impalpable tides in the similitude of the further banks of a great stream. It was a suggestive resemblance to Lucien Royce, and he winced as he looked upon it. He was not sorry when it had gone,
for the gathering mists soon pervaded the forests, and hid cliffs and abysses and even the familiar path, save for the step before the eye, and in this still whiteness all the world was lost; at last one could only hear—for it too shared the invisibilities—the rain falling steadily, drearily, all the day and all the long, long hours of the black night. The bowling-alley was deserted; lawn-tennis had succumbed to the weather; the horses stood in the stalls. One might never know that the hotel at New Helvetia Springs existed except that now and again, in convolutions of mist as it rolled, a gable high up might reveal itself for a moment, or a peaked turret; unless indeed one were a ghost, to find some spectral satisfaction in slipping viewless through the white enveloping nullity, and gazing in at the window of the great parlor, where a log fire was ruddily aflare and the elders perused their newspapers or worked their tidies, and the youth swung in rocking-chairs and exchanged valuable ideas, and played cards, and read a novel aloud, and hung in groups about the tortured piano. So close stood a poor ghost to the window one day, risking observation, that he might have read, over the charming outline of sloping shoulders clad faultlessly in soft gray cloth, the page of the novel which Miss Fordyce had brought there to catch the light; so close that he might have heard every syllable of the conversation which ensued when the man in whom he discovered her destiny—the cold, inexpressive-looking, personified conventionality—came and sat beside her on the sofa. But the poor ghost had more scruples than reality of existence, and, still true to the sanctions that control gentlemen in a world in which he had no more part, he turned hastily away that no syllable might reach him. And as he turned he ran almost into the arms of a man who had been tramping heavily up and down the veranda in the white obscurities, all unaware of his propinquity. It might have been better if he had!
