Overview

The fracture table is set, the geriatric patient is positioned, the tourniquet pressure has to be selected in the next thirty seconds, and the fluoroscopy team is asking for your imaging plan before the first incision. Apply outdated principles to today's operative environment and you produce the wrong-level fusion, the iatrogenic peroneal palsy, the periprosthetic infection, or the unplanned excision that turns curable sarcoma into amputation. This book translates every major orthopaedic procedure into the operative reasoning, anatomical orientation, implant selection, and complication awareness that distinguishes reliable practice from technique that merely approximates the textbook. Inside this book: - Fixation construct mastery - choose between sliding hip screw and cephalomedullary nail for intertrochanteric fractures with the biomechanical clarity that prevents cutout and rotation failure. - Internervous interval discipline - execute the Smith-Petersen, deltopectoral, Kocher, and Watson-Jones approaches with the layered anatomy that protects every muscle's nerve supply. - Arthroplasty decision frameworks - match cemented versus uncemented fixation, posterior-stabilized versus cruciate-retaining, anatomic versus reverse shoulder to patient bone quality and functional demand. - Spine deformity correction - apply Lenke classification to adolescent idiopathic scoliosis and execute multilevel pedicle screw constructs with three-dimensional correction maneuvers. - Oncologic margin discipline - plan biopsy tracts that preserve limb salvage, execute wide local excision, and reconstruct with allograft, megaprosthesis, or allograft-prosthetic composite matched to defect. - Pediatric growth-aware management - apply Salter-Harris classification to physeal fractures and time DDH, SCFE, and Perthes interventions to the developmental window. - Metastatic disease judgment - apply Mirels scoring to identify impending fractures and select intramedullary nailing, plate-cement augmentation, or endoprosthetic reconstruction. - ERAS-integrated perioperative care - combine regional anesthesia, tranexamic acid, restrictive transfusion, and risk-stratified VTE prophylaxis into outpatient and same-day arthroplasty pathways. Written for orthopaedic surgeons, residents, fellows, advanced practice providers, and medical students whose patients depend on operative reasoning that holds up under pressure. Open this book and commit to the technical excellence that every patient on your operative schedule deserves.

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