By Louis Solomon, David Warwick, Selvadurai Nayagam
A entire advent to the sphere of orthopaedics and trauma.
summary: A finished advent to the sector of orthopaedics and trauma
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Additional resources for Apley's system of orthopaedics and fractures
19 CT for complex fractures (a) A plain x-ray shows a fracture of the calcaneum but the details are obscure. CT sagittal and axial views (b,c) give a much clearer idea of the seriousness of this fracture. New multi-slice CT scanners provide images of high quality from which multi-planar reconstructions in all three orthogonal planes can be produced. Three-dimensional surface rendered reconstructions and volume rendered reconstructions may help in demonstrating anatomical contours, but ﬁne detail is lost in this process.
Structural deformity A deformity which results from a permanent change in anatomical structure cannot be voluntarily corrected. It is important to distinguish postural scoliosis from structural (ﬁxed) scoliosis. The former is non-progressive and benign; the latter is usually progressive and may require treatment. ‘Fixed deformity’ This term is ambiguous. It seems to mean that a joint is deformed and unable to move. Not so – it means that one particular movement cannot be completed. Thus the knee may be able to ﬂex fully but not extend fully – at the limit of its extension it is still ‘ﬁxed’ in a certain amount of ﬂexion.
New multi-slice CT scanners provide images of high quality from which multi-planar reconstructions in all three orthogonal planes can be produced. Three-dimensional surface rendered reconstructions and volume rendered reconstructions may help in demonstrating anatomical contours, but ﬁne detail is lost in this process. Clinical applications Because CT achieves excellent contrast resolution and spatial localization, it is able to display the size, shape and position of bone and soft-tissue masses in transverse planes.