Operative Procedures | 456+ Technique Guides

Operative Procedures Workbench - 456+ Surgical procedures

Comprehensive step-by-step operative procedure guides for advanced orthopaedic practice. Each procedure covers indications, patient positioning, key steps, structures at risk, closure, aftercare, and failure planning.

Arthroplasty — 69 procedures

adult-reconstruction (67 procedures)

Allograft-Prosthetic Composite (APC) Reconstruction - Fellowship-level guide to allograft-prosthetic composite (APC) reconstruction: combining a structural bulk allograft (restoring bone stock and providing soft-tissue/tendon reattachment) with a prosthesis (providing the joint surface) for massive segmental bone loss after tumour resection, failed revision arthroplasty or periprosthetic bone loss; the advantages over a megaprosthesis (bone stock, soft-tissue attachment), the site-specific uses, and the allograft-related complications (nonunion, resorption, fracture, infection).
Complex Primary THA (Dysplasia, Protrusio, Ankylosis, Post-Traumatic) - How to replace the hip that primary technique alone cannot serve — Crowe-graded dysplasia with the cup at the true acetabulum and the subtrochanteric shortening osteotomy that makes high dislocations reducible without stretching the sciatic nerve, protrusio acetabuli's medialised floor grafted back to lateralise the centre of rotation, the ankylosed or fused hip converted with abductor honesty, post-traumatic arthroplasty through old fixation with infection excluded first, and the implant, nerve and expectation arithmetic that separates these operations from routine arthroplasty.
Comprehensive Knee Osteotomy — HTO, DFO and TTO - Consultant-level guide to high tibial, distal femoral and tibial tubercle osteotomy, including deformity localisation, mechanical-axis planning, joint-line control, slope and patellar-height effects, biplanar technique, fixation, rehabilitation and failure management
Constrained Condylar Knee Revision Arthroplasty - Consultant-level guide to diagnosing instability, excluding infection, reconstructing bone and joint line, selecting CCK rather than PS or hinge, zonal fixation, gap balancing and failure management in revision knee arthroplasty.
Constrained Total Knee Replacement (VVC/CCK/Hinged) - Surgical technique guide for Constrained Total Knee Replacement (VVC/CCK/Hinged) - constraint selection, AORI bone loss reconstruction, enhanced exposure, popliteal vessel safety and revision cementation
Conversion THA (Failed Hip Fracture Fixation) - Comprehensive surgical technique guide for conversion total hip arthroplasty following failed hip fracture fixation - evidence-based approach with detailed operative steps and complication management
Conversion THA after Failed Hemiarthroplasty - Consultant-level guide to diagnosing painful hemiarthroplasty, excluding infection, deciding stem retention or revision, reconstructing acetabular erosion and protrusio, preventing instability and managing conversion complications.
Core Decompression — Femoral Head AVN - How to perform core decompression for pre-collapse (Ficat/ARCO I–II) femoral head osteonecrosis — the percutaneous lateral exposure through vastus lateralis step by step, biplanar-fluoroscopy trajectory to the anterosuperior lesion, the 5 mm subchondral safety margin, single-versus-multiple core choice and adjuncts (tantalum, vascularised fibula).
Distal Femoral Osteotomy - How to perform a varus-producing distal femoral osteotomy for the valgus knee with lateral-compartment osteoarthritis — the lateral exposure step by step, opening- versus closing-wedge technique, CORA-based correction, fixation, rehabilitation, and complications.
Free Vascularised Fibular Graft - Surgical technique guide for Free Vascularised Fibular Graft (FVFG) for large segmental long-bone defects and femoral-head osteonecrosis, including lateral leg approach, harvest, anastomosis, and fixation.
Girdlestone Resection Arthroplasty of the Hip - Pathology-led spacer-free hip resection for infection and non-reconstructable disease: selection, sampling, implant and cement removal, debridement, bone preservation, dead-space planning, rehabilitation and conversion assessment
High Tibial Osteotomy - How to perform a high tibial osteotomy (HTO) for medial compartment osteoarthritis with varus malalignment — the medial opening-wedge exposure and biplanar osteotomy step by step, opening- versus closing-wedge decision, Fujisawa-point correction, rehabilitation, and complications.
Hip Abductor Tendon Repair - How to repair the 'rotator cuff of the hip' — why lateral hip pain with a Trendelenburg lurch is a gluteus medius tear until proven otherwise and not 'trochanteric bursitis' by default, the examination triad (resisted-abduction pain, 30-second single-leg-stance test, Trendelenburg gait) and MRI's fatty-atrophy verdict that decides repairability, open double-row transosseous-equivalent repair onto a prepared trochanteric footprint step by step, the endoscopic alternative for partial undersurface tears, gluteus maximus transfer and reconstruction when the tendon is gone, and the slow, protected rehabilitation this repair cannot survive without.
Hip Fusion Takedown and Conversion to THA - How to give a fused hip back its motion — why conversions are driven by the neighbours (back pain, ipsilateral knee, contralateral hip) rather than the fused joint itself, the abductor assessment that predicts everything and the EMG that sometimes settles it, re-deriving acetabular landmarks inside a fusion mass with the teardrop and obturator foramen under fluoroscopy, the in-situ neck osteotomy that creates a joint where none exists, staged expectations for a gait relearned after decades, and the nerve, dislocation and limp arithmetic that makes this conversion the most demanding 'primary' in arthroplasty.
Hip Resurfacing Arthroplasty - Consultant-level operative technique for modern metal-on-metal whole-joint hip resurfacing via the posterior approach, covering restricted patient selection, device-specific planning, femoral and acetabular preparation, bailout to total hip arthroplasty, ARMD surveillance and revision strategy.
Hybrid Total Hip Replacement (Cemented Stem, Uncemented Cup) - Consultant-level operative technique for hybrid total hip arthroplasty using a cemented femoral stem and uncemented acetabular component, including fixation selection, posterior exposure, implant-specific cementing, bailout strategies and perioperative safety
Knee Arthrodesis - Surgical technique guide for Knee Arthrodesis (knee fusion)
Knee Synovectomy - Surgical technique guide for Knee Synovectomy (open and arthroscopic)
Management of the Stiff Total Knee Arthroplasty - Diagnostic and operative guide to post-TKA stiffness, manipulation under anaesthesia, arthroscopic or open arthrolysis, extensile exposure and cause-directed revision
Minimally Invasive Posterior THA - Surgical technique guide for Minimally Invasive Posterior Total Hip Arthroplasty - exam preparation
Patellar Resurfacing in Primary Total Knee Arthroplasty - Operative technique guide for patellar resurfacing during primary TKA — indications and evidence for routine versus selective resurfacing, native thickness measurement, composite thickness restoration, medialised patellar button, patellar tracking assessment with the no-thumb test, and management of complications including fracture, AVN, clunk and loosening
Patellofemoral Arthroplasty - Decision-led guide to patellofemoral arthroplasty for isolated end-stage patellofemoral disease: selection, component positioning, tracking, patellar resurfacing and conversion strategy.
Periprosthetic Joint Infection — DAIR - Decision-led operative guide to debridement, antimicrobial therapy and implant retention for acute hip and knee periprosthetic joint infection.
Periprosthetic Joint Infection — One-Stage Exchange Revision - Decision-led operative guide to direct one-stage exchange revision for hip and knee periprosthetic joint infection.
Primary Total Hip Arthroplasty - How to perform a primary total hip arthroplasty — the posterior (Moore/Southern) exposure step by step, cup and stem technique, the Lewinnek safe zone and capsular repair for dislocation prevention, and rehabilitation.
Primary Total Knee Arthroplasty - Standard Measured Resection Technique - Surgical technique guide for Primary Total Knee Arthroplasty - Standard Measured Resection Technique
Primary Total Knee Replacement - Comprehensive Technique - How to perform a primary total knee replacement through the medial parapatellar approach — the exposure step by step, the tibial and femoral cuts, femoral rotation references, gap balancing, patellar resurfacing and cementation.
Primary Total Knee Replacement (TKR) - How to perform a primary total knee replacement - the medial parapatellar arthrotomy step by step, measured-resection bone cuts, femoral rotation and soft-tissue gap balancing, and the evidence behind implant and fixation choices.
Revision THA — Cup-Cage Construct for Pelvic Discontinuity - Surgical technique for cup-cage reconstruction in revision total hip arthroplasty with chronic pelvic discontinuity and severe acetabular bone loss — Paprosky classification, extensile posterior approach, distraction technique, tantalum cup plus antiprotrusio cage, bone grafting, fixation principles, complications and outcomes
Revision THA — Femoral Impaction Bone Grafting - Operative technique for femoral impaction bone grafting in revision total hip arthroplasty for cavitary femoral bone loss — indications, defect containment, sequential graft impaction, polished tapered cemented stem, Exeter/Slooff technique, complications and outcomes
Revision THA Bone Loss and Reconstruction - Advanced orthopaedic guide to revision total hip arthroplasty bone loss and reconstruction: pre-operative workup, Paprosky classification, acetabular reconstruction, pelvic discontinuity, femoral fixation strategy, extended trochanteric osteotomy and complications.
Revision TKA — Stems, Offsets and Metaphyseal Fixation Principles - Operative technique and fixation principles for revision total knee arthroplasty using stems, offset adapters, cones and sleeves — zonal fixation concept, diaphyseal engagement, joint line restoration and AORI defect management
Revision Total Hip Replacement - Surgical technique guide for Revision Total Hip Replacement
Revision Total Hip Replacement - Acetabular Component - How to revise a failed acetabular component — the posterior exposure and step-by-step technique, mandatory infection workup, Paprosky bone-loss classification, defect-driven reconstruction (jumbo cup, augments, cup-cage, custom triflange), dual mobility for instability, and complications.
Revision Total Hip Replacement - Femoral Component - Surgical technique guide for femoral-component revision total hip replacement - the posterior approach, the extended trochanteric osteotomy (ETO), Paprosky-driven stem selection and diaphyseal fixation.
Revision Total Hip Replacement for Aseptic Loosening - Surgical technique guide for Revision Total Hip Replacement for Aseptic Loosening
Revision Total Hip Replacement for Recurrent Instability - Surgical technique guide for Revision Total Hip Replacement for Recurrent Instability
Revision Total Knee Arthroplasty for Aseptic Loosening - A consultant-level guide to revision total knee arthroplasty for aseptic loosening: failure-mechanism confirmation, EBJIS-based infection exclusion, component extraction, extensor-safe exposure, AORI bone-loss assessment, zonal fixation, cones and sleeves, stems, joint-line restoration, constraint selection and postoperative recovery.
Revision Total Knee Replacement - Femoral Component - Surgical technique guide for Revision Total Knee Replacement - Femoral Component
Revision Total Knee Replacement - Patellar Component (Resurfacing/Revision) - How to revise the patellar component in total knee arthroplasty — the medial parapatellar exposure step by step, the bone-stock-driven decision to resurface, augment, patelloplasty or patellectomy, the composite-thickness and no-thumb-tracking rules, intra-operative fracture management, and rehabilitation.
Revision Total Knee Replacement - Tibial Component - Surgical technique guide for Revision Total Knee Replacement - Tibial Component with AORI classification, defect management, and constraint selection
Revision Total Knee Replacement (rTKR) - Surgical technique guide for Revision Total Knee Replacement (rTKR)
THA Revision - Acetabular Component (Jumbo Cup/Augments) - Comprehensive surgical technique for revision acetabuloplasty using jumbo cups and augments for Paprosky II/IIIA defects with detailed operative steps, complications, and exam-focused clinical scenarios
THA Revision - Femoral Component (Extensively Porous Stem) - How to revise an aseptically loose femoral stem with an extensively porous-coated cylindrical stem and an extended trochanteric osteotomy — the posterior exposure step by step, the Paprosky femoral classification, the scratch-fit fixation principle, and global registry outcomes.
Tibial Tubercle Osteotomy - Comprehensive guide to the tibial tubercle osteotomy (TTO) for extensile exposure in difficult and revision total knee arthroplasty, extensor mechanism repair and patellofemoral reconstruction — the long, laterally-pedicled anterior tibial crest osteotomy, its step-by-step technique, fragment fixation, and complication avoidance.
TKA Revision - Femoral Component with Sleeves - Comprehensive surgical technique for revision TKA with metaphyseal sleeves for AORI Type 2B/3 femoral bone defects - evidence-based approach
TKA Revision - Tibial Component with Cones - How to revise a total knee arthroplasty with a porous metal tibial cone for AORI Type 2B/3 bone loss — the extensile exposure and component removal, reaming to bleeding bone, press-fit cone and cemented baseplate technique, stem load-sharing, and complications.
TKA Surgical Approaches - Comprehensive guide to medial parapatellar, subvastus, midvastus, and lateral approaches for total knee arthroplasty including indications, technique, and complications
Total Hip Arthroplasty - Revision with Extended Trochanteric Osteotomy - Surgical technique guide for revision total hip arthroplasty with an Extended Trochanteric Osteotomy - the posterior approach and ETO exposure step by step, fragment blood-supply preservation, cement removal, cable fixation, stem selection by Paprosky grade, and protected weight-bearing rehabilitation.
Total Hip Arthroplasty - Two-Stage Revision for Chronic Periprosthetic Joint Infection - Comprehensive surgical technique guide for two-stage revision THA for chronic periprosthetic joint infection with MSIS criteria, articulating spacer, high-dose antibiotic cement protocol, and reimplantation strategies
Total Hip Arthroplasty — SuperPATH Technique - Consultant-level operative guide to SuperPATH total hip arthroplasty: terminology, evidence, patient selection, direct superior exposure, femoral preparation with the head intact, in-situ neck osteotomy, portal-assisted acetabular preparation, component verification, conversion and complication management.
Total Hip Arthroplasty Surgical Approaches - Comprehensive guide to THA surgical approaches including posterior, direct anterior, anterolateral, and lateral approaches with nerve injury patterns, dislocation rates, and AOANJRR outcomes data
Total Hip Replacement - Cemented Femoral Technique (Modern 3rd/4th Generation) - Comprehensive surgical technique guide for modern cemented femoral component insertion using third and fourth-generation cementing principles with detailed attention to canal preparation, retrograde cement insertion, and pressurization techniques for optimal fixation and long-term survival
Total Hip Replacement - Direct Anterior Approach (DAA) - Comprehensive surgical technique guide for Total Hip Replacement via Direct Anterior Approach - internervous plane between TFL and Sartorius - complete operative steps, danger zones, and exam-focused clinical pearls
Total Hip Replacement - Direct Lateral Approach (Hardinge/Transgluteal) - How to perform a total hip replacement through the direct lateral (Hardinge/transgluteal) approach — splitting the anterior third of gluteus medius and minimus in line with their fibres, reflecting the anterior abductor-capsule sleeve off the greater trochanter, and the meticulous transosseous abductor repair that determines outcome.
Total Hip Replacement - Posterior Approach (Kocher-Langenbeck Modified) - Comprehensive surgical technique guide for total hip replacement via modified posterior approach, including enhanced soft tissue repair techniques, acetabular component positioning, and strategies to minimize dislocation risk
Total Hip Replacement Dislocation - Comprehensive Assessment and Management - Evidence-based surgical technique for managing THA instability through systematic assessment, component revision, dual mobility, and soft tissue reconstruction
Total Hip Replacement with Ceramic Bearing Surfaces - How to perform a total hip replacement with a ceramic-on-ceramic bearing for the young, active patient — the posterior (Moore/Southern) exposure laid out step by step, precision acetabular positioning in the Lewinnek zone, clean-and-dry taper impaction of the ceramic head, and the squeak/fracture pitfalls.
Total Hip Replacement with Dual Mobility Cup - How to perform a total hip replacement with a dual mobility cup — the posterior exposure step by step, acetabular preparation and rim assessment, the monoblock versus modular construct, mobile liner and head assembly, intraprosthetic dislocation prevention, and rehabilitation.
Total Knee Arthroplasty - Cemented - Comprehensive surgical technique guide for cemented total knee arthroplasty including medial parapatellar approach, gap balancing, femoral rotation principles, and complication management - advanced orthopaedic practice
Total Knee Arthroplasty - Medial Parapatellar Approach - Comprehensive surgical technique guide for total knee arthroplasty using the medial parapatellar approach — the exposure laid out step by step, femoral rotation landmarks, gap balancing, third-generation cement technique, danger zones, registry survivorship and exam pearls.
Total Knee Arthroplasty for Valgus Deformity - How to perform a total knee arthroplasty in the valgus knee — the medial versus lateral (Keblish) exposure, the gap-driven lateral release sequence (Whiteside), the Krackow anatomic classification, soft-tissue balancing, and constraint selection.
Total Knee Replacement Instability - Assessment and Constraint Ladder Management - Comprehensive surgical technique for assessing and managing TKR instability using the constraint ladder approach, from posterior-stabilized to rotating hinge prostheses
Two-Stage Exchange for Infected TKA - Complete surgical technique for two-stage revision arthroplasty for periprosthetic joint infection of TKA including diagnosis, Stage 1 explantation with antibiotic spacer, Stage 2 reimplantation criteria, and antibiotic protocols for exam preparation
Two-Stage Revision THA - Stage 1: Antibiotic Cement Spacer Insertion - Comprehensive surgical technique for stage 1 two-stage revision THA with an antibiotic cement spacer for periprosthetic joint infection and advanced orthopaedic practice
Two-Stage Revision TKA - Stage 1: Antibiotic Cement Spacer Insertion - Comprehensive surgical technique for stage 1 two-stage revision TKA with an antibiotic cement spacer for periprosthetic knee infection and advanced orthopaedic practice
Unicompartmental Knee Replacement (UKR/Oxford) - Surgical technique for unicompartmental (Oxford) knee replacement — patient selection and the intact-ACL rule, the minimally invasive medial exposure, minimal tibial resection, mobile-bearing balance, and complication management.

arthroplasty (2 procedures)

Chiari Pelvic Osteotomy - Comprehensive exam guide to the Chiari medial displacement pelvic osteotomy as a salvage procedure for hip dysplasia and subluxation with incongruent joints — mechanism of medialisation and capsular fibrocartilage metaplasia, indications versus periacetabular osteotomy, surgical technique including iliac osteotomy from sciatic notch to AIIS, complications including sciatic nerve injury and femoral nerve palsy, evidence-based long-term outcomes, and exam-level viva preparation
Periacetabular Osteotomy (Ganz/Bernese PAO) - Comprehensive exam guide to Bernese periacetabular osteotomy for symptomatic acetabular dysplasia in the young adult - indications, correction targets (LCEA, Tonnis angle, anterior coverage), modified Smith-Petersen and rectus-sparing approach, the four osteotomy cuts, complications (LFCN injury, sciatic nerve, nonunion, AVN, intra-articular extension), outcomes and conversion to THA

Trauma — 68 procedures

trauma (66 procedures)

Acetabular Fracture ORIF - Both Column - Consultant-level operative guide to associated both-column acetabular fractures: pattern recognition, secondary congruence, approach selection, reduction, fixation, arthroplasty-inclusive rescue and complications
Acetabular Fracture ORIF - Comprehensive Approach Selection - Consultant-level guide to morphology-led approach selection for acetabular fracture fixation, including posterior, ilioinguinal, anterior intrapelvic, pararectus, combined and extensile strategies
Acetabular Fracture ORIF - Ilioinguinal Approach - Consultant-level guide to the classic three-window ilioinguinal approach for acetabular fracture fixation, from morphology-led selection and surgical anatomy to reduction, fixation, closure and complication rescue
Acetabular Fracture ORIF - Kocher-Langenbeck Approach - Complete surgical technique guide for the Kocher-Langenbeck posterior approach to acetabular fractures - the workhorse approach for posterior wall, posterior column, and transverse fracture patterns.
Acetabular Fracture ORIF - Posterior Column/Wall - Consultant-level guide to posterior column and posterior wall acetabular fracture reconstruction through the Kocher–Langenbeck approach, including joint clearance, marginal impaction, column-first reduction, fragment-specific wall fixation and failure rescue
Acetabular Fracture ORIF - Posterior Wall - Consultant-level guide to isolated posterior wall acetabular fractures, from post-reduction CT and dynamic stability examination through marginal-impaction reconstruction, fragment-specific fixation and long-term surveillance
Ankle Fracture ORIF - Weber B/C Fibula with Medial Malleolus - How to perform ORIF of a Weber B/C fibula fracture with a medial malleolus fracture — the lateral fibular and medial malleolar exposures laid out step by step, fibular length and rotation, syndesmotic assessment (Cotton and Hook tests), and the medial malleolar fixation decision.
Antegrade Femoral Nailing - Consultant-level operative guide to antegrade femoral nailing: physiology-led timing, implant-specific trochanteric or piriformis entry, reduction, reaming, locking, rotation control, subtrochanteric variants and failure management
Anterior Column Acetabular Fracture — ORIF - Consultant-level operative guide to anterior-column acetabular fracture fixation: fracture definition, non-operative and arthroplasty thresholds, ilioinguinal versus anterior intrapelvic exposure, corona mortis and obturator safety, reduction of the dome and quadrilateral surface, suprapectineal and infrapectineal fixation, column screws, imaging, closure and failure management.
Both-Bone Forearm Diaphyseal ORIF (Radius & Ulna) - Surgical technique guide for open reduction and internal fixation of adult both-bone forearm diaphyseal fractures - restoring the radial bow and interosseous space, Henry vs Thompson approaches, PIN protection, Galeazzi and Monteggia, and radioulnar synostosis prevention
Calcaneal Fracture ORIF (Extensile Lateral and Sinus Tarsi) - How to fix a displaced intra-articular calcaneal fracture — who to operate on and when, the wrinkle test and timing, extensile lateral versus sinus tarsi approach selection, step-by-step reduction of the posterior facet onto the constant fragment, restoring Bohler's angle, height and width, perimeter plating, Broden-view fluoroscopy, the wound-edge necrosis problem, and salvage with subtalar fusion when the joint fails.
Circular Frame Deformity Correction (Ilizarov and Hexapod) and Bone Transport - How to correct deformity and replace lost bone with a circular frame — the tension-stress law and what a real corticotomy preserves, CORA-based deformity analysis and where the osteotomy must go, classic Ilizarov rings versus hexapod struts with software hinges, rate and rhythm and the latency that starts regenerate, bone transport for segmental defects with docking-site rules, the Paley problem-obstacle-complication vocabulary, pin-site discipline, and the joints, nerves and regenerate that must all be shepherded to frame removal.
Coronoid Process Fracture Fixation - Operative technique guide for coronoid process fracture fixation — Regan-Morrey and O'Driscoll classifications, anteromedial facet buttress restoration, Hotchkiss medial approach, suture lasso versus plate fixation, elbow stability reconstruction after terrible triad injuries
Distal Femur Fracture ORIF - Pattern-led reduction and fixation of isolated native distal femur fractures
Distal Radius External Fixation (Spanning and Non-Spanning) - Operative technique guide for spanning and non-spanning external fixation of distal radius fractures — indications, ligamentotaxis principles, pin placement, frame construction, danger structures, over-distraction avoidance, and post-operative care
Distal Radius ORIF with Volar Locking Plate - Fragment-specific reduction and safe volar locking plate fixation of distal radius fractures
Distal Radius: Closed Reduction, Casting and K-Wire Fixation - How to reduce and wire the displaced distal radius — the acceptable-reduction numbers that define success, haematoma block versus regional anaesthesia, the Charnley reduction manoeuvre and three-point moulding, what the DRAFFT trials actually showed about wires versus plates versus moulded casts, radial styloid and dorsal wire configurations with the Kapandji intrafocal levering technique, superficial radial nerve protection with mini-incisions, and the redisplacement surveillance that catches failure in week one, not week six.
Dynamic Hip Screw (DHS) for Intertrochanteric Fracture - How to fix an intertrochanteric femur fracture with a dynamic hip screw — the direct lateral exposure laid out step by step, the tip-apex distance rule, the DHS-versus-nail decision, and aftercare.
Emergency Four-compartment Fasciotomy of the Leg - Operative guide to diagnosis, two-incision decompression of all four leg compartments, muscle assessment, open wound care and staged closure
Exchange Intramedullary Nailing for Long-Bone Nonunion - Operative decision-making and technique for exchange intramedullary nailing of selected femoral and tibial shaft nonunions, including infection sampling, deformity correction, fixation, adjuncts and salvage
External Fixation Principles - Decision-making, safe pin and wire placement, frame biomechanics, damage-control and definitive external fixation, circular correction, aftercare and conversion
Femoral Head Fracture ORIF (Pipkin) - How to manage the femoral head fracture that arrives with a hip dislocation — the emergent reduction that outranks everything, Pipkin classification as an approach-selector rather than trivia, why infrafoveal fragments tolerate excision and suprafoveal fragments demand anatomical fixation, choosing between the Smith-Petersen anterior approach and the Ganz trochanteric-flip surgical dislocation, headless-screw fixation countersunk below cartilage, the femoral neck fracture (Pipkin III) that changes everything including the arthroplasty conversation, and the AVN and heterotopic ossification arithmetic every consent must carry.
Femoral Neck Fracture - Dynamic Hip Screw (DHS) Fixation - Surgical technique guide for Femoral Neck Fracture - Dynamic Hip Screw (DHS) Fixation
Hemiarthroplasty for Femoral Neck Fracture - Comprehensive surgical technique guide for cemented hip hemiarthroplasty in displaced intracapsular femoral neck fractures — the posterior (Moore/Southern) exposure step by step, third-generation cementing, enhanced soft-tissue repair, and the hemi-versus-THA decision.
Humeral Shaft Fracture Fixation (Plating vs Nailing) - Surgical technique guide for humeral shaft fracture fixation - operative versus conservative (Sarmiento bracing) decision-making, anterolateral/posterior/MIPO approaches, radial nerve protection, and compression plating versus intramedullary nailing
Iliac Crest Bone Graft Harvest (Anterior, Posterior and RIA) - How to harvest autologous bone graft — why iliac crest autograft remains the biological reference standard, choosing anterior crest, posterior crest or reamer-irrigator-aspirator by volume and position, the anterior technique with the lateral femoral cutaneous nerve and ASIS-avulsion rules, the posterior technique with cluneal-nerve and sciatic-notch boundaries, cancellous versus tricortical structural blocks, donor-site morbidity numbers for honest consent, and how RIA changed the volume game.
Iliosacral (Sacroiliac) Screw Fixation - Percutaneous iliosacral screw fixation for posterior pelvic ring injuries — sacral fractures and sacroiliac joint disruptions; fluoroscopic corridor anatomy, dysmorphic sacrum recognition, nerve-root and vascular danger zones, step-by-step percutaneous technique, trans-sacral screws, and post-operative rehabilitation
Local Muscle Flaps for Open Tibia (Gastrocnemius and Soleus) - How to cover the open tibia with the leg's own muscles — the rule of thirds that assigns gastrocnemius to the proximal third and soleus to the middle third with free tissue for the distal third, fix-and-flap timing inside the orthoplastic 72-hour doctrine, medial gastrocnemius harvest step by step from the mid-calf interval to the sural-nerve-protected rotation, the hemisoleus refinement that preserves push-off, why the flap's pedicle anatomy decides its reliable reach, and the graft-over-muscle sequence that finishes the reconstruction.
Masquelet Induced-Membrane Technique for Segmental Bone Loss - Two-stage reconstruction of a segmental bone defect: excision of non-viable tissue, stable fixation and PMMA spacer induction followed by membrane-preserving cancellous autografting
Neck of Femur Fractures - Dynamic Hip Screw and Cannulated Screws - Surgical technique guide for Neck of Femur Fractures - Dynamic Hip Screw and Cannulated Screws
Open Fracture Debridement and Reconstruction - Consultant-level management of open long-bone fractures from first antibiotics and protected transfer through systematic excisional debridement, saline irrigation, skeletal stability, vascular repair and early orthoplastic coverage
Open Reduction and Internal Fixation of Radial Head Fracture - Selection and fixation of reconstructible radial head fractures, including whole-forearm assessment, approach choice, posterior interosseous nerve protection by pronation, headless-screw and safe-zone plate techniques, instability reconstruction and early rehabilitation
ORIF Distal Humerus Fracture — Olecranon Osteotomy Approach - Consultant-level fixation of complete articular distal humerus fractures through a chevron olecranon osteotomy, including ulnar-nerve strategy, articular-first reconstruction, parallel or orthogonal bicolumnar plating, osteotomy repair and early protected motion
ORIF Supracondylar Fracture Humerus - Paediatric - Surgical technique guide for ORIF Supracondylar Fracture Humerus - Paediatric
Osteomyelitis — Surgical Debridement and Dead-Space Management - Operative guide to long-bone osteomyelitis: fracture-related infection diagnosis, microbiological sampling, adequate debridement, implant strategy, dead-space management, skeletal stability and durable soft-tissue coverage.
Paediatric Ankle Fractures — Salter-Harris ORIF - Operative guide to paediatric distal tibial physeal and transitional ankle fractures: CT planning, gentle reduction, fracture-specific approaches, physeal-respecting fixation and growth-arrest surveillance.
Paediatric Monteggia Fracture-Dislocation — Ulnar Fixation and Radial Head Reduction - Decision-led operative guide to acute unstable and missed paediatric Monteggia lesions: restore ulnar alignment, prove concentric radiocapitellar reduction and add radial-head surgery only when required.
Patella ORIF — Tension Band and Screw Fixation - Open reduction and internal fixation of displaced transverse patellar fractures using modified anterior tension band wiring or cannulated screw tension band constructs — indications, midline anterior approach, articular reduction, fixation techniques, complications and rehabilitation
Pelvic Ring External Fixation - Damage-control and temporary pelvic external fixation: pattern selection, supra-acetabular and iliac-crest corridors, fluoroscopic proof, frame reduction and integration with haemorrhage control.
Percutaneous Acetabular Column Screws - How to fix acetabular columns through stab incisions along fluoroscopic corridors — the minimally-displaced and elderly fracture patterns that trade open reduction's perfection for percutaneous fixation's physiology, the anterior column's antegrade and retrograde corridors with the obturator-outlet view that owns them, the posterior column's ischial corridor, why every screw lives between the joint it must not enter and the pelvis's resident structures, the combined-view discipline that proves a corridor before a wire commits to it, and the honest boundaries where displacement or corridor anatomy sends the fracture back to the open guides.
Perilunate Dislocation — Reduction, Repair and Fixation - Acute perilunate and lunate dislocation management: emergency reduction, injury-pattern imaging, dorsal and volar exposure selection, carpal realignment, ligament repair, fracture fixation and protected rehabilitation.
Periprosthetic Distal Femur Fracture — ORIF - Consultant-level operative guide to periprosthetic distal femur fracture fixation above total knee arthroplasty: implant-stability assessment, Rorabeck and Su classification, plate versus nail versus replacement, biological reduction, lateral locked plating, interprosthetic fixation, medial support, weight bearing and failure management.
Periprosthetic Femoral Fracture — Vancouver Classification & Reconstruction - Decision-led operative management of postoperative periprosthetic femoral fractures around a hip stem: stem-stability assessment, Vancouver classification, B1 fixation, B2/B3 revision, Type C fixation, complications and salvage.
Pilon Fracture Reconstruction — Staged Fixation and ORIF - Consultant-level guide to pilon fracture assessment, temporising ankle-spanning fixation, CT-directed reconstruction, definitive ORIF and salvage strategies
Posterior Pelvic Ring ORIF (Sacral and Crescent Fractures) - Open reduction and internal fixation of the posterior pelvic ring for sacral fractures, crescent iliac fractures and SI joint disruptions — posterior and anterior approaches, reduction techniques, spinopelvic fixation and complication management
Preperitoneal Pelvic Packing - How to pack the exsanguinating pelvis — why pelvic haemorrhage is mostly venous and bony and what that means for the packing-versus-angiography debate, the non-negotiable prerequisite of a mechanically stabilised ring, the Denver three-packs-a-side technique through a suprapubic preperitoneal incision kept separate from the laparotomy, the 24-to-48-hour de-packing rules, and how packing and angioembolisation work as partners rather than rivals.
Proximal Femoral Nail (Cephalomedullary Nail) for Intertrochanteric Fracture - How to perform cephalomedullary nailing for an intertrochanteric (peritrochanteric) hip fracture — the fracture-table set-up, percutaneous greater-trochanter entry and the step-by-step nail and cephalic-screw technique, the tip-apex distance rule, short-versus-long nail selection, and the prevention of cut-out.
Proximal Femoral Valgus Osteotomy for Neck Nonunion - How to rescue the femoral neck nonunion in the young hip by changing physics rather than chasing biology — Pauwels' insight that a vertical nonunion fails from shear and a valgus intertrochanteric osteotomy converts that shear into compression, patient selection by head viability and abduction radiographs, calculating the wedge from the Pauwels angle, the 120-degree blade plate technique step by step with the seating-chisel discipline that decides everything, why the nonunion itself is usually left untouched, and the honest ledger against arthroplasty in the older patient.
Proximal Humerus Fracture - Plating vs Hemiarthroplasty - Operative guide for proximal humerus fracture fixation - the deltopectoral exposure laid out step by step, ORIF locking-plate technique versus hemiarthroplasty and reverse shoulder arthroplasty, and rehabilitation.
Proximal Humerus Intramedullary Nailing - Surgical technique guide for antegrade intramedullary nailing of proximal humeral and surgical neck fractures — anterosuperior deltoid-split approach, straight-nail entry biomechanics, proximal and distal locking, tuberosity fixation, and post-operative rehabilitation
Proximal Humerus ORIF with Locking Plate - Surgical technique guide for open reduction and internal fixation of displaced proximal humeral fractures using precontoured locking plates — deltopectoral approach, tuberosity reduction, calcar support, axillary nerve protection, and post-operative rehabilitation
Retrograde Femoral Nailing - Surgical technique guide for Retrograde Femoral Nailing
Retrograde Superior Pubic Ramus Screw Fixation - Surgical technique for percutaneous retrograde medullary superior pubic ramus screw fixation of anterior pelvic ring injuries - corridor planning, multiplanar fluoroscopy, danger structures and combined ring fixation
Reverse Total Shoulder Arthroplasty for Proximal Humerus Fracture - Surgical technique guide for reverse total shoulder arthroplasty as primary treatment of complex proximal humeral fractures in elderly patients — indications, deltopectoral approach, glenoid and humeral preparation, tuberosity reconstruction, complications and outcomes
Septic Arthritis — Arthroscopic Washout and Debridement - Arthroscopic irrigation and debridement for native-joint septic arthritis of the knee, shoulder, hip and ankle — emergency management, portals, synovectomy technique, repeat washouts, role of open arthrotomy, antibiotic strategy, complications and rehabilitation
Shoulder Hemiarthroplasty for Acute Proximal Humerus Fracture - How to perform hemiarthroplasty for an acute 3- or 4-part proximal humerus fracture in the elderly patient — the extensile deltopectoral exposure step by step, prosthetic height determination using the pectoralis major landmark, tuberosity fixation with bone graft and heavy sutures, aftercare, and the modern shift to reverse shoulder arthroplasty.
Subtrochanteric Femoral Fracture Fixation - Surgical technique guide for fixation of subtrochanteric femoral fractures using cephalomedullary nailing, including Russell-Taylor classification, deformity correction, reduction techniques, implant selection, management of atypical bisphosphonate-related fractures, and prophylactic fixation of impending lesions
Supracondylar Humerus Fracture - Closed Reduction Percutaneous Pinning - How to perform closed reduction and percutaneous K-wire pinning of a displaced pediatric supracondylar humerus fracture — the reduction maneuver step by step, the lateral-entry versus crossed-pin decision, ulnar-nerve protection, and the pink pulseless hand.
Symphysis Pubis Plating (Anterior Pelvic Ring ORIF) - Surgical technique guide for open reduction and internal fixation of the pubic symphysis with anterior plating in open-book and combined pelvic ring injuries — Pfannenstiel approach, corona mortis protection, reduction techniques, plate selection, and the critical role of posterior ring stabilisation
Talar Neck and Body Fracture ORIF - Open reduction and internal fixation of talar neck and body fractures — dual-incision approach, Hawkins classification, retrograde blood supply, AVN risk, anatomic reduction to prevent varus malunion, lag-screw and plate fixation, post-traumatic arthritis
Temporary Spanning External Fixation (Knee and Ankle) - How to span the wrecked periarticular limb — the span-scan-plan doctrine for high-energy tibial plateau and pilon fractures, ligamentotaxis and what a travelling traction achieves, knee-spanning frames with femoral and tibial pins kept out of the zone of injury and out of the future plate's territory, the ankle delta frame with the transcalcaneal pin passed medial-to-lateral to protect the neurovascular bundle, foot-plate extensions against equinus, over-distraction and pin-site discipline, and the staged timeline to definitive fixation.
Terrible Triad ORIF - Elbow Dislocation with Radial Head and Coronoid Fractures - How to reconstruct the terrible triad elbow injury — the lateral Kocher exposure step by step, the mandatory coronoid-then-radial-head-then-LCL sequence, the ORIF-versus-replacement and overstuffing decisions, and rehabilitation.
Tibial Intramedullary Nailing - How to perform reamed locked intramedullary nailing of the tibial shaft — infrapatellar versus suprapatellar entry, the correct start point, reamed versus unreamed nailing, blocking (Poller) screws, distal interlocking and fibular fixation.
Tibial Plateau Fracture ORIF - Surgical technique guide for open reduction and internal fixation of tibial plateau fractures - Schatzker and three-column classification, staged management of high-energy injuries, compartment syndrome and vascular assessment, anterolateral and posteromedial approaches, articular reduction and buttress fixation
Transverse Acetabular Fracture ORIF - Surgical technique guide for Transverse Acetabular Fracture ORIF
Traumatic Brachial Plexus Exploration and Reconstruction - Consultant-level guide to adult traumatic brachial plexus exploration: lesion mapping, supraclavicular and infraclavicular exposure, root-avulsion assessment, nerve grafting, nerve transfers, donor selection, microsurgical coaptation and rehabilitation

basic-science (2 procedures)

Bone Grafts - Comprehensive guide to bone grafts including autograft, allograft, ceramics, demineralized bone matrix, and bone morphogenetic proteins.
Targeted Muscle Reinnervation (TMR) & Regenerative Peripheral Nerve Interface (RPNI) - Fellowship-level guide to TMR and RPNI: modern surgical techniques that give a cut nerve 'somewhere to go' to prevent and treat amputation neuroma and phantom limb pain, improve myoelectric prosthesis control, their evidence, and how they differ from traditional neuroma management.

Spine — 34 procedures

spine (34 procedures)

Anterior Cervical Corpectomy and Fusion - Consultant-level guide to cervical corpectomy: indication by retrovertebral pathology, CT and MRI planning, safe anterior exposure, inside-out decompression, OPLL and dural ossification, anterior-column reconstruction, construct selection and complication rescue
Anterior Cervical Discectomy and Fusion (ACDF) - Single Level - How to perform a single-level Anterior Cervical Discectomy and Fusion (ACDF) — the Smith-Robinson approach step by step, the avascular plane medial to the carotid sheath, complete discectomy with PLL removal, cage plus anterior plate fixation, and the structures at risk in each layer.
Anterior Lumbar Interbody Fusion (ALIF) - Consultant-level planning and operative guide to L4-L5 and L5-S1 anterior lumbar interbody fusion: patient selection, retroperitoneal access, vascular and autonomic safety, discectomy, alignment, cage and fixation strategy, complications and revision
Anterior Odontoid Screw Fixation - Selection, reduction and direct anterior screw fixation of a recent odontoid fracture, including fracture-line geometry, trajectory planning, biplanar imaging, lag technique and conversion to posterior C1–C2 fixation
Anterior Spinal Fusion for Scoliosis - How to correct scoliosis from the front — why the anterior column's convex-side compression corrects while saving fusion levels in the thoracolumbar and lumbar curve (Lenke 5's home ground), the crankshaft problem in the young that anterior fusion was built to prevent, thoracoscopic and open thoracotomy or thoracoabdominal exposures with the segmental vessels' ligation debate, disc excision as the correction's engine, single-rod and dual-rod instrumentation, why posterior all-pedicle-screw surgery took most of the territory and what the anterior operation still does better, and the pulmonary and vascular arithmetic every anterior consent carries.
Balloon Kyphoplasty - How to perform balloon kyphoplasty for a painful vertebral compression fracture — bilateral transpedicular cannulation under biplanar fluoroscopy, cavity creation with the inflatable bone tamp, and low-pressure high-viscosity PMMA cement delivery for height restoration and kyphosis correction.
C1–C2 Posterior Fusion (Goel–Harms Technique) - Consultant-level guide to posterior C1–C2 fusion: instability assessment, reducibility, vertebral-artery planning, C1 lateral-mass fixation, C2 pedicle, pars and translaminar options, reduction, grafting, complications and revision
Cauda Equina Decompression - Emergency posterior lumbar decompression for cauda equina syndrome — the midline exposure and step-by-step laminectomy, the timing-of-surgery evidence across CES-R and CES-I, dural tear and wrong-level avoidance, and rehabilitation.
Cervical Disc Arthroplasty - Consultant-level guide to cervical disc arthroplasty, including selection against ACDF, dynamic imaging, anterior exposure, complete decompression, endplate-preserving preparation, device-specific sizing, fluoroscopic placement, complications and revision
Cervical Laminoplasty — Open-Door and French-Door - Consultant-level guide to cervical laminoplasty for multilevel degenerative cervical myelopathy and OPLL, including alignment and K-line selection, muscle-preserving exposure, controlled gutters, hinge protection, fixation, C5 palsy, axial pain and revision
Cervical Spinal Fusion (ACDF) - Comprehensive surgical technique guide for Anterior Cervical Discectomy and Fusion (ACDF) - evidence-based approach for cervical degenerative disease
Cranial Tongs & Halo Application (Cervical Traction and Halo-Vest Immobilisation) - Surgical technique guide for Gardner-Wells tongs cervical traction and halo ring-vest immobilisation - pin safe zones, traction protocols, torque specifications, paediatric considerations and complication management
Early-Onset Scoliosis: Growing Rods - How to control a young child's collapsing spine while the chest still needs to grow — why early fusion trades a straight radiograph for lethal restrictive lung disease and thoracic-insufficiency thinking reframes the whole field, casting and bracing as the delay tactics that sometimes cure, traditional growing rods with their six-monthly lengthening anaesthetics against magnetically-controlled rods lengthened awake in clinic, the dual-rod proximal-and-distal anchor construct step by step, the law of diminishing returns that flattens each lengthening's yield, autofusion and the 'graduation' decision, and the complication arithmetic — implant, wound, junctional — that makes this a programme, not an operation.
Hemivertebra Excision - How to remove the wedge that bends a growing spine — formation-failure hemivertebrae classified by segmentation status and why the fully-segmented lumbosacral hemivertebra is the one that cannot be watched, the VACTERL screen every congenital curve triggers, timing surgery early (age 1 to 5) while the compensatory curves are still flexible and unstructural, posterior-only pedicle-based excision step by step with the convex compression that closes the gap, short-segment fusion that spends only two motion segments, neuromonitoring as a condition of operating, and the crankshaft and junctional problems surveillance exists to catch.
Lumbar Decompression for Degenerative Spinal Stenosis - Operative guide to level selection, central and lateral-recess decompression, facet-preserving laminotomy or laminectomy, durotomy management and postoperative neurological surveillance
Microscopic Lumbar Discectomy - How to perform a microscopic lumbar discectomy for a symptomatic disc herniation — prone positioning with a free abdomen, three-point level verification, the unilateral interlaminar exposure, thin-bone-then-Kerrison laminotomy, limited discectomy with mandatory foramen exploration, and recognition of the postoperative epidural haematoma.
Muscular Dystrophy Scoliosis — Posterior Instrumented Fusion - Decision-led operative guide to posterior instrumented fusion for progressive scoliosis in Duchenne and Becker muscular dystrophy, including cardiopulmonary optimisation, distal-level selection, deformity correction and complication rescue.
Occipitocervical Fusion - How to fuse the skull to the cervical spine and set the head angle a patient must live with — the craniocervical instabilities from rheumatoid cranial settling to condyle fractures and tumours that demand it, why the occipito-C2 angle and gaze position are fixed forever at the moment the rods are locked, occipital keel plating with its venous-sinus depth limits, C1-C2 fixation options beneath it, the vertebral artery's four appearances in one operation, structural grafting for a fusion that cannot be allowed to fail, and the swallowing and gaze complications that come from fusing the wrong angle.
Percutaneous Pedicle Screw Fixation - How to instrument the thoracolumbar spine through stab incisions — the burst fractures, damage-control cases and degenerative constructs where sparing the paraspinal muscles buys real physiology, the owl's-eye anatomy of the pedicle on true AP fluoroscopy and the never-cross-medial rule that keeps Jamshidi needles out of the canal, wire-guided cannulated screws and rod passage beneath the fascia step by step, when a percutaneous construct is internal bracing removed after union versus a fusion's fixation, navigation's honest place, and the boundaries where deficit or deformity sends the spine back to the open operation.
Percutaneous Vertebroplasty - Operative technique guide for percutaneous vertebroplasty in painful osteoporotic and selected pathological vertebral compression fractures — patient selection, transpedicular approach, PMMA cement injection under continuous fluoroscopy, cement leak detection and management
Posterior Cervical Foraminotomy (Keyhole) - Surgical technique guide for posterior cervical keyhole foraminotomy — open and minimally invasive tubular approaches for unilateral cervical radiculopathy, facet-preserving nerve root decompression, step-by-step operative technique, indications, complications and contrast with ACDF
Posterior Cervical Laminectomy - Surgical technique guide for Posterior Cervical Laminectomy
Posterior Cervical Laminectomy and Fusion - Comprehensive surgical technique guide for posterior cervical laminectomy and fusion for multilevel cervical myelopathy
Posterior Lumbar Decompression and Fusion (PLDF) - How to perform posterior lumbar decompression and instrumented fusion — the prone midline exposure step by step, pedicle screw insertion at the Magerl point with five-wall probing, the decompression-versus-fusion decision, dural tear management and rehabilitation.
Posterior Lumbar Interbody Fusion (PLIF) - Operative technique guide for posterior lumbar interbody fusion (PLIF) — indications, posterior midline approach, wide laminectomy with bilateral facetectomy, thecal sac retraction, endplate preparation, dual cage insertion, pedicle screw-rod fixation, complications and post-operative rehabilitation
Posterior Spinal Fusion and Instrumentation for Adolescent Idiopathic Scoliosis (PSF) - Surgical technique guide for Posterior Spinal Fusion and Instrumentation for Adolescent Idiopathic Scoliosis (PSF)
Spinal Epidural Abscess — Surgical Decompression - Surgical technique guide for emergency decompression of a spinal epidural abscess — posterior laminectomy for dorsal collections, anterior debridement for ventral pus with vertebral osteomyelitis, indications, instrumentation, complications and post-operative rehabilitation
Spinal Osteotomy Techniques: PSO, VCR, and SPO - How to perform three-column spinal osteotomies for fixed deformity — Smith-Petersen (SPO), pedicle subtraction (PSO) and vertebral column resection (VCR) — with the posterior exposure laid out step by step, osteotomy selection, complications and the structured response to a neuromonitoring change.
Spinal Tuberculosis — Debridement and Fusion - How to perform radical anterior debridement, anterior column reconstruction and posterior instrumented fusion for Pott disease of the spine — indications, approach selection, step-by-step operative technique, graft and cage options, complications and post-operative management.
Spine Tumour Decompression and Stabilization - Surgical technique guide for metastatic spinal cord compression and primary spine tumour surgery - posterior decompression, separation surgery and pedicle-screw stabilization.
Spinopelvic Dissociation - Lumbopelvic Fixation - Comprehensive surgical technique for lumbopelvic fixation in spinopelvic dissociation - posterior instrumentation for U-type and H-type sacral fractures with Denis zone III involvement
Spondylolisthesis Reduction and Fusion - Surgical technique guide for instrumented reduction and fusion of high-grade isthmic and degenerative spondylolisthesis — posterior approach, wide decompression, pedicle-screw instrumentation, gradual slip reduction, interbody support and L5 nerve-root protection
Thoracic Disc Herniation — Discectomy - Surgical technique guide for discectomy in thoracic disc herniation — approach selection by herniation location, posterolateral (transpedicular/costotransversectomy), lateral extracavitary and transthoracic approaches, cord protection, level localisation, and management of calcified discs
Thoracolumbar Burst Fracture: Posterior Stabilisation - How to stabilise the thoracolumbar burst fracture — TLICS scoring and the PLC as the decision hinge, why the stable burst with intact neurology does as well without surgery, pedicle-screw constructs short versus long with the load-sharing classification deciding, ligamentotaxis reduction through lordosing rods, index-level screws, when to decompress and the lamina-fracture dural trap, percutaneous options and implant removal in the unfused, and kyphosis-recurrence salvage.

Hand & Wrist — 64 procedures

hand (64 procedures)

Anterior Interosseous Nerve Exploration and Decompression - Consultant-level operative guide to diagnosing anterior interosseous nerve palsy, localising the lesion, selecting proximal forearm decompression or fascicular surgery, releasing the pronator and FDS arches, and managing recovery or failed reinnervation.
Boutonnière Deformity — Reconstruction - Consultant-level guide to chronic boutonnière reconstruction: staging, Elson assessment, passive correction, central-slip repair or reconstruction, lateral-band balancing, terminal-tendon tenotomy, dynamic testing and hand therapy
Carpal Tunnel Release - Open & Endoscopic - How to perform carpal tunnel release - open and endoscopic - step by step: the ring-finger-axis palmar exposure, identifying and protecting the palmar cutaneous and recurrent motor branches, dividing the transverse carpal ligament distal-to-proximal in the midline, and the open-versus-endoscopic decision.
Carpal Tunnel Release - Open Technique - Surgical technique guide for open carpal tunnel release - advanced orthopaedic practice operative-surgery preparation
Cubital Tunnel Decompression - How to decompress the ulnar nerve at the elbow — the lazy-S medial exposure laid out step by step, identification and protection of the medial antebrachial cutaneous nerve, the systematic release of all four compression sites, the simple decompression versus anterior transposition decision, and rehabilitation.
De Quervain's Tenosynovitis - First Dorsal Compartment Release - Surgical technique guide for De Quervain's Tenosynovitis - First Dorsal Compartment Release
Digit Replantation - Decision-making, microsurgical replantation, monitoring and rehabilitation after complete digit amputation
Distal Radius Corrective Osteotomy - Three-dimensional planning and reconstruction of symptomatic distal radius malunion
DRUJ Procedures — Darrach, Sauvé-Kapandji & Ulnar Shortening - Comprehensive surgical technique guide for distal radioulnar joint procedures including Darrach resection arthroplasty, Sauvé-Kapandji arthrodesis with pseudarthrosis, ulnar shortening osteotomy for ulnar impaction syndrome, and TFCC anatomy
Dupuytren Contracture: Comprehensive Management - Treatment selection and safe limited fasciectomy for primary, advanced and recurrent Dupuytren disease
Dupuytren Limited Fasciectomy - Goal-led planning, exposure, neurovascular protection, selective fascial excision and reconstruction for primary and recurrent Dupuytren disease
EIP-to-EPL Tendon Transfer (EPL Rupture) - Complete surgical technique guide for EIP-to-EPL tendon transfer for EPL rupture after distal radius fracture — includes EPL rupture aetiology, EIP anatomy, transfer technique, tension setting, and post-operative management
Extensor Tendon Reconstruction - Comprehensive guide to extensor tendon reconstruction including zone-specific techniques, tendon transfers, grafting options, and rehabilitation protocols for chronic extensor deficiency.
Extensor Tendon Repair (Zones I-VIII) - Comprehensive zone-specific surgical technique guide for extensor tendon injuries from DIP to forearm, covering acute repair, reconstruction, and zone-specific protocols
Finger DIP and PIP Arthrodesis - How to fuse the small joints of the finger so the hand still works — why fusion remains the honest answer for the painful destroyed DIP and for the PIP in the index and middle fingers that pinch, the position arithmetic that changes digit by digit (DIP 0 to 10 degrees, PIP cascading from 25 degrees radially to 40 degrees ulnarly), cup-and-cone preparation that lets angle be dialled after the cuts, headless compression screw against tension band against interosseous wiring, the mucous-cyst and swan-neck contexts the DIP fusion frequently arrives in, and the nonunion and nail arithmetic of hardware down a 2-millimetre canal.
Finger Fracture Fixation (Phalangeal & Metacarpal) - Surgical technique guide for Finger Fracture Fixation covering metacarpal and phalangeal fractures
Fingertip Amputation Reconstruction - Assessment and reconstruction of fingertip amputations using semi-occlusive care, local advancement, homodigital, cross-finger and thenar flaps, revision amputation and nail-support planning
First CMC Arthroplasty (Trapeziectomy ± LRTI) - How to perform trapeziectomy for basal thumb (first carpometacarpal) osteoarthritis — the Wagner volar exposure step by step, piecemeal trapeziectomy with radial artery protection, the trapeziectomy-alone vs LRTI vs suspensionplasty decision, and rehabilitation.
Flexor Tendon Repairs Across Zones 1–5 - Zone-specific assessment, exposure, tendon reconstruction, combined-injury repair and rehabilitation for flexor tendon injuries from fingertip to forearm
Forearm Fasciotomy: Complete Volar and Dorsal Release - Clinical diagnosis, pressure adjuncts, extensile volar and selective dorsal decompression, viability assessment and staged wound management for acute forearm compartment syndrome
Four-Corner Fusion and Limited Wrist Fusion - How to salvage the SLAC and SNAC wrist with scaphoid excision and four-corner fusion — staging the arthritis, choosing between four-corner fusion and proximal row carpectomy, the dorsal ligament-sparing exposure, correcting the DISI lunate before fusion, preparing and grafting the capitate-lunate-hamate-triquetrum joints, fixation options and the circular-plate problem, plus the STT fusion variant and what to do when a limited fusion fails.
Galeazzi Fracture ORIF - Open reduction and internal fixation of Galeazzi fracture-dislocation — distal-third radial shaft fracture with disruption of the distal radioulnar joint: recognition of DRUJ instability, volar Henry approach, anatomic plate fixation, DRUJ assessment, and staged management of residual instability
Ganglion Cyst Excision - Dorsal Wrist - Comprehensive surgical technique guide for dorsal wrist ganglion cyst excision including stalk identification, scapholunate ligament protection, and superficial radial nerve preservation
Glomus Tumour Excision - How to find and remove the fingertip's smallest tormentor — the classic triad of paroxysmal pain, pinpoint tenderness and cold sensitivity that makes glomus tumour a history-and-examination diagnosis, Love's pin test and Hildreth's tourniquet test performed properly, MRI's role and its honest miss rate, the transungual approach with meticulous nail-bed repair against the lateral subperiosteal alternative that spares the nail, why complete excision cures and incomplete excision recurs, and the years-long diagnostic delay these patients have usually already served.
Hand Corrective Osteotomy (Metacarpal and Phalangeal Malunion) - How to straighten the malunited hand — why rotational malunion is the unforgiving deformity (every 10 degrees of metacarpal rotation scissors the fingertip 2 cm across its neighbour), the scissoring examination that plain films cannot replace, choosing the osteotomy site between the malunion itself and the metacarpal base, step-cut versus transverse rotational correction, apex-directed closing and opening wedges for phalangeal angulation, fixation that permits the early motion the hand cannot heal without, and the stiffness arithmetic that makes patient selection most of the operation.
Hand Fasciotomy (Compartment Syndrome Release) - How to decompress compartment syndrome of the hand — recognising the intrinsic-minus posture and pain on intrinsic stretch when classic signs fail, the ten compartments and the incisions that reach them, dorsal two-incision release of the interossei and adductor, thenar and hypothenar releases, carpal tunnel extension, finger decompression when digits are threatened, second-look and closure strategy, and the Volkmann-type sequelae of the missed case.
Hand Infections — Surgical Drainage - Comprehensive surgical technique guide for hand infection drainage including flexor tenosynovitis (Kanavel's signs), deep space infections, paronychia, felon, web space abscess, and herpetic whitlow — organism selection, incision planning, and post-operative irrigation
Kienböck Disease — Surgical Management - Stage- and cartilage-directed operative management of lunate osteonecrosis, including radial and capitate shortening, vascularised bone grafting, limited fusion, proximal row carpectomy and total wrist fusion.
Mallet Finger — Management and Fixation - Management of terminal extensor tendon (mallet) injuries at the DIP joint - continuous extension splinting for tendinous and most bony mallets, with operative fixation (extension-block pinning, ORIF, pull-out suture) reserved for large bony fragments with volar subluxation or open injuries
Nail Bed & Fingertip Injury Repair - Surgical technique for nail bed and fingertip injury repair — when to trephine versus remove the nail plate, anatomical repair of the germinal and sterile matrix, the Seymour open physeal fracture, and Allen-zone fingertip reconstruction with V-Y advancement and other flaps.
PIP Joint Arthroplasty - How to replace the finger's most motion-hungry joint — why the ring and little fingers' grip role makes them arthroplasty's home while the pinch-loaded index stays fusion territory, silicone spacers against surface-replacing implants argued by evidence rather than novelty, the approach menu (dorsal Chamay, volar A1-sparing, lateral) with the central slip as the decision's hinge, implant technique step by step, the extensor-lag and coronal-drift arithmetic that follows every design, and the revision-to-fusion salvage every consent names.
Pollicization (Index Finger Transfer) - Decision-led operative guide to index-finger pollicization for severe congenital thumb deficiency, including pedicle dissection, skeletal transfer, intrinsic balancing and rehabilitation.
Pronator Syndrome Release - Median Nerve Decompression at Elbow/Forearm - How to decompress the median nerve in pronator syndrome — the volar exposure step by step, the four potential compression sites (ligament of Struthers, lacertus fibrosus, between the pronator heads, FDS arch), protecting the AIN and brachial artery, and rehabilitation.
Proximal Interphalangeal Joint Fracture-Dislocation Fixation - Decision-led operative guide to PIP joint fracture-dislocations: extension-block pinning, fragment fixation, dynamic external fixation, volar plate arthroplasty and hemi-hamate reconstruction.
Proximal Row Carpectomy - How to perform a proximal row carpectomy for the SLAC or SNAC wrist and Kienbock disease — the two joint surfaces that must be intact before you start, the dorsal ligament-sparing exposure, piecemeal excision of scaphoid, lunate and triquetrum while protecting the radioscaphocapitate ligament, styloidectomy and capsular interposition options, why the incongruent radiocapitate articulation still works, early motion aftercare, and the age and stage limits that keep the operation honest.
Radial Styloidectomy - Surgical technique guide for radial styloidectomy — limited dorsoradial excision of the radial styloid process for localised radioscaphoid impingement, as an adjunct in stage I SLAC/SNAC wrist, scaphoid nonunion, and after proximal-row carpectomy — emphasising preservation of the radioscaphocapitate and long radiolunate ligament origins to avoid ulnar carpal translation
Radial Tunnel and PIN Decompression - How to free the posterior interosseous nerve through its five-site gauntlet — the crucial distinction between PIN palsy (motor loss, finger-drop, an EMG-positive lesion) and radial tunnel syndrome (pain without weakness, an EMG-usually-silent diagnosis living in tennis elbow's differential), the arcade of Frohse and its four companion compression sites, the interval approaches (brachioradialis-split, BR-ECRL, and the anterior route) with the superficial radial nerve as the guide, supinator release step by step, why radial tunnel surgery's results are humbler than its anatomy is elegant, and the tumour-and-mimic screen every finger-drop demands before anyone blames a tunnel.
Ray Amputation (Hand & Foot) - Fellowship-level guide to ray amputation/resection - removal of a digit together with all or part of its metacarpal or metatarsal - in the hand (for tumour, trauma, infection, ischaemia or a non-functional digit) and the foot (commonly for the diabetic/ischaemic forefoot) - covering border versus central ray resection, the central-ray reconstruction problem (gap closure to avoid a widened web and digital malrotation), foot-specific biomechanical consequences (transfer lesions), and the functional and aesthetic principles that guide the choice between ray amputation and digit-only or transmetatarsal options.
Rheumatoid Elbow Synovectomy & Radial Head Excision - Surgical technique guide for Rheumatoid Elbow Synovectomy & Radial Head Excision
Rheumatoid Hand Surgery (MCP Arthroplasty, Synovectomy and Tendon Rebalancing) - How to reconstruct the rheumatoid hand — the deformity cascade from MCP synovitis to ulnar drift and volar subluxation, the caput ulnae syndrome and extensor tendon ruptures, operation sequencing rules (proximal before distal, tendons before joints you cannot splint), silicone MCP arthroplasty step by step with crossed intrinsic transfer, extensor tenosynovectomy and rupture reconstruction, and what biologic-era disease has changed about who reaches theatre.
Scaphoid Nonunion — Vascularised Bone Graft (1,2-ICSRA and Medial Femoral Condyle) - Operative technique for vascularised bone grafting of scaphoid nonunion with proximal pole AVN or humpback deformity — dorsal 1,2-ICSRA pedicled graft, volar pedicled and free MFC options, humpback correction, DISI reduction, headless compression screw fixation
Scaphoid ORIF - Dorsal Approach (Proximal Pole) - Surgical technique guide for Scaphoid ORIF - Dorsal Approach (Proximal Pole)
Scapholunate Ligament Reconstruction - Dorsal Capsulodesis - Surgical technique guide for Scapholunate Ligament Reconstruction - Dorsal Capsulodesis
Single-Portal Endoscopic Carpal Tunnel Release - Consultant-level guide to Agee-style single-portal endoscopic carpal tunnel release: selection, anatomy, device-specific setup, ligament recognition, distal-to-proximal division, conversion, complications and rehabilitation
Skin Grafting in the Hand - Fellowship-level guide to skin grafting in the hand: split- versus full-thickness grafts, the stages of graft take and why a well-vascularised bed is essential (grafts fail on bare bone/tendon/cartilage without periosteum/paratenon/perichondrium), donor-site selection (including glabrous skin for palmar defects), the reconstructive ladder, and the causes of graft failure (haematoma, infection, shear).
Swan-Neck Deformity Correction - How to correct swan-neck deformity — finding which of the four engines is driving PIP hyperextension (mallet imbalance, FDS loss, intrinsic tightness, volar plate laxity), the Nalebuff type that decides the operation, FDS hemitendon tenodesis and spiral oblique retinacular ligament reconstruction step by step, Fowler central slip tenotomy for the mallet-driven finger, intrinsic release in the rheumatoid hand, and salvage of the stiff destroyed PIP joint.
Tendon Transfers for Median and Ulnar Nerve Palsy - Operative guide to tendon transfers for irreversible median and ulnar nerve palsies — the Brand EIP opponensplasty (median palsy workhorse) and the Zancolli lasso and FDS four-tail for ulnar claw correction, plus adductor reconstruction for Froment's sign.
Tendon Transfers for Radial Nerve Palsy - Comprehensive operative technique for tendon transfers to restore wrist, finger and thumb extension in irreparable radial nerve or posterior interosseous nerve palsy — classic PT to ECRB, FCR to EDC, PL to EPL transfers, tensioning principles, donor selection and post-operative re-education
Tendon Transfers for Radial Nerve Palsy - Comprehensive guide to radial nerve palsy management including tendon transfer surgery, functional restoration, and operative techniques
Tendon Transfers for Radial, Median and Ulnar Nerve Palsy - Comprehensive exam guide to tendon transfers for radial, median and ulnar nerve palsy covering principles of tendon transfer (one tendon one function, expendable donor, synergy, straight line of pull, supple joints), standard transfers for low and high radial nerve palsy (Pronator teres to ECRB, FCR to EPL, PL to EDC), median nerve palsy (opponensplasty, Camitz, FDS ring transfer), ulnar nerve palsy (claw correction with Zancolli, Stiles-Bunnell, Brand transfers, intrinsic replacement), timing and outcomes
TFCC Repair (Arthroscopic and Open) - How to treat triangular fibrocartilage complex tears — Palmer and Atzei classification-directed decisions, the fovea sign and hook test, arthroscopic debridement of central tears, outside-in capsular repair of peripheral tears, foveal reattachment for the unstable DRUJ, when an ulnar shortening osteotomy does the work instead, rotation-limited rehabilitation, and salvage when the DRUJ stays unstable.
Thumb CMC Arthrodesis - How to fuse the thumb carpometacarpal joint for basal thumb arthritis in the young, high-demand hand — who genuinely does better with fusion than trapeziectomy, why STT arthritis is the gatekeeping check, the Wagner and dorsal exposures, cup-and-cone preparation, the clenched-fist fusion position (palmar and radial abduction with pronation), fixation choices, nonunion and malposition management, and honest counselling about the flat-hand trade-off.
Thumb Metacarpophalangeal Joint Arthrodesis - Surgical technique guide for arthrodesis of the thumb metacarpophalangeal joint for painful arthritis, chronic instability, post-traumatic destruction and rheumatoid Z-collapse deformity — dorsal approach, joint preparation, fixation options, complication avoidance and rehabilitation
Thumb Reconstruction: Pollicization & Toe-to-Hand Transfer - Fellowship-level guide to reconstructing the absent or deficient thumb: the Blauth classification of thumb hypoplasia, the type-IIIA/IIIB pivot on carpometacarpal stability, index-finger pollicization for the high grades, and toe-to-hand transfer for traumatic and congenital thumb loss.
Thumb UCL Repair / Reconstruction (Stener Lesion) - Surgical technique guide for thumb UCL repair and reconstruction — acute Stener lesion repair with suture anchors and chronic reconstruction with free tendon graft
Total Wrist Arthroplasty - How to replace the wrist and who genuinely should have one — the motion-versus-durability trade against total wrist fusion argued honestly, why the low-demand rheumatoid patient with bilateral disease remains the signature indication and the young labourer remains the signature contraindication, fourth-generation implant design and what it fixed about its predecessors, the dorsal approach and carpal-platform preparation step by step, the distal-component fixation that decides survivorship, the functional 'dart-thrower-adjacent' arc a modern TWA actually delivers, and the salvage arithmetic when it fails.
Trigger Finger / Thumb Release (A1 Pulley) - Surgical technique guide for A1 pulley release in trigger finger and trigger thumb - open and percutaneous techniques, digital nerve protection, paediatric considerations
Ulnar Nerve Decompression at Guyon's Canal - Surgical technique guide for Ulnar Nerve Decompression at Guyon's Canal
Ulnar Shortening Osteotomy - How to shorten the ulna for ulnocarpal abutment — confirming that variance is the disease, the neutral-rotation and pronated-grip films, choosing shortening over the wafer procedure, the subcutaneous-border exposure between ECU and FCU, precision oblique osteotomy with lag-screw and compression plating, how much to shorten and the sigmoid-notch caution, plate-irritation and nonunion management, and where the osteotomy fits alongside TFCC surgery.
Upper Limb Amputation - Comprehensive guide to upper limb amputation - level selection, finger to forequarter techniques, prosthetic considerations, targeted muscle reinnervation, replantation decisions for orthopaedic exam
Upper Limb Nerve Transfers (Oberlin and Key Motor Transfers) - How to rewire the paralysed upper limb by lending working fascicles to failed nerves — why distal nerve transfers beat proximal grafts on the motor endplate's 12-to-18-month clock, the Oberlin ulnar-fascicle-to-biceps transfer for elbow flexion step by step with intraoperative stimulation choosing the donor fascicle, the double transfer that adds brachialis, spinal-accessory-to-suprascapular for shoulder external rotation and triceps-branch-to-axillary for abduction, the expendable-donor and synergy rules that make transfers safe, and the motor re-education that converts a rewired nerve into a usable arm.
Wrist Arthrodesis (Total, 4-Corner & PRC) - Comprehensive surgical technique guide for total wrist arthrodesis, 4-corner fusion, and proximal row carpectomy — SLAC/SNAC staging, procedure selection, plate fixation, and outcomes
Wrist Arthroscopy - Comprehensive surgical technique guide for wrist arthroscopy — portals, TFCC repair, SL ligament assessment, ganglion decompression, and carpal instability evaluation
Zone 2 Flexor Tendon Repair - Assessment, exposure, FDP and selective FDS repair, pulley venting, dynamic glide testing and repair-specific early rehabilitation for Zone 2 flexor tendon injury

Foot & Ankle — 61 procedures

foot-ankle (61 procedures)

Achilles Tendon Repair - Open repair of an acute Achilles tendon rupture — the posteromedial exposure step by step, Krackow core suture with epitendinous reinforcement, paratenon closure, augmentation for chronic or large-gap rupture, and accelerated functional rehabilitation.
Ankle Arthrodesis - How to perform ankle (tibiotalar) arthrodesis — arthroscopic portal placement and the open anterior and transfibular exposures step by step, the non-negotiable four-point fusion position, screw versus plate versus retrograde tibiotalocalcaneal nail fixation, and the arthrodesis-versus-TAR decision.
Ankle Arthroscopy - Surgical technique guide for anterior and posterior ankle arthroscopy — portal placement, nerve protection, distraction, impingement resection, osteochondral lesion treatment and loose body removal
Ankle Fracture ORIF - Trimalleolar - How to perform ORIF of a trimalleolar ankle fracture — the three-incision fibula-first exposure step by step, posterior malleolus fixation through the posterolateral interval, syndesmotic assessment and fixation, and rehabilitation.
Ankle Syndesmosis Fixation - Surgical technique guide for fixation of the disrupted distal tibiofibular syndesmosis in ankle fractures and high ankle sprains — intra-operative testing, reduction, screw versus suture-button fixation, malreduction recognition, and post-operative rehabilitation
Bunionette (Tailor's Bunion) Correction - Comprehensive surgical technique guide for correction of a bunionette (Tailor's bunion) — Coughlin classification, lateral condylectomy, distal chevron and diaphyseal/oblique rotational osteotomies, fixation, and post-op rehab
Charcot Neuro-Osteoarthropathy — Foot Reconstruction - Consultant-level guide to Charcot foot reconstruction, including active-disease offloading, perfusion and infection work-up, braceability, exostectomy, deformity correction, midfoot superconstruct arthrodesis, hindfoot salvage, protected loading and failure management
Cheilectomy - Cheilectomy for hallux rigidus (Coughlin-Shurnas Grade I–II) — the dorsomedial approach to the first MTP joint step by step, the 30/70/50 resection rule, the intra-operative 70 degree dorsiflexion check, and rehabilitation.
Chevron Osteotomy for Mild Hallux Valgus - Surgical technique guide for Chevron Osteotomy for Mild Hallux Valgus
Chopart Amputation — Transverse-Tarsal Disarticulation - Consultant-level guide to Chopart amputation, including level selection, perfusion and infection assessment, plantar-flap planning, talonavicular and calcaneocuboid disarticulation, tendon balancing, residual-limb protection, prosthetic rehabilitation and failure management
Chronic Achilles Reconstruction with FHL Transfer - Consultant-level guide to chronic Achilles reconstruction with flexor hallucis longus transfer, including functional assessment, defect mapping, FHL harvest, neurovascular protection, calcaneal fixation, adjunctive reconstruction, rehabilitation and failure management
Chronic Achilles Reconstruction: V-Y Advancement and Gastrocnemius Turndown Flap - Operative technique for chronic Achilles tendon reconstruction with a V-Y gastrocnemius advancement slide and a gastrocnemius fascial turndown flap — indications by gap size, harvest, slide and turndown steps, complications and rehabilitation
Common Peroneal Nerve Decompression - Comprehensive surgical technique guide for common peroneal nerve decompression with anatomy, technique, and viva scenarios
Cotton Osteotomy (Medial Cuneiform Opening Wedge) - How to plantarflex the first ray and finish a flatfoot reconstruction — why forefoot varus left uncorrected rocks a beautifully reconstructed hindfoot back into valgus, the tripod concept and the simulated-correction examination that reveal residual first-ray elevation, the dorsal opening-wedge osteotomy of the medial cuneiform step by step with graft sizing from the deformity, its position in the flexible-flatfoot sequence after calcaneal osteotomies and tendon transfer, the alternative first-TMT fusion when the joint itself is unstable or arthritic, and the union and transfer-load arithmetic of a small osteotomy with a large job.
Dwyer Calcaneal Osteotomy - Lateral closing wedge calcaneal osteotomy for cavovarus deformity
First MTP Joint Arthrodesis - Comprehensive guide to first MTP arthrodesis for end-stage hallux rigidus and severe hallux valgus, including fusion position, technique, and complications
First MTPJ Arthrodesis - First metatarsophalangeal joint fusion for hallux rigidus and salvage
Flexor Digitorum Longus Transfer for Progressive Collapsing Foot Deformity - Deformity-led reconstruction for flexible progressive collapsing foot deformity using selective FDL transfer, calcaneal osteotomy, medial-column and ligament balancing
Foot & Ankle Amputation Levels - Fellowship-level guide to partial foot and ankle amputation levels - toe, ray, transmetatarsal, Lisfranc, Chopart, Syme and Pirogoff/Boyd - their biomechanics, muscle-balance pitfalls, and outcomes versus transtibial amputation.
Freiberg Disease: Surgical Management of Lesser Metatarsal-Head Infraction - Procedure selection, dorsal exposure, joint-preserving reconstruction and salvage surgery for symptomatic Freiberg disease of a lesser metatarsal head
Gastrocnemius Recession (Strayer / Vulpius) - Surgical technique guide for gastrocnemius recession (Strayer aponeurotic release and Vulpius-Baker lengthening) for isolated gastrocnemius contracture — Silfverskiöld test, indications, posteromedial approach, sural nerve protection, postoperative rehabilitation and complications
Girdlestone-Taylor Flexor-to-Extensor Transfer (Claw Toe) - Surgical technique guide for the Girdlestone-Taylor flexor digitorum longus to extensor transfer for flexible clawed lesser toes - intrinsic-minus pathomechanics, indications, step-by-step transfer, MTP balancing, K-wire fixation, complications and rehabilitation
Haglund Deformity and Insertional Achilles Correction - Decision-led surgery for symptomatic posterosuperior calcaneal impingement and insertional Achilles tendinopathy: open debridement and reattachment, endoscopic calcaneoplasty, Zadek osteotomy, wound protection and rehabilitation
Hallux Sesamoid Excision - How to remove the most loaded small bone in the body without unbalancing the toe it serves — the sesamoids' pulley-and-shield job under the first metatarsal head and the pathologies that end it (fracture nonunion, avascular necrosis, intractable sesamoiditis, infected ulceration), the bipartite-versus-fracture distinction every consultation must make, the medial approach to the tibial sesamoid with its plantar digital nerve and the plantar-lateral or dorsal-first-webspace routes to the fibular, shelling the sesamoid out of the FHB tendon with the defect repaired, why the other sesamoid is untouchable, and the cock-up and drift arithmetic that makes reconstruction and orthotic aftercare part of the operation.
Hallux Valgus Correction — Chevron, Scarf and Lapidus - Triplanar decision-making and operative technique for symptomatic hallux valgus: distal chevron, Scarf osteotomy, first tarsometatarsal Lapidus arthrodesis, selective soft-tissue balancing, Akin osteotomy and failure management
Jones Fracture Fixation (Proximal Fifth Metatarsal) - How to manage the proximal fifth metatarsal by zone and fix the one that will not heal — the three-zone map that separates the benign tuberosity avulsion from the watershed Jones fracture and the stress-fracture diaphysis, the vascular watershed that explains zone 2's nonunion reputation, operative indications from the athlete's primary fixation to the sclerotic delayed union, intramedullary screw technique with the high-and-inside starting point and the size arithmetic that fills the canal, when to add bone graft and biologics, the cavovarus foot that must be recognised before it refractures the screw, and the return timelines that make this small fracture a career question in sport.
Jones Tendon Transfer (EHL to First Metatarsal) - Operative guide to modified Jones extensor hallucis longus transfer for flexible claw hallux in cavovarus reconstruction, including donor assessment, hallux interphalangeal fusion, first-metatarsal fixation, tensioning and failure management.
Keller Resection Arthroplasty - How to use the oldest operation on the great toe honestly — resecting the proximal third of the proximal phalanx to decompress the destroyed first MTPJ in the low-demand elderly foot, why the fusion is the default answer and the Keller survives only in a defined niche (the frail, the ulcerated diabetic hallux, the shoe-comfort patient), the cock-up and transfer-metatarsalgia physics that follow when flexor continuity is lost, the interposition and pin refinements that tame them, and the boundaries that keep an easy operation from being an easy mistake.
Lapidus Procedure — First TMT Arthrodesis for Hallux Valgus - A triplanar operative guide to first tarsometatarsal arthrodesis for hallux valgus: selection, instability assessment, joint preparation, derotation, fixation, sagittal control and nonunion rescue.
Lateral Column Lengthening - Component-led operative guide to Evans and sinus-tarsi lateral calcaneal lengthening osteotomies for flexible forefoot abduction: selection, facet-safe planning, controlled correction, graft or wedge choice, fixation and failure rescue.
Lateral Ligament Reconstruction - Surgical reconstruction of chronic lateral ankle instability — the modified Broström (direct anatomic repair) with the Gould modification (inferior extensor retinaculum reinforcement) laid out step by step through the anterolateral exposure, plus internal brace augmentation and non-anatomic tenodesis (Chrisman-Snook, Watson-Jones) for salvage.
Lesser Toe Deformity Correction - How to correct hammer, claw and mallet toes — the dorsal PIPJ arthrodesis for rigidity, the Girdlestone-Taylor flexor-to-extensor transfer for the flexible claw toe, and DIPJ fusion for the mallet toe — with the Kelikian push-up test driving the decision.
Lisfranc Amputation - How to amputate through the tarsometatarsal joints and keep the residual foot walking straight — why the Lisfranc level exists between the transmetatarsal and the Chopart on the diabetic and trauma amputation ladder, the equinovarus deformity that unbalanced tendons guarantee and the tibialis-anterior and peroneal insertions that removal of the metatarsal bases threatens, preserving the second metatarsal base keystone or reattaching what its removal strips, percutaneous Achilles lengthening as the near-routine companion, the plantar-flap closure and its perfusion arithmetic, and the footwear and orthotic aftermath that decides daily function.
Medial Displacement Calcaneal Osteotomy (MDCO) - Operative technique for medial displacement calcaneal osteotomy to correct hindfoot valgus in flexible flatfoot and stage II PTTD — lateral oblique approach, osteotomy landmarks, medial translation technique, screw fixation, combination with FDL transfer and lateral column lengthening, complications and rehabilitation
Metatarsal Fracture ORIF - Central Rays - Surgical technique guide for open reduction and internal fixation of displaced central (2nd-4th) metatarsal fractures — the dorsal intermetatarsal exposure step by step, dorsalis pedis and superficial peroneal nerve protection, the plate vs intramedullary screw vs K-wire decision, rotation and the metatarsal parabola.
Morton's Neuroma Excision - How to excise an interdigital (Morton's) neuroma — the dorsal approach laid out step by step, division of the deep transverse metatarsal ligament to expose the neuroma plantar to it, the 3 cm proximal transection that prevents stump neuroma, and the dorsal versus plantar evidence.
Open Reduction and Internal Fixation of Ankle Fracture - Operative technique for ORIF of ankle fractures — the fibula-first fixation sequence, lateral and medial exposures with their danger structures, syndesmotic assessment under fluoroscopy, and posterior malleolar fixation.
ORIF Lisfranc Injury (Tarsometatarsal Fracture-Dislocation) - Consultant-level guide to open reduction and internal fixation of an unstable Lisfranc injury: soft-tissue timing, dorsal exposure, reduction sequence, fixation choice, fluoroscopic checks and aftercare.
Os Trigonum Excision and FHL Release - How to treat posterior ankle impingement at its source — the accessory ossicle behind the talus that dancers and footballers compress with every pointe and every strike, the forced-plantarflexion examination and guided-injection test that make the diagnosis, flexor hallucis longus tenosynovitis as the constant companion sharing one operation, open posteromedial excision with the neurovascular bundle owned before the ossicle, the posterior endoscopic alternative and its two-portal discipline, and the return-to-pointe timeline that decides careers.
Peroneal Tendon Repair & Groove Deepening - Surgical technique for peroneal tendon repair with superior peroneal retinaculum (SPR) reconstruction and selective retromalleolar groove deepening — the lateral approach posterior to the fibula step by step, sural nerve protection, the tendon-repair algorithm, and rehabilitation.
Peroneal Tendon Repair and Reconstruction - Operative decision-making and technique for peroneal tendon tears, rupture and instability: tissue-preserving repair, graft reconstruction, selective tenodesis, superior peroneal retinaculum repair and rehabilitation.
Plantar Fascia Release (Open/Endoscopic) + Baxter's Nerve Decompression - How to release the plantar fascia for recalcitrant plantar fasciitis — the open medial approach at the plantar/non-plantar skin junction step by step, partial (medial one-third to one-half) release only to avoid arch collapse, Baxter's nerve decompression, and rehabilitation.
Posterior Tibial Tendon Dysfunction - Surgical Reconstruction - How to reconstruct the failed posterior tibial tendon — the FDL transfer to the navicular plus medial displacement calcaneal osteotomy (MDCO), the medial exposure step by step, stage-based decision-making (flexible versus rigid), and rehabilitation.
Rheumatoid Forefoot Reconstruction - Comprehensive operative guide for reconstruction of the rheumatoid forefoot — first MTP arthrodesis combined with lesser metatarsal head resection (Hoffmann) or Weil shortening osteotomies and claw toe correction, including immunosuppression considerations and post-operative rehabilitation
Scarf and Akin Osteotomy for Hallux Valgus - How to perform the scarf Z-osteotomy of the first metatarsal with an Akin osteotomy of the proximal phalanx for hallux valgus — the dorsomedial exposure step by step, troughing prevention, the stepwise lateral release, and rehabilitation.
Scarf Osteotomy for Moderate-Severe Hallux Valgus - Surgical technique guide for Scarf Osteotomy for Moderate-Severe Hallux Valgus
Subtalar Arthrodesis - Isolated subtalar joint fusion via the lateral sinus tarsi approach — exposure and operative steps, the 0–5 degree valgus heel-alignment target, screw fixation, complications and viva points.
Supramalleolar Osteotomy (Distal Tibia Realignment) - Joint-preserving realignment osteotomy of the distal tibia for asymmetric varus or valgus ankle osteoarthritis — indications, pre-operative planning, medial opening-wedge and lateral closing-wedge techniques, fibular osteotomy, plate fixation, complications, and rehabilitation
Syme Amputation (Ankle Disarticulation) - Surgical technique guide for Syme ankle disarticulation for unsalvageable hindfoot/forefoot disease, detailing the exposure, subperiosteal calcaneal dissection, heel pad preservation and anchoring, and prosthetic fitting.
Tarsal Navicular Fracture ORIF - Open reduction and internal fixation of tarsal navicular fractures — Sangeorzan body fractures, tuberosity avulsions, and high-risk stress fractures in athletes — recognising the navicular as the keystone of the medial longitudinal arch and its watershed central blood supply that predisposes to avascular necrosis and nonunion
Tarsal Tunnel Release (Posterior Tibial Nerve Decompression) - How to perform a complete tarsal tunnel release — the medial curvilinear exposure from 8 cm above the malleolus to the navicular tuberosity, division of both layers of the flexor retinaculum, the critical abductor hallucis release, the three nerve branches, and evidence-based outcomes.
Tarsometatarsal (TMT) Arthrodesis - Isolated or Multi-Ray - How to perform tarsometatarsal (Lisfranc) arthrodesis - isolated or multi-ray - via dual dorsal longitudinal incisions with meticulous dorsalis pedis and deep peroneal nerve protection, fish-scale joint preparation, tripod foot alignment, and selective fusion that preserves the mobile lateral column.
Tendo-Achilles Lengthening - Tendo-Achilles lengthening — the percutaneous Hoke triple hemisection, the Vulpius V-Y gastrocnemius recession, and the open Z-plasty — for equinus contracture in cerebral palsy, the diabetic foot, clubfoot and Charcot. Silfverskiold-guided technique selection, the full step-by-step operative sequence, sural-nerve protection, and over-lengthening avoidance.
Tibialis Anterior Tendon Transfer (Whole / Split) - Surgical technique guide for whole and split anterior tibial tendon transfer — SPLATT for relapsed idiopathic clubfoot after Ponseti correction and for dynamic supination in cerebral palsy and stroke, harvest of the TA insertion, rerouting and bony fixation under tension, concurrent tendo-Achilles lengthening
Tibialis Posterior Tendon Transfer for Foot Drop - Surgical technique guide for tibialis posterior tendon transfer through the interosseous membrane to the dorsum of the foot for foot drop from common peroneal nerve palsy, leprosy, or irreversible anterior compartment loss
Tibiotalocalcaneal Arthrodesis (Hindfoot Nail) - Surgical technique guide for tibiotalocalcaneal (TTC) arthrodesis using a retrograde hindfoot intramedullary nail for combined tibiotalar and subtalar arthritis, failed total ankle replacement, Charcot hindfoot, avascular talus and severe hindfoot deformity
Total Ankle Replacement (Tibiotalar Arthroplasty) - Surgical technique guide for total ankle replacement in end-stage tibiotalar arthritis — anterior approach, mobile-bearing versus fixed-bearing designs, alignment, gutter management, complications and registry outcomes
Transmetatarsal Amputation - How to perform a transmetatarsal amputation that heals and keeps working — the diabetic forefoot indications and the perfusion arithmetic that predicts healing, staged debridement before closure in the septic foot, the long plantar flap and the metatarsal parabola with plantar-bevelled cuts, why equinus is the mode of failure and how Achilles lengthening prevents the transfer ulcer, rocker-sole rehabilitation without a prosthesis, and the honest healing rates with BKA as the fallback.
Triple Arthrodesis - Triple arthrodesis (subtalar, talonavicular, calcaneocuboid) — the dual-incision Ollier lateral plus medial exposure step by step, joint-by-joint cartilage removal and fixation, the 0-5 degree valgus alignment target, and the long-term outcome evidence.
Turf Toe Repair (Plantar Plate, First MTPJ) - How to repair the hyperextended great toe that ends seasons — the plantar plate-sesamoid complex as the first MTPJ's undercarriage and the forced-dorsiflexion mechanism that tears it, grading that separates the strapped grade 1 from the operative grade 3, the diastasis and proximal-migration radiographic signs read against the contralateral foot, the medial-plantar approach protecting the plantar digital nerve, direct plantar-plate repair with sesamoid series decisions from fracture fixation to excision-with-reconstruction, and the push-off rehabilitation timeline that returns athletes without re-tearing the repair.
Weil Osteotomy for Lesser Metatarsalgia and Metatarsal Length Abnormalities - Oblique metatarsal neck osteotomy parallel to the weight-bearing surface for transfer metatarsalgia, plantar plate insufficiency and metatarsal length discrepancy

Sports Medicine — 33 procedures

sports-medicine (33 procedures)

ACL Reconstruction - Bone-Patellar Tendon-Bone (BTB) Autograft - Surgical technique guide for ACL Reconstruction - Bone-Patellar Tendon-Bone (BTB) Autograft
ACL Reconstruction - Hamstring Autograft (4-Strand) - How to perform arthroscopic anatomic single-bundle ACL reconstruction with a 4-strand hamstring autograft via the trans-anteromedial portal — hamstring harvest, anatomic femoral and tibial tunnel placement, suspensory fixation, tensioning and criteria-based return to sport.
ACL Reconstruction Technique - How to perform anatomic ACL reconstruction — the arthroscopic exposure and portal setup, femoral and tibial tunnel placement at the native footprints, graft selection (BTB, hamstring, quadriceps, allograft), fixation and tensioning, rehabilitation and complications.
ACL Reconstruction with Quadriceps Tendon Autograft - Consultant-level guide to ACL reconstruction with quadriceps tendon autograft, covering graft selection, MRI planning, soft-tissue and bone-block harvest, anatomic tunnel creation, fixation, rehabilitation and failure management
Arthroscopic Partial Meniscectomy - Surgical technique guide for Arthroscopic Partial Meniscectomy
Autologous Chondrocyte Implantation (ACI) - Comprehensive guide to autologous chondrocyte implantation and MACI - two-stage cartilage repair, indications, surgical technique, and outcomes for orthopaedic examination
High Tibial Osteotomy (HTO) - Medial Opening Wedge - Comprehensive surgical technique guide for medial opening wedge high tibial osteotomy, including planning, fixation, and lateral hinge fracture management,
High Tibial Osteotomy with Concurrent ACL Reconstruction — Medial Opening Wedge - Patient-specific planning and operative technique for combined medial opening-wedge high tibial osteotomy and ACL reconstruction in the unstable varus knee.
Hip Arthroscopy for Femoroacetabular Impingement (FAI) - Consultant-level operative guide to hip arthroscopy for femoroacetabular impingement syndrome, including selection, imaging, postless and post-assisted traction, portal strategy, labral preservation, selective rim correction, femoral osteochondroplasty, capsular management, rehabilitation and revision planning.
Lateral Extra-Articular Tenodesis and ALL Reconstruction - How to augment an ACL reconstruction against rotatory failure — the anterolateral complex and why the pivot shift is not an ACL-only sign, who genuinely benefits (the STABILITY trial numbers and the consensus indications), the modified Lemaire tenodesis step by step with the ITB strip passed deep to the LCL, anatomic anterolateral ligament reconstruction as the alternative, the fixation position that avoids over-constraining the lateral compartment, and rehabilitation that follows the ACL.
Lateral Retinacular Release - Surgical technique for open and arthroscopic lateral retinacular release of the knee - the narrow modern indication for isolated excessive lateral patellar tilt, the lengthening alternative, and the danger of iatrogenic medial instability
Medial Collateral Ligament Repair and Reconstruction - Decision-making and operative technique for acute medial-sided repair and anatomic reconstruction of chronic valgus or anteromedial rotatory instability
Meniscal Allograft Transplantation - Arthroscopic-assisted meniscal allograft transplantation for the symptomatic meniscus-deficient knee, including selection, sizing, root fixation, graft passage, peripheral repair and concurrent correction
Meniscal Repair - All-Inside and Inside-Out Techniques - Surgical technique guide for Meniscal Repair - All-Inside and Inside-Out Techniques
Meniscal Root Repair - How to repair a meniscal root tear — why root detachment is functionally a total meniscectomy and how it fast-tracks arthritis, the middle-aged medial posterior root versus the young traumatic lateral root with ACL injury, the ghost sign and extrusion on MRI, LaPrade classification, transtibial pull-out repair step by step with cinch-stitch fixation over an anterior cortical button, when to add high tibial osteotomy or choose non-operative care, and the slow flexion-limited rehabilitation that lets the root heal.
Microfracture and Bone-Marrow Stimulation for Osteochondral Lesions of the Talus - Surgical technique guide for arthroscopic microfracture and marrow stimulation of osteochondral lesions of the talus (OLT) — indications by lesion size, anterior arthroscopic approach, debridement, microfracture technique, fibrocartilage formation, medial malleolar osteotomy considerations, complications and rehabilitation
Microfracture Technique - Comprehensive guide to microfracture for articular cartilage repair — marrow-stimulation technique, patient selection, operative steps, rehabilitation and outcomes for the orthopaedic exam
MPFL Reconstruction - Surgical technique guide for Medial Patellofemoral Ligament (MPFL) Reconstruction
Multiligament Knee Reconstruction (Knee Dislocation) - Decision-led operative guide to multiligament knee injury: emergency reduction and vascular assessment, pattern definition, timing, repair versus reconstruction, tunnel planning, graft fixation and rehabilitation
Osteochondral Allograft (OCA) - Comprehensive guide to fresh osteochondral allograft transplantation - indications, storage, surgical technique, and outcomes for orthopaedic examination
Osteochondral Autograft Transfer (OATS) - Comprehensive guide to osteochondral autograft transfer system - mosaicplasty technique, indications, donor sites, and outcomes for orthopaedic examination
Osteochondritis Dissecans of the Knee — Fixation - A lesion-led operative guide to knee osteochondritis dissecans: stability assessment, fragment salvageability, drilling, arthroscopic or open reduction, fixation, bone grafting and failure rescue.
Patellar Tendon Repair - Comprehensive surgical technique guide for acute patellar tendon repair — the midline anterior-knee exposure laid out step by step, transosseous versus suture-anchor fixation, the essential augmentation that protects the repair, patellar-height restoration, and the chronic-rupture reconstruction options.
PCL Avulsion Fracture Fixation - How to fix a posterior cruciate ligament tibial avulsion — why the bony avulsion is a different disease from the midsubstance tear, the dashboard mechanism and the posterior sag that must not be missed, the prone Burks–Schaffer posteromedial approach with the medial gastrocnemius protecting the popliteal vessels, lag-screw fixation of the large fragment and suture techniques for the comminuted one, arthroscopic transtibial alternatives, and the hamstring-avoiding rehabilitation that protects the repair.
PCL Reconstruction - How to reconstruct the posterior cruciate ligament — the dashboard-injury injury, the posterior drawer and grading, the transtibial 'killer turn' versus the tibial inlay, single versus double bundle, graft choice and the combined PCL-plus-posterolateral-corner case.
Posterolateral Corner (PLC) Reconstruction of the Knee - Surgical technique guide for anatomic posterolateral corner reconstruction — LaPrade fibular-and-tibial-based technique, common peroneal nerve protection, combined cruciate and osteotomy considerations, graft selection and fixation
Primary Quadriceps Tendon Repair with Suture Anchor Technique - Complete surgical technique guide for Primary Quadriceps Tendon Repair using suture anchors - exam preparation with anatomy, Krackow suture technique, rehabilitation protocol, and viva scenarios
Proximal Hamstring Repair - How to reattach the hamstrings to the ischial tuberosity — the waterskiing-lunge mechanism and the bruise-down-the-thigh presentation, the operative rule of thumb (two or three tendons retracted over two centimetres in an active patient, repaired inside four weeks), the prone gluteal-crease approach with the posterior femoral cutaneous nerve above and the sciatic nerve lateral, suture-anchor footprint repair step by step, the chronic retracted tear that needs sciatic neurolysis and sometimes Achilles allograft, and the hamstring-bracing rehabilitation that guards the repair for twelve slow weeks.
Quadriceps Tendon Repair - Complete surgical technique guide for Quadriceps Tendon Repair including transosseous technique, augmentation strategies, and rehabilitation - exam preparation
Remplissage for Engaging Hill-Sachs Lesions - Arthroscopic remplissage technique for engaging Hill-Sachs lesions in anterior shoulder instability — glenoid track concept, combined Bankart repair, infraspinatus tenodesis and posterior capsulodesis, indications relative to glenoid bone loss thresholds, complications and rehabilitation
Revision ACL Reconstruction - How to perform revision ACL reconstruction — failure analysis, CT tunnel assessment, the one-stage versus two-stage decision, graft selection, anatomic tunnel drilling through the anteromedial portal, and anterolateral augmentation.
Tibial Spine (Intercondylar Eminence) Fracture Fixation - Arthroscopic-assisted reduction and fixation of tibial spine avulsion fractures — Meyers and McKeever classification, physeal-sparing techniques, suture versus screw fixation, complications and rehab
Trochleoplasty for Patellar Instability - Surgical technique guide for sulcus-deepening trochleoplasty in severe high-grade trochlear dysplasia (Dejour B/D) for recurrent lateral patellar instability

Shoulder & Elbow — 49 procedures

shoulder (49 procedures)

ACJ Reconstruction / Stabilisation - Surgical technique guide for acromioclavicular joint reconstruction and stabilisation — Rockwood classification, Weaver-Dunn, suspensory fixation (Dog-Bone/TightRope), and acute vs chronic management
Adult Monteggia Fracture-Dislocation — ORIF - Operative management of adult Monteggia fracture-dislocations: pattern recognition, CT planning, anatomical ulnar reconstruction, radial-head and coronoid management, stability testing and rehabilitation
Anatomic Total Shoulder Arthroplasty - Consultant-level guide to patient selection, three-dimensional glenoid planning, deltopectoral exposure, humeral and glenoid reconstruction, subscapularis repair, rehabilitation and revision after anatomic total shoulder arthroplasty
Arthroscopic Bankart Repair for Anterior Shoulder Instability - Surgical technique guide for Arthroscopic Bankart Repair for Anterior Shoulder Instability
Arthroscopic Capsular Shift / Plication for Shoulder Instability - Consultant-level operative guide to arthroscopic capsular plication for symptomatic multidirectional shoulder instability: diagnosis, rehabilitation failure, bone-loss exclusion, direction-specific tensioning, axillary-nerve safety, selective interval closure, rescue and criteria-based recovery
Arthroscopic Posterior Labral Repair (Posterior Shoulder Instability) - Arthroscopic reverse Bankart repair and posterior capsular plication for posterior shoulder instability - indications, portal placement, anchor technique, bone loss assessment, complications and rehabilitation
Arthroscopic Rotator Cuff Repair - Single Row Technique - Surgical technique guide for Arthroscopic Rotator Cuff Repair - Single Row Technique
Arthroscopic Rotator Cuff Repair — Double Row / Transosseous-Equivalent Suture Bridge - Consultant-level operative guide to double-row transosseous-equivalent rotator cuff repair: reparability, tear-pattern reduction, layered cuff anatomy, medial and lateral fixation, bridge tension, failure rescue and criteria-based rehabilitation
Arthroscopic SLAP Repair (Shoulder) - Consultant-level guide to arthroscopic superior-labral repair: diagnosis, normal variants, repair-versus-tenodesis selection, portal and anchor safety, dynamic stability, failure rescue and return-to-throwing rehabilitation
Arthroscopic Subacromial Decompression (Acromioplasty) for Impingement Syndrome - Comprehensive surgical technique guide for arthroscopic subacromial decompression - evidence-based approach for external shoulder impingement
Biceps Tenodesis / Tenotomy (LHB) - Surgical technique guide for Long Head of Biceps Tenodesis and Tenotomy
Calcific Tendinitis of the Shoulder - Barbotage and arthroscopic excision of calcific tendinitis of the shoulder — the subacromial exposure and portal anatomy laid out step by step, the barbotage versus arthroscopic decision, the greater-than-50% rotator cuff repair threshold, and rehabilitation.
Capitellum and Coronal Shear Fracture ORIF - Consultant-level guide to capitellar and trochlear coronal shear fracture fixation: CT classification, approach selection, fragment-specific reduction, headless screws, posterior-column reconstruction, associated injuries and rehabilitation
Clavicle ORIF (Midshaft & Distal) - Surgical technique guide for Clavicle ORIF covering midshaft (Allman Group I) and distal (Neer IIA/IIB) fractures
Distal Biceps Tendon Repair - How to repair a distal biceps tendon rupture — the single anterior (modified Boyd-Anderson) exposure laid out step by step with the radial tuberosity approach, cortical-button fixation, the supination manoeuvre that protects the posterior interosseous nerve, single versus two-incision decision, and rehabilitation.
Distal Clavicle Excision (Mumford Procedure) - Open and arthroscopic distal clavicle excision (Mumford procedure) for ACJ osteoarthritis, post-traumatic arthritis, and distal clavicle osteolysis
Distal Humerus ORIF - Distal humerus ORIF — intra-articular bicolumnar fracture fixation
Elbow Arthrodesis - How to fuse the elbow when nothing else is left — why the elbow tolerates fusion worse than any major joint and there is no position that serves both the face and the world, the salvage indications after infection, trauma and failed replacement, choosing the angle for one patient's life, posterior compression-plate technique with the ulnar nerve transposed and the olecranon worked into the construct, grafting the notoriously nonunion-prone interface, and the honest functional contract signed before the saw.
Elbow Arthroscopy - Elbow arthroscopy — portals, OCD, loose bodies, contracture release
Elbow Contracture Release (Open and Arthroscopic) - How to release the stiff elbow — the functional arc that defines the indication, extrinsic versus intrinsic contracture, the lateral column procedure step by step, the Hotchkiss over-the-top medial release, when heterotopic ossification is excised and how recurrence is prevented, the ulnar nerve rule that prevents the operation's signature complication, arthroscopic release selection, and the static-progressive splinting programme that holds the gain.
Frozen Shoulder: MUA and Arthroscopic Capsular Release - How to treat refractory adhesive capsulitis — staging the disease and exhausting the injection-and-therapy pathway first, what the FROST trial actually showed, manipulation under anaesthesia with the short-lever technique and its fracture-avoidance rules, arthroscopic 360-degree capsular release starting at the rotator interval and coracohumeral ligament, the axillary nerve corridor at the inferior capsule, the diabetic caveat, and the immediate-motion aftercare that decides the result.
Irreparable Rotator Cuff Salvage: SCR and Tendon Transfers - What to do when the cuff cannot be repaired — defining irreparability by retraction, fatty infiltration and the acromiohumeral interval rather than by tear size alone, the decision tree that sends the arthritic and pseudoparalytic to reverse replacement, superior capsular reconstruction technique and its honest prerequisites, latissimus dorsi and lower trapezius transfers for the posterosuperior deficit with the vector argument between them, pectoralis major for the failed subscapularis, and the humbler options — partial repair, biceps tenotomy, debridement — that serve the pain-dominant low-demand shoulder.
Latarjet / Coracoid Transfer for Anterior Shoulder Instability - Surgical technique guide for the Latarjet coracoid transfer procedure for anterior shoulder instability with significant glenoid bone loss
McLaughlin Procedure for Locked Posterior Shoulder Dislocation - Open subscapularis or lesser-tuberosity transfer for an engaging reverse Hill-Sachs lesion after posterior shoulder dislocation, with defect, glenoid and soft-tissue decision-making
Medial Epicondylitis Release - How to operate on golfer's elbow when a year of proper non-operative care has failed — separating true flexor-pronator tendinosis from its two great mimics at the medial elbow (ulnar neuritis and MCL insufficiency), the mini-open debridement of the pathological common flexor origin, why the ulnar nerve makes this operation more dangerous than its lateral cousin, handling coexisting cubital tunnel symptoms at the same sitting, and the slow tendon-rehabilitation contract that follows.
Mini-Open Rotator Cuff Repair - Surgical technique guide for Mini-Open Rotator Cuff Repair
Open Bankart Repair for Anterior Shoulder Instability - Surgical technique guide for Open Bankart Repair for Anterior Shoulder Instability - deltopectoral approach, subscapularis takedown, capsulolabral repair.
Open Debridement of Elbow OA (Outerbridge–Kashiwagi Procedure) - How to debride the arthritic elbow — why primary elbow OA is an impingement disease of the fossae and process tips with a preserved mid-arc, the Outerbridge–Kashiwagi ulnohumeral arthroplasty step by step through a triceps split with fossa fenestration, olecranon and coronoid tip excision and loose-body clearance, the arthroscopic osteocapsular alternative, the same ulnar nerve rule as every stiff-elbow operation, and where interposition and total elbow replacement take over.
Open Rotator Cuff Repair - Comprehensive surgical technique guide for Open Rotator Cuff Repair including deltoid-splitting and deltopectoral approaches
ORIF Olecranon - ORIF olecranon fracture — tension band wiring and plate fixation
Pectoralis Major Tendon Repair - Acute and Chronic Reconstruction - How to repair a pectoralis major tendon rupture - the deltopectoral exposure step by step, mobilising the retracted sternal head, preparing the lateral lip of the bicipital groove, suture-anchor fixation at the 45-degree 'deadman' angle, augmentation in chronic and high-demand cases, and the strict 6-week protection protocol.
Posterior Bone Block / Posterior Shoulder Instability - Posterior Bankart repair, bone block (Eden-Hybinette), and posterior capsulorrhaphy for posterior shoulder instability
Radial Head Arthroplasty (RHA) - Surgical technique guide for Radial Head Arthroplasty (RHA) — Kocher approach, terrible triad and Essex-Lopresti. advanced orthopaedic practice operative-surgery preparation.
Radial Nerve Exploration - Radial nerve exploration — humeral shaft, posterior interosseous nerve (PIN)
Reverse Shoulder Arthroplasty (RSA) - How to perform reverse shoulder arthroplasty through the deltopectoral approach — the Grammont design rationale, inferior glenoid exposure and baseplate positioning step by step, scapular notching prevention, and rehabilitation.
Reverse TSA Revision - Surgical technique guide for Reverse TSA Revision
Revision Shoulder Arthroplasty to Reverse - Comprehensive surgical technique guide for revision of failed shoulder arthroplasty to reverse total shoulder replacement
Scapula Fracture ORIF - How to fix the scapula that actually needs fixing — why over 90 percent of scapular fractures are treated in a sling and the displacement thresholds (glenopolar angle, medialisation, angulation, intra-articular step) that define the operative minority, the high-energy company this fracture keeps and the chest injuries that outrank it, the Judet posterior approach and its muscle-sparing windows through the infraspinatus-teres minor interval, glenoid fossa fixation by fragment pattern, the floating shoulder decision, and the branch-by-branch protection of the suprascapular and axillary nerves.
Scapular Winging: Tendon Transfers - How to treat the winged scapula — telling medial (serratus, long thoracic) from lateral (trapezius, spinal accessory) winging at the couch, why most long thoracic palsies recover and deserve 12 to 18 months before any transfer, pectoralis major transfer with graft prolongation to the inferior angle for serratus palsy, the Eden-Lange lateralisation of levator and rhomboids for trapezius palsy, the iatrogenic accessory nerve injury that deserves early repair instead, and scapulothoracic fusion as the honest answer in dystrophic muscle.
Shoulder Arthrodesis - Glenohumeral arthrodesis for brachial plexus palsy, failed arthroplasty, irreparable rotator cuff with deltoid loss, infection, and flail shoulder
Shoulder Arthroplasty Revision - Comprehensive surgical technique guide for revision shoulder arthroplasty including anatomic TSA and conversion to reverse shoulder arthroplasty
Shoulder Hemiarthroplasty - Deltopectoral Approach - Comprehensive surgical technique guide for shoulder hemiarthroplasty via deltopectoral approach for proximal humerus fractures and glenohumeral arthritis
Sternoclavicular Joint Reconstruction - How to manage the unstable sternoclavicular joint — why posterior dislocation is a mediastinal emergency reduced with cardiothoracic cover, the physeal fracture masquerading as dislocation in patients under twenty-five, closed reduction technique with the towel-clip rescue, figure-of-eight hamstring reconstruction through clavicular and manubrial tunnels for the chronically unstable joint, medial clavicle excision for the arthritic variant with the costoclavicular ligament preserved, why transfixing pins are banned by the weight of migration fatalities, and the innominate vein that sits one drill-plunge behind everything.
Subpectoral Biceps Tenodesis - Open subpectoral biceps tenodesis technique for long head of biceps tendinopathy, instability and partial tears — axillary-fold incision, groove debridement, interference screw or cortical button fixation, length-tension restoration, nerve protection
Suprascapular Nerve Release - How to decompress the shoulder's most entrapped nerve at its two notches — why suprascapular-notch compression weakens both spinati while spinoglenoid-notch lesions silently waste infraspinatus alone, the volleyball player's ganglion and the labral tear that fills it, EMG and MRI convicting the level before any release, arthroscopic transligamentous release of the superior transverse scapular ligament step by step, the open posterior alternative, when the paralabral cyst is drained by fixing the labrum instead of opening the notch, and the recovery arithmetic of a nerve released before its muscle is fat.
Tennis Elbow Release - Lateral epicondyle release (open + arthroscopic) for tennis elbow
Total Elbow Replacement - Total elbow replacement (linked, unlinked, semiconstrained) — the Bryan-Morrey triceps-on exposure and operative sequence step by step, linked versus unlinked implant selection, lifetime activity restrictions, complications and revision.
Triceps Tendon Repair - How to repair a distal triceps tendon rupture — the posterior exposure step by step, suture-anchor versus transosseous tunnel fixation, tensioning at 30–40° flexion, augmentation for chronic tears, and rehabilitation.
Ulnar Nerve Anterior Transposition (Subcutaneous / Submuscular) - Surgical technique guide for anterior transposition of the ulnar nerve in cubital tunnel syndrome where simple in-situ decompression is insufficient — subcutaneous, intramuscular and submuscular (Learmonth) techniques, nerve mobilisation with blood supply preservation, and management of revision and complex cases

Paediatrics — 40 procedures

paediatric (40 procedures)

Boyd Amputation - How to perform the calcaneotibial-fusion amputation and why it exists — the heel-pad problem every ankle-level amputation must solve and Boyd's answer of fusing the retained calcaneus to the tibia so the pad cannot migrate, its home territory in fibular hemimelia and paediatric limb deficiency where preserving the calcaneal apophysis protects growth and end-bearing, the operative sequence from talectomy through forward-translated calcaneotibial fusion, the comparison with Syme's amputation argued honestly, and the prosthetic realities that make these end-bearing stumps lifelong walkers.
Brachial Plexus Birth Injury — Reconstruction - Decision-making and operative technique for primary microsurgical reconstruction, nerve transfers and secondary shoulder reconstruction after brachial plexus birth injury
Camptodactyly Correction - How to manage the congenitally bent little finger with proportionate care — the PIP flexion contracture whose usual author is an abnormal FDS or lumbrical insertion, the infancy and adolescent-growth-spurt presentation peaks, why stretching and splinting is the first and often only treatment with surgery reserved for severe progressive contractures, the exploration that inventories every abnormal structure from skin to volar plate, FDS release or transfer as the operative core, the bony changes that mark the point of no full return, and the honest counselling that surgical fingers improve but rarely straighten completely.
Cerebral Palsy — Open Adductor Release for Hip Displacement - Consultant-level guide to open sequential adductor longus, gracilis and selective adductor brevis release for early cerebral-palsy hip displacement, including surveillance, route selection, obturator-nerve protection, iliopsoas decisions, rehabilitation and failure management
Cerebral Palsy — Open Medial Hamstring Lengthening for Flexed-Knee Gait - Consultant-level guide to selecting and performing open medial hamstring lengthening for cerebral-palsy flexed-knee gait, including gait analysis, surgical dose, semitendinosus and semimembranosus technique, neural protection, rehabilitation and failure management
Clubfoot (CTEV) — Ponseti Method & Posteromedial Release - Surgical technique guide for congenital talipes equinovarus - Ponseti manipulation and casting, percutaneous Achilles tenotomy, foot abduction bracing, tibialis anterior transfer, and posteromedial release for resistant deformity
Congenital Muscular Torticollis - Sternocleidomastoid Release - Surgical technique guide for sternocleidomastoid release in congenital muscular torticollis - unipolar and bipolar release, danger structures, paediatric considerations and the exclusion of non-muscular torticollis
Congenital Pseudarthrosis of the Tibia: Surgical Management - How to manage one of paediatric orthopaedics' hardest problems — the anterolateral bowed tibia that must never be osteotomised, the NF-1 association that shapes counselling from the first visit, bracing to protect the pre-fracture bow, the surgical triad of radical hamartoma excision, intramedullary rodding and biological augmentation, when circular frames and vascularised fibula transfers earn their complexity, cross-union techniques that changed the union arithmetic, and the honest amputation conversation that a minority of these legs eventually require.
Congenital Vertical Talus — Minimally Invasive Correction - Consultant-level guide to diagnosis, reverse-Ponseti casting, limited talonavicular reduction and fixation, Achilles tenotomy, bracing, recurrence and salvage for congenital vertical talus.
Cubitus Varus Correction — Supracondylar Osteotomy - Consultant-level guide to three-dimensional assessment and corrective distal-humeral osteotomy for cubitus varus, including closing-wedge, dome and step-cut planning, fixation, neurovascular safety and failure management.
Curly Toe Correction (Flexor Tenotomy) - How to manage the child's curly toe with proportionate surgery — why most curly toes never need anything but reassurance, the flexion-adduction-supination deformity of the third and fourth toes and the flexor tightness that drives it, the evidence that strapping does not work, open percutaneous-style flexor tenotomy through a tiny plantar incision after age three for the persistent symptomatic toe, why tenotomy alone equals flexor-to-extensor transfer in the randomised comparison, and the Butler racquet operation for the different problem of the overlapping fifth toe.
DDH Open Reduction (Medial & Anterior Approaches) - Surgical technique guide for open reduction of developmental dysplasia of the hip in infants and young children - medial (Ludloff/Ferguson) versus anterior (Smith-Petersen/bikini) approach selection, obstacles to reduction, capsulorrhaphy, concurrent femoral and pelvic osteotomy, spica casting and avascular necrosis
DDH: Closed Reduction, Arthrogram and Spica - How to reduce the dislocated infant hip closed — the 6-to-18-month window after Pavlik failure, examination and arthrography under anaesthesia, reading the dye pool and the obstacles to reduction, the safe zone of Ramsey and why adductor tenotomy widens it, the human position that protects the femoral head from AVN, spica application and in-cast MRI confirmation, the twelve-week cast programme, and the surveillance to maturity that catches residual dysplasia while it can still be steered.
Epiphysiodesis for Leg-Length Discrepancy - Operative-surgery guide to permanent growth-plate arrest for leg-length discrepancy — timing and growth prediction (Green-Anderson, Moseley, Paley), the percutaneous drill-and-curette exposure step by step, Phemister and PETS alternatives, and complications.
Femoral Varus Derotation Osteotomy (VDRO) - Surgical technique guide for proximal femoral varus derotation osteotomy - correction of excessive femoral anteversion and coxa valga to improve hip containment in DDH, Perthes, and neuromuscular hip subluxation
Guided Growth / Hemiepiphysiodesis (Tension-Band Plating) - Surgical technique guide for temporary hemiepiphysiodesis with tension-band plating (eight-Plate) for paediatric coronal and sagittal angular deformity - growth-plate principles, CORA planning, overcorrection avoidance, reversibility and rebound
Hip Spica Cast Application - Surgical technique guide for Hip Spica Cast Application
Limb Lengthening with Magnetic Intramedullary Nails - How to lengthen a limb from the inside — who genuinely needs lengthening and the discrepancy thresholds, magnetic nail versus circular frame trade-offs including the weight-bearing restriction and the STRYDE withdrawal told honestly, pre-operative planning of canal, nail and osteotomy, the ream-vent-osteotomise sequence with a low-energy percutaneous osteotomy, external remote controller programming at Ilizarov's rates, the joint-protection physiotherapy that femoral and tibial lengthening each demand, congenital-limb caveats about unstable hips and ACL-deficient knees, and regenerate surveillance to consolidation and implant removal.
Paediatric ACL Reconstruction (Physeal-Sparing) - How to reconstruct the ACL in a knee that is still growing — why the old advice to wait for maturity traded growth plates for menisci and cartilage, staging skeletal age (Tanner, bone age, growth remaining) as the operation-selector, the Micheli-Kocher iliotibial-band combined intra- and extra-articular reconstruction for the youngest knees, all-epiphyseal socket techniques for the middle years, transphyseal soft-tissue grafts with the vertical-central-tunnel rules for adolescents nearing maturity, the growth-disturbance surveillance every family signs up to, and the re-rupture arithmetic that makes rehabilitation and return-to-sport gating half the operation.
Paediatric Both-Bone Forearm Fracture — Flexible Intramedullary Nailing - Surgical technique guide for flexible intramedullary nailing of displaced paediatric both-bone forearm fractures — antegrade ulnar and retrograde radial insertion, radial bow restoration, physis protection, and complication avoidance
Paediatric Femoral Shaft Fracture — Flexible Intramedullary Nailing - How to perform titanium elastic (flexible) intramedullary nailing of a paediatric femoral shaft fracture — the retrograde distal-entry exposure step by step, pre-bent nail and balanced three-point fixation principles, length-stable fracture selection, end-cap use, and complication avoidance.
Paediatric Lateral Humeral Condyle Fracture ORIF - Open reduction and internal fixation of displaced paediatric lateral humeral condyle fractures — Kocher lateral approach, posterior soft-tissue preservation, K-wire or screw fixation, Milch and Weiss classification, nonunion risk and complications
Paediatric Medial Epicondyle Fracture ORIF - Open reduction and internal fixation of displaced paediatric medial humeral epicondyle (apophyseal avulsion) fractures - absolute and relative indications, the medial approach with ulnar nerve protection, single cannulated screw fixation, and the displacement-threshold controversy
Paediatric Radial Neck Fracture Management - Surgical technique guide for management of paediatric radial neck (proximal radial physis) fractures — Judet classification, closed reduction manoeuvres (Patterson, percutaneous push), Métaizeau intramedullary elastic nailing, open reduction, AVN prevention, and rehabilitation
Pelvic Osteotomies — A Comparative Overview - Comparative overview of pelvic osteotomies for hip dysplasia - redirectional (Salter, triple, periacetabular/PAO), reshaping (Pemberton, Dega) and salvage (Chiari, shelf/Staheli) procedures, with selection by triradiate status, congruity and age
Pemberton & Dega Acetabuloplasty - Surgical technique guide for incomplete pericapsular acetabular reshaping osteotomies in developmental dysplasia of the hip - Pemberton (triradiate hinge) and Dega (posterior cortex hinge), indications, anatomy, technique, complications
Perthes Containment Surgery (Femoral & Pelvic Osteotomy) - Surgical technique guide for containment surgery in Legg-Calvé-Perthes disease - femoral varus osteotomy, Salter pelvic osteotomy, combined and salvage procedures, prognostic factors and the containment principle
Physeal Bar Resection - Selection, three-dimensional mapping and operative technique for physeal bar resection, interposition and deformity management in a growing child.
Polydactyly Correction - How to correct the duplicated digit properly — why thumb duplication is a reconstruction and never a simple excision, Wassel-Flatt classification as the operative map with type IV as the commonest examination case, preserving the ulnar thumb and rebuilding the radial collateral ligament and thenar insertions onto it, the Bilhaut-Cloquet combination and its nail-and-physis caveats, postaxial polydactyly's spectrum from suture ligation of the pedunculated type B digit to formal reconstruction of type A, and the growth-length surveillance that follows every duplicated thumb to maturity.
Salter Innominate Osteotomy - Surgical technique guide for the Salter innominate osteotomy - redirectional single pelvic osteotomy for developmental dysplasia of the hip and residual acetabular dysplasia, with operative steps, danger zones and comparison with Pemberton and Dega osteotomies
SCFE — Modified Dunn Procedure (Surgical Hip Dislocation and Subcapital Realignment) - Operative technique guide for the modified Dunn procedure in moderate-to-severe and unstable slipped capital femoral epiphysis — Ganz surgical hip dislocation, retinacular flap development, subcapital realignment, and epiphyseal blood supply protection
SCFE Deformity Correction: Imhäuser / Southwick Osteotomy - How to correct the healed slipped epiphysis that leaves the head pointing backwards — the retroversion-varus-extension deformity a moderate-to-severe SCFE builds into the proximal femur and the impingement it grinds into the acetabular rim, why the intertrochanteric level trades correction perfection for vascular safety against the subcapital osteotomy's opposite bargain, the Imhäuser flexion-internal-rotation osteotomy planned from the slip angle, Southwick's triplane geometry distinguished, blade-plate execution on the trochanteric table, the modified Dunn alternative argued honestly for the unstable acute slip, and the arthrosis clock all SCFE corrections race.
Selective Dorsal Rhizotomy (SDR) for Spastic Cerebral Palsy - Surgical technique guide for Selective Dorsal Rhizotomy (SDR) for Spastic Cerebral Palsy
Septic Hip: Open Washout (Paediatric and Adult) - How to decompress the septic hip — why hours matter for cartilage and the femoral head's blood supply, Kocher and Caird criteria against transient synovitis, ultrasound and aspiration, the anterior Smith-Petersen arthrotomy step by step with pus sampled before a drop of saline, why the anterior route protects the retinacular vessels, the neonatal caveats and the medial and arthroscopic alternatives, drain-and-loose-closure logic, antibiotic duration, and the AVN and growth-arrest surveillance that follows every case.
Sprengel Deformity Correction - Operative technique guide for surgical correction of Sprengel deformity (congenital elevated scapula) - the Woodward and Green procedures, omovertebral bone excision, supraspinous resection, clavicular osteotomy, brachial plexus protection, and paediatric considerations
SUFE Pinning - In Situ Fixation with Single Central Screw - Comprehensive examination guide to in situ screw fixation for slipped upper femoral epiphysis (SUFE/SCFE), including Loder classification, Southwick angle measurement, screw positioning, and AVN prevention strategies
Supracondylar Humeral Osteotomy for Cubitus Varus - Comprehensive surgical technique guide for corrective osteotomy of cubitus varus deformity following malunited supracondylar fractures
Syndactyly Release - How to separate webbed fingers — simple versus complex and complete versus incomplete classification, why border digits are released early and only one side of a digit is ever operated at a time, the dorsal commissural flap and interdigitating zigzag design, why skin is always deficient and where the full-thickness graft comes from, nail-fold reconstruction with pulp flaps in complete syndactyly, the common neurovascular bifurcation that sets the release's depth, web creep surveillance through growth, and the syndromic hand's different rules.
Tarsal Coalition Resection - Calcaneonavicular and Talocalcaneal - Comprehensive surgical technique for resection of calcaneonavicular and talocalcaneal coalitions with muscle interposition to restore subtalar motion in symptomatic rigid flatfoot
Triple Pelvic Osteotomy (Steel / Tönnis) - How to redirect the adolescent dysplastic acetabulum when the triradiate cartilage bars a PAO and a Salter cannot swing far enough — cutting all three bones (ilium, ischium, pubis) to free the acetabular fragment completely, the Steel and Tönnis variants distinguished by their ischial cuts, who sits in the window between the young child's single-cut Salter and the mature adolescent's periacetabular osteotomy, the sciatic nerve at the ischial cut and the obturator structures at the pubic cut, correcting coverage without retroverting the socket, and the fixation and union arithmetic of a free acetabular fragment in a growing pelvis.

Oncology — 24 procedures

oncology (24 procedures)

Allograft-Prosthetic Composite (APC) Reconstruction - How to perform an allograft-prosthetic composite reconstruction after bone-tumour resection — cementing a long-stem prosthesis into a structural allograft, the step-cut and plate host-allograft junction, the abductor and patellar-tendon reattachment that is the biological advantage over a megaprosthesis, junction nonunion and allograft fracture management, and the APC-versus-megaprosthesis-versus-osteoarticular decision.
Amputation for Tumour (Forequarter, Hindquarter & Rotationplasty) - Surgical technique guide for amputation in musculoskeletal oncology - oncological principles, forequarter (Berger), hindquarter (external hemipelvectomy), transfemoral/transtibial amputation, and Van Nes rotationplasty
CT-Guided Radiofrequency Ablation of Osteoid Osteoma - Operative guide to CT-guided radiofrequency ablation of osteoid osteoma, including diagnostic confirmation, biopsy strategy, trajectory planning, coaxial nidus access, device-specific thermal dosing, protection of skin, cartilage and nerves, difficult-site techniques, recurrence and rehabilitation.
Curettage, Local Adjuvant & Reconstruction (GCT and benign-aggressive bone lesions) - How to perform intralesional extended curettage of benign-aggressive bone lesions — the cortical window, high-speed burr, local adjuvants (phenol, cryotherapy, PMMA), cavity reconstruction, and giant cell tumour specifics including denosumab.
Distal Femoral Replacement (Megaprosthesis) - Multidisciplinary planning, oncologic resection, modular rotating-hinge reconstruction, fixation, soft-tissue restoration and failure management for distal femoral replacement
Endoprosthetic Reconstruction (Tumour Megaprosthesis) - Surgical technique guide for modular endoprosthetic replacement after segmental bone resection for primary bone sarcoma and metastatic disease - proximal femur, distal femur, proximal tibia, proximal humerus, Henderson failure modes, soft-tissue reconstruction
Expandable (Growing) Endoprosthesis in the Skeletally Immature - How to reconstruct a periphyseal bone sarcoma in a growing child with an expandable endoprosthesis — distal femoral resection and hinged reconstruction step by step, minimally invasive versus non-invasive electromagnetic lengthening, predicting and managing limb-length discrepancy, and the decision against rotationplasty and amputation.
Forequarter (Interscapulothoracic) Amputation - How to perform a forequarter (interscapulothoracic) amputation for an unresectable shoulder-girdle or proximal-humeral tumour — the clavicle-first anterior (Berger) exposure, early subclavian vascular control, brachial-plexus division, scapular detachment and chest-wall flap cover, with phantom-pain management and the limb-salvage (Tikhoff-Linberg) contrast.
Hindquarter Amputation (External Hemipelvectomy) - How to perform an external hemipelvectomy (hindquarter amputation) for an unresectable pelvic or proximal-thigh sarcoma — the classic posterior gluteal flap and the anterior quadriceps flap alternative, iliac vessel control, division of the pubic symphysis and sacroiliac joint, durable flap cover, complications and contrast with internal hemipelvectomy.
Hip Disarticulation - How to remove the limb through the hip joint when nothing distal can be saved — the tumour, infection and vascular catastrophes that reach this level and the hindquarter alternative above it, the posterior gluteal flap that becomes the sitting and socket surface, the racquet incision and vessel-first sequence at the femoral triangle, muscle-group management from the psoas to the short external rotators, why the prosthetic reality (high energy cost, low long-term use) must be spoken before consent rather than after rehabilitation, and the phantom-pain and wound arithmetic of amputation at its most proximal ambulatory level.
Intercalary Resection and Reconstruction for Diaphyseal Tumours - How to perform an intercalary (joint-preserving) resection and reconstruction for a diaphyseal bone sarcoma — wide en-bloc resection with the adjacent joints preserved, the four reconstructions (structural allograft, vascularised fibula, Capanna composite, intercalary spacer), fixation and the dominant complications of nonunion, graft fracture and infection.
Internal Hemipelvectomy (Periacetabular / Enneking Type II Resection) - How to perform a limb-sparing periacetabular (Enneking Type II) internal hemipelvectomy for pelvic sarcoma — the ilioinguinal/utilitarian exposure with iliac-vessel and femoral-nerve control, the pubic, ischial and supracetabular osteotomies, en-bloc resection, reconstruction options (saddle, custom/3D-printed endoprosthesis, hip transposition, allograft-composite, flail hip) and the high blood-loss and infection burden.
Musculoskeletal Tumour Biopsy — Principles & Technique - Surgical technique guide for biopsy of bone and soft-tissue tumours - core needle vs open incisional vs excisional biopsy, tract planning, sarcoma centre principles, and the consequences of poorly-executed biopsy
Osteochondroma Excision - How to remove the commonest benign bone tumour properly — the cartilage-capped exostosis growing away from the physis on its own marrow-continuous stalk, the symptoms that earn surgery from bursae and snapping tendons to nerve and vessel compression, the malignant-change surveillance arithmetic (cap thickness over 2 centimetres in the adult is the number that matters), extraperiosteal excision at the stalk's base taking the entire cartilage cap and overlying perichondrium in one piece, hereditary multiple exostoses with its higher transformation rate and forearm deformity problems, and why leaving cap behind is the recurrence mechanism.
Prophylactic Fixation of Metastatic Bone Disease (Impending Fracture) - How to prevent a pathological fracture — the Mirels score and the threshold to fix, the whole-bone fixation principle (long cephalomedullary nail spanning the femur), cement augmentation of lytic defects, pre-operative embolisation of vascular metastases, the fixation-versus-endoprosthesis decision, and adjuvant radiotherapy plus bone-targeted systemic therapy.
Proximal Femoral Endoprosthetic Replacement for Tumour - How to perform a modular proximal femoral replacement (megaprosthesis) after wide resection of a proximal femoral tumour — biopsy-tract planning and Enneking margins, the extended lateral exposure and the structures at risk, modular implant assembly with a bipolar or dual-mobility articulation, abductor and capsule reconstruction to restore abduction and cut the high dislocation rate, complications and adjuvant therapy timing.
Proximal Humeral Endoprosthetic Replacement for Tumour - How to perform a proximal humeral endoprosthetic replacement after wide tumour resection — the deltopectoral or extended exposure step by step, the critical decision to preserve or sacrifice the axillary nerve and deltoid, modular cemented prosthesis with synthetic mesh soft-tissue reconstruction, allograft-prosthetic composite as an alternative, and the functional outcome (stable shoulder, functional hand, limited active elevation).
Proximal Tibial Endoprosthetic Replacement for Tumour - How to perform a wide resection of the proximal tibia for an osteosarcoma and reconstruct it with a modular endoprosthesis — the two signature problems (extensor-mechanism reconstruction and soft-tissue cover), the medial gastrocnemius flap that solves both, the rotating-hinge articulation, protection of the neurovascular bundle and common peroneal nerve, complications and rehab.
Rotationplasty (Van Nes) for Distal Femoral / Knee Tumours - How to perform a Van Nes (Borggreve) rotationplasty for a distal femoral or proximal tibial sarcoma in a skeletally immature child — wide resection of the tumour and knee, 180-degree rotation of the distal limb so the ankle becomes a knee, with sciatic nerve and vessel preservation, femorotibial fixation and prosthetic rehabilitation.
Sacral and Pelvic Tumour Resection (Internal Hemipelvectomy) - Operative technique guide for internal hemipelvectomy and sacrectomy for primary pelvic and sacral tumours — Enneking zones, staged anterior-posterior approaches, margin planning, neurovascular control, reconstruction options and functional trade-offs
Structural Allograft Reconstruction after Bone Tumour Resection - Consultant-level guide to intercalary, osteoarticular and allograft-prosthesis composite reconstruction after bone tumour resection, including graft matching, fixation, vascularised-fibula augmentation, junction biology, rehabilitation and failure management
Total En-Bloc Spondylectomy for Spinal Tumour (Tomita Technique) - How to perform total en-bloc spondylectomy for an isolated primary or solitary metastatic spinal tumour — the piecemeal-versus-en-bloc oncological principle, WBB staging and the Tomita score, the posterior-only Tomita technique with pediculotomy and the threadwire saw (T-saw), cord and great-vessel protection, anterior column reconstruction, and the local-control rationale.
Wide / Compartmental Excision of Soft-Tissue Sarcoma - How to perform a wide excision of an extremity soft-tissue sarcoma with an oncological margin — image-guided core biopsy along a resectable tract, the en-bloc principle of taking a continuous cuff of normal tissue (and why historical compartmentectomy is now largely replaced by wide margins plus radiotherapy), neurovascular preservation versus sacrifice and reconstruction, clipping the tumour bed for adjuvant radiotherapy, flap cover, margins and local recurrence.
Wide Local Excision & Limb Salvage — Surgical Margins in Sarcoma - Surgical technique guide for wide local excision and limb salvage in bone and soft-tissue sarcoma - Enneking margins, R0/R1/R2 classification, limb salvage versus amputation, biopsy tract excision, and reconstruction options

Approaches & Principles — 14 procedures

surgical-approaches (8 procedures)

Anterior Approach to the Cervical Spine - Comprehensive exam-focused review of Anterior Approach to the Cervical Spine including clinical presentation, investigation, management, and key exam points
Kocher-Langenbeck Approach to the Posterior Acetabulum - Comprehensive exam-focused review of Kocher-Langenbeck posterior approach to the acetabulum including surgical anatomy, technique, indications, and key exam points
Surgical Approaches to the Ankle, Hindfoot and Foot - Advanced orthopaedic guide to surgical approaches around the ankle, hindfoot and foot, including anterior ankle, posterolateral ankle, medial ankle, sinus tarsi, extensile lateral calcaneus, dorsal midfoot and medial first-ray exposures.
Surgical Approaches to the Cervical and Thoracolumbar Spine - Advanced orthopaedic guide to cervical, thoracic, thoracolumbar and lumbar spine surgical approaches, including anterior cervical, posterior cervical, posterior thoracolumbar, anterior thoracic, lateral retroperitoneal, LLIF, OLIF and ALIF exposures.
Surgical Approaches to the Forearm, Wrist and Hand - Advanced orthopaedic guide to surgical approaches in the forearm, wrist and hand, including Henry, Thompson, carpal tunnel, scaphoid, flexor tendon and extensor tendon exposures.
Surgical Approaches to the Hip and Pelvis - An advanced orthopaedic guide to choosing and describing surgical approaches around the hip, acetabulum and pelvis, including relevant anatomy, imaging, exposure selection, operative steps and complications.
Surgical Approaches to the Knee - Advanced orthopaedic guide to surgical approaches around the knee, including medial parapatellar, subvastus, midvastus, lateral parapatellar, posteromedial and posterolateral exposures.
Surgical Approaches to the Shoulder and Elbow - An advanced orthopaedic guide to choosing and describing surgical approaches around the shoulder, proximal humerus and elbow, including anatomy, exposure selection, operative steps, complications and evidence.

general-ortho (5 procedures)

Above-Knee Amputation (Transfemoral) - Surgical technique guide for Above-Knee (Transfemoral) Amputation
Amputation Surgical Principles - Comprehensive guide to amputation surgical principles - level selection, myodesis vs myoplasty, bone handling, nerve management, prosthetic considerations, phantom limb pain for orthopaedic exam
Below-Knee Amputation (Transtibial) - Surgical technique guide for Below-Knee (Transtibial) Amputation
Lower Limb Amputation Levels - Comprehensive guide to lower limb amputation levels - toe, ray, transmetatarsal, Chopart, Lisfranc, Syme, transtibial, knee disarticulation, transfemoral, hip disarticulation. Energy expenditure, prosthetic outcomes, healing considerations for orthopaedic exam
Through-Knee Amputation (Knee Disarticulation and Gritti-Stokes) - How to amputate through the knee and when to prefer it — the non-ambulator for whom it is the best level in surgery, end-bearing and muscle balance versus the prosthetic knee-centre problem, Bowker's sagittal-flap disarticulation with gastrocnemius cover step by step, patellar tendon to cruciate anchoring, traction neurectomy of the tibial nerve, the Gritti-Stokes variant and its patellar nonunion problem, and rehabilitation from immediate transfer-friendly stumps to polycentric prosthetic knees.

general (1 procedures)

Hip Arthrodesis - Consultant-level operative planning, technique, complications and conversion principles for the exceptionally rare contemporary hip arthrodesis.

Operative Procedures Workbench - 456+ Surgical procedures

Arthroplasty — 69 procedures

adult-reconstruction (67 procedures)

Allograft-Prosthetic Composite (APC) Reconstruction - Fellowship-level guide to allograft-prosthetic composite (APC) reconstruction: combining a structural bulk allograft (restoring bone stock and providing soft-tissue/tendon reattachment) with a prosthesis (providing the joint surface) for massive segmental bone loss after tumour resection, failed revision arthroplasty or periprosthetic bone loss; the advantages over a megaprosthesis (bone stock, soft-tissue attachment), the site-specific uses, and the allograft-related complications (nonunion, resorption, fracture, infection).
Complex Primary THA (Dysplasia, Protrusio, Ankylosis, Post-Traumatic) - How to replace the hip that primary technique alone cannot serve — Crowe-graded dysplasia with the cup at the true acetabulum and the subtrochanteric shortening osteotomy that makes high dislocations reducible without stretching the sciatic nerve, protrusio acetabuli's medialised floor grafted back to lateralise the centre of rotation, the ankylosed or fused hip converted with abductor honesty, post-traumatic arthroplasty through old fixation with infection excluded first, and the implant, nerve and expectation arithmetic that separates these operations from routine arthroplasty.
Comprehensive Knee Osteotomy — HTO, DFO and TTO - Consultant-level guide to high tibial, distal femoral and tibial tubercle osteotomy, including deformity localisation, mechanical-axis planning, joint-line control, slope and patellar-height effects, biplanar technique, fixation, rehabilitation and failure management
Constrained Condylar Knee Revision Arthroplasty - Consultant-level guide to diagnosing instability, excluding infection, reconstructing bone and joint line, selecting CCK rather than PS or hinge, zonal fixation, gap balancing and failure management in revision knee arthroplasty.
Constrained Total Knee Replacement (VVC/CCK/Hinged) - Surgical technique guide for Constrained Total Knee Replacement (VVC/CCK/Hinged) - constraint selection, AORI bone loss reconstruction, enhanced exposure, popliteal vessel safety and revision cementation
Conversion THA (Failed Hip Fracture Fixation) - Comprehensive surgical technique guide for conversion total hip arthroplasty following failed hip fracture fixation - evidence-based approach with detailed operative steps and complication management
Conversion THA after Failed Hemiarthroplasty - Consultant-level guide to diagnosing painful hemiarthroplasty, excluding infection, deciding stem retention or revision, reconstructing acetabular erosion and protrusio, preventing instability and managing conversion complications.
Core Decompression — Femoral Head AVN - How to perform core decompression for pre-collapse (Ficat/ARCO I–II) femoral head osteonecrosis — the percutaneous lateral exposure through vastus lateralis step by step, biplanar-fluoroscopy trajectory to the anterosuperior lesion, the 5 mm subchondral safety margin, single-versus-multiple core choice and adjuncts (tantalum, vascularised fibula).
Distal Femoral Osteotomy - How to perform a varus-producing distal femoral osteotomy for the valgus knee with lateral-compartment osteoarthritis — the lateral exposure step by step, opening- versus closing-wedge technique, CORA-based correction, fixation, rehabilitation, and complications.
Free Vascularised Fibular Graft - Surgical technique guide for Free Vascularised Fibular Graft (FVFG) for large segmental long-bone defects and femoral-head osteonecrosis, including lateral leg approach, harvest, anastomosis, and fixation.
Girdlestone Resection Arthroplasty of the Hip - Pathology-led spacer-free hip resection for infection and non-reconstructable disease: selection, sampling, implant and cement removal, debridement, bone preservation, dead-space planning, rehabilitation and conversion assessment
High Tibial Osteotomy - How to perform a high tibial osteotomy (HTO) for medial compartment osteoarthritis with varus malalignment — the medial opening-wedge exposure and biplanar osteotomy step by step, opening- versus closing-wedge decision, Fujisawa-point correction, rehabilitation, and complications.
Hip Abductor Tendon Repair - How to repair the 'rotator cuff of the hip' — why lateral hip pain with a Trendelenburg lurch is a gluteus medius tear until proven otherwise and not 'trochanteric bursitis' by default, the examination triad (resisted-abduction pain, 30-second single-leg-stance test, Trendelenburg gait) and MRI's fatty-atrophy verdict that decides repairability, open double-row transosseous-equivalent repair onto a prepared trochanteric footprint step by step, the endoscopic alternative for partial undersurface tears, gluteus maximus transfer and reconstruction when the tendon is gone, and the slow, protected rehabilitation this repair cannot survive without.
Hip Fusion Takedown and Conversion to THA - How to give a fused hip back its motion — why conversions are driven by the neighbours (back pain, ipsilateral knee, contralateral hip) rather than the fused joint itself, the abductor assessment that predicts everything and the EMG that sometimes settles it, re-deriving acetabular landmarks inside a fusion mass with the teardrop and obturator foramen under fluoroscopy, the in-situ neck osteotomy that creates a joint where none exists, staged expectations for a gait relearned after decades, and the nerve, dislocation and limp arithmetic that makes this conversion the most demanding 'primary' in arthroplasty.
Hip Resurfacing Arthroplasty - Consultant-level operative technique for modern metal-on-metal whole-joint hip resurfacing via the posterior approach, covering restricted patient selection, device-specific planning, femoral and acetabular preparation, bailout to total hip arthroplasty, ARMD surveillance and revision strategy.
Hybrid Total Hip Replacement (Cemented Stem, Uncemented Cup) - Consultant-level operative technique for hybrid total hip arthroplasty using a cemented femoral stem and uncemented acetabular component, including fixation selection, posterior exposure, implant-specific cementing, bailout strategies and perioperative safety
Knee Arthrodesis - Surgical technique guide for Knee Arthrodesis (knee fusion)
Knee Synovectomy - Surgical technique guide for Knee Synovectomy (open and arthroscopic)
Management of the Stiff Total Knee Arthroplasty - Diagnostic and operative guide to post-TKA stiffness, manipulation under anaesthesia, arthroscopic or open arthrolysis, extensile exposure and cause-directed revision
Minimally Invasive Posterior THA - Surgical technique guide for Minimally Invasive Posterior Total Hip Arthroplasty - exam preparation
Patellar Resurfacing in Primary Total Knee Arthroplasty - Operative technique guide for patellar resurfacing during primary TKA — indications and evidence for routine versus selective resurfacing, native thickness measurement, composite thickness restoration, medialised patellar button, patellar tracking assessment with the no-thumb test, and management of complications including fracture, AVN, clunk and loosening
Patellofemoral Arthroplasty - Decision-led guide to patellofemoral arthroplasty for isolated end-stage patellofemoral disease: selection, component positioning, tracking, patellar resurfacing and conversion strategy.
Periprosthetic Joint Infection — DAIR - Decision-led operative guide to debridement, antimicrobial therapy and implant retention for acute hip and knee periprosthetic joint infection.
Periprosthetic Joint Infection — One-Stage Exchange Revision - Decision-led operative guide to direct one-stage exchange revision for hip and knee periprosthetic joint infection.
Primary Total Hip Arthroplasty - How to perform a primary total hip arthroplasty — the posterior (Moore/Southern) exposure step by step, cup and stem technique, the Lewinnek safe zone and capsular repair for dislocation prevention, and rehabilitation.
Primary Total Knee Arthroplasty - Standard Measured Resection Technique - Surgical technique guide for Primary Total Knee Arthroplasty - Standard Measured Resection Technique
Primary Total Knee Replacement - Comprehensive Technique - How to perform a primary total knee replacement through the medial parapatellar approach — the exposure step by step, the tibial and femoral cuts, femoral rotation references, gap balancing, patellar resurfacing and cementation.
Primary Total Knee Replacement (TKR) - How to perform a primary total knee replacement - the medial parapatellar arthrotomy step by step, measured-resection bone cuts, femoral rotation and soft-tissue gap balancing, and the evidence behind implant and fixation choices.
Revision THA — Cup-Cage Construct for Pelvic Discontinuity - Surgical technique for cup-cage reconstruction in revision total hip arthroplasty with chronic pelvic discontinuity and severe acetabular bone loss — Paprosky classification, extensile posterior approach, distraction technique, tantalum cup plus antiprotrusio cage, bone grafting, fixation principles, complications and outcomes
Revision THA — Femoral Impaction Bone Grafting - Operative technique for femoral impaction bone grafting in revision total hip arthroplasty for cavitary femoral bone loss — indications, defect containment, sequential graft impaction, polished tapered cemented stem, Exeter/Slooff technique, complications and outcomes
Revision THA Bone Loss and Reconstruction - Advanced orthopaedic guide to revision total hip arthroplasty bone loss and reconstruction: pre-operative workup, Paprosky classification, acetabular reconstruction, pelvic discontinuity, femoral fixation strategy, extended trochanteric osteotomy and complications.
Revision TKA — Stems, Offsets and Metaphyseal Fixation Principles - Operative technique and fixation principles for revision total knee arthroplasty using stems, offset adapters, cones and sleeves — zonal fixation concept, diaphyseal engagement, joint line restoration and AORI defect management
Revision Total Hip Replacement - Surgical technique guide for Revision Total Hip Replacement
Revision Total Hip Replacement - Acetabular Component - How to revise a failed acetabular component — the posterior exposure and step-by-step technique, mandatory infection workup, Paprosky bone-loss classification, defect-driven reconstruction (jumbo cup, augments, cup-cage, custom triflange), dual mobility for instability, and complications.
Revision Total Hip Replacement - Femoral Component - Surgical technique guide for femoral-component revision total hip replacement - the posterior approach, the extended trochanteric osteotomy (ETO), Paprosky-driven stem selection and diaphyseal fixation.
Revision Total Hip Replacement for Aseptic Loosening - Surgical technique guide for Revision Total Hip Replacement for Aseptic Loosening
Revision Total Hip Replacement for Recurrent Instability - Surgical technique guide for Revision Total Hip Replacement for Recurrent Instability
Revision Total Knee Arthroplasty for Aseptic Loosening - A consultant-level guide to revision total knee arthroplasty for aseptic loosening: failure-mechanism confirmation, EBJIS-based infection exclusion, component extraction, extensor-safe exposure, AORI bone-loss assessment, zonal fixation, cones and sleeves, stems, joint-line restoration, constraint selection and postoperative recovery.
Revision Total Knee Replacement - Femoral Component - Surgical technique guide for Revision Total Knee Replacement - Femoral Component
Revision Total Knee Replacement - Patellar Component (Resurfacing/Revision) - How to revise the patellar component in total knee arthroplasty — the medial parapatellar exposure step by step, the bone-stock-driven decision to resurface, augment, patelloplasty or patellectomy, the composite-thickness and no-thumb-tracking rules, intra-operative fracture management, and rehabilitation.
Revision Total Knee Replacement - Tibial Component - Surgical technique guide for Revision Total Knee Replacement - Tibial Component with AORI classification, defect management, and constraint selection
Revision Total Knee Replacement (rTKR) - Surgical technique guide for Revision Total Knee Replacement (rTKR)
THA Revision - Acetabular Component (Jumbo Cup/Augments) - Comprehensive surgical technique for revision acetabuloplasty using jumbo cups and augments for Paprosky II/IIIA defects with detailed operative steps, complications, and exam-focused clinical scenarios
THA Revision - Femoral Component (Extensively Porous Stem) - How to revise an aseptically loose femoral stem with an extensively porous-coated cylindrical stem and an extended trochanteric osteotomy — the posterior exposure step by step, the Paprosky femoral classification, the scratch-fit fixation principle, and global registry outcomes.
Tibial Tubercle Osteotomy - Comprehensive guide to the tibial tubercle osteotomy (TTO) for extensile exposure in difficult and revision total knee arthroplasty, extensor mechanism repair and patellofemoral reconstruction — the long, laterally-pedicled anterior tibial crest osteotomy, its step-by-step technique, fragment fixation, and complication avoidance.
TKA Revision - Femoral Component with Sleeves - Comprehensive surgical technique for revision TKA with metaphyseal sleeves for AORI Type 2B/3 femoral bone defects - evidence-based approach
TKA Revision - Tibial Component with Cones - How to revise a total knee arthroplasty with a porous metal tibial cone for AORI Type 2B/3 bone loss — the extensile exposure and component removal, reaming to bleeding bone, press-fit cone and cemented baseplate technique, stem load-sharing, and complications.
TKA Surgical Approaches - Comprehensive guide to medial parapatellar, subvastus, midvastus, and lateral approaches for total knee arthroplasty including indications, technique, and complications
Total Hip Arthroplasty - Revision with Extended Trochanteric Osteotomy - Surgical technique guide for revision total hip arthroplasty with an Extended Trochanteric Osteotomy - the posterior approach and ETO exposure step by step, fragment blood-supply preservation, cement removal, cable fixation, stem selection by Paprosky grade, and protected weight-bearing rehabilitation.
Total Hip Arthroplasty - Two-Stage Revision for Chronic Periprosthetic Joint Infection - Comprehensive surgical technique guide for two-stage revision THA for chronic periprosthetic joint infection with MSIS criteria, articulating spacer, high-dose antibiotic cement protocol, and reimplantation strategies
Total Hip Arthroplasty — SuperPATH Technique - Consultant-level operative guide to SuperPATH total hip arthroplasty: terminology, evidence, patient selection, direct superior exposure, femoral preparation with the head intact, in-situ neck osteotomy, portal-assisted acetabular preparation, component verification, conversion and complication management.
Total Hip Arthroplasty Surgical Approaches - Comprehensive guide to THA surgical approaches including posterior, direct anterior, anterolateral, and lateral approaches with nerve injury patterns, dislocation rates, and AOANJRR outcomes data
Total Hip Replacement - Cemented Femoral Technique (Modern 3rd/4th Generation) - Comprehensive surgical technique guide for modern cemented femoral component insertion using third and fourth-generation cementing principles with detailed attention to canal preparation, retrograde cement insertion, and pressurization techniques for optimal fixation and long-term survival
Total Hip Replacement - Direct Anterior Approach (DAA) - Comprehensive surgical technique guide for Total Hip Replacement via Direct Anterior Approach - internervous plane between TFL and Sartorius - complete operative steps, danger zones, and exam-focused clinical pearls
Total Hip Replacement - Direct Lateral Approach (Hardinge/Transgluteal) - How to perform a total hip replacement through the direct lateral (Hardinge/transgluteal) approach — splitting the anterior third of gluteus medius and minimus in line with their fibres, reflecting the anterior abductor-capsule sleeve off the greater trochanter, and the meticulous transosseous abductor repair that determines outcome.
Total Hip Replacement - Posterior Approach (Kocher-Langenbeck Modified) - Comprehensive surgical technique guide for total hip replacement via modified posterior approach, including enhanced soft tissue repair techniques, acetabular component positioning, and strategies to minimize dislocation risk
Total Hip Replacement Dislocation - Comprehensive Assessment and Management - Evidence-based surgical technique for managing THA instability through systematic assessment, component revision, dual mobility, and soft tissue reconstruction
Total Hip Replacement with Ceramic Bearing Surfaces - How to perform a total hip replacement with a ceramic-on-ceramic bearing for the young, active patient — the posterior (Moore/Southern) exposure laid out step by step, precision acetabular positioning in the Lewinnek zone, clean-and-dry taper impaction of the ceramic head, and the squeak/fracture pitfalls.
Total Hip Replacement with Dual Mobility Cup - How to perform a total hip replacement with a dual mobility cup — the posterior exposure step by step, acetabular preparation and rim assessment, the monoblock versus modular construct, mobile liner and head assembly, intraprosthetic dislocation prevention, and rehabilitation.
Total Knee Arthroplasty - Cemented - Comprehensive surgical technique guide for cemented total knee arthroplasty including medial parapatellar approach, gap balancing, femoral rotation principles, and complication management - advanced orthopaedic practice
Total Knee Arthroplasty - Medial Parapatellar Approach - Comprehensive surgical technique guide for total knee arthroplasty using the medial parapatellar approach — the exposure laid out step by step, femoral rotation landmarks, gap balancing, third-generation cement technique, danger zones, registry survivorship and exam pearls.
Total Knee Arthroplasty for Valgus Deformity - How to perform a total knee arthroplasty in the valgus knee — the medial versus lateral (Keblish) exposure, the gap-driven lateral release sequence (Whiteside), the Krackow anatomic classification, soft-tissue balancing, and constraint selection.
Total Knee Replacement Instability - Assessment and Constraint Ladder Management - Comprehensive surgical technique for assessing and managing TKR instability using the constraint ladder approach, from posterior-stabilized to rotating hinge prostheses
Two-Stage Exchange for Infected TKA - Complete surgical technique for two-stage revision arthroplasty for periprosthetic joint infection of TKA including diagnosis, Stage 1 explantation with antibiotic spacer, Stage 2 reimplantation criteria, and antibiotic protocols for exam preparation
Two-Stage Revision THA - Stage 1: Antibiotic Cement Spacer Insertion - Comprehensive surgical technique for stage 1 two-stage revision THA with an antibiotic cement spacer for periprosthetic joint infection and advanced orthopaedic practice
Two-Stage Revision TKA - Stage 1: Antibiotic Cement Spacer Insertion - Comprehensive surgical technique for stage 1 two-stage revision TKA with an antibiotic cement spacer for periprosthetic knee infection and advanced orthopaedic practice
Unicompartmental Knee Replacement (UKR/Oxford) - Surgical technique for unicompartmental (Oxford) knee replacement — patient selection and the intact-ACL rule, the minimally invasive medial exposure, minimal tibial resection, mobile-bearing balance, and complication management.

arthroplasty (2 procedures)

Chiari Pelvic Osteotomy - Comprehensive exam guide to the Chiari medial displacement pelvic osteotomy as a salvage procedure for hip dysplasia and subluxation with incongruent joints — mechanism of medialisation and capsular fibrocartilage metaplasia, indications versus periacetabular osteotomy, surgical technique including iliac osteotomy from sciatic notch to AIIS, complications including sciatic nerve injury and femoral nerve palsy, evidence-based long-term outcomes, and exam-level viva preparation
Periacetabular Osteotomy (Ganz/Bernese PAO) - Comprehensive exam guide to Bernese periacetabular osteotomy for symptomatic acetabular dysplasia in the young adult - indications, correction targets (LCEA, Tonnis angle, anterior coverage), modified Smith-Petersen and rectus-sparing approach, the four osteotomy cuts, complications (LFCN injury, sciatic nerve, nonunion, AVN, intra-articular extension), outcomes and conversion to THA

Trauma — 68 procedures

trauma (66 procedures)

Acetabular Fracture ORIF - Both Column - Consultant-level operative guide to associated both-column acetabular fractures: pattern recognition, secondary congruence, approach selection, reduction, fixation, arthroplasty-inclusive rescue and complications
Acetabular Fracture ORIF - Comprehensive Approach Selection - Consultant-level guide to morphology-led approach selection for acetabular fracture fixation, including posterior, ilioinguinal, anterior intrapelvic, pararectus, combined and extensile strategies
Acetabular Fracture ORIF - Ilioinguinal Approach - Consultant-level guide to the classic three-window ilioinguinal approach for acetabular fracture fixation, from morphology-led selection and surgical anatomy to reduction, fixation, closure and complication rescue
Acetabular Fracture ORIF - Kocher-Langenbeck Approach - Complete surgical technique guide for the Kocher-Langenbeck posterior approach to acetabular fractures - the workhorse approach for posterior wall, posterior column, and transverse fracture patterns.
Acetabular Fracture ORIF - Posterior Column/Wall - Consultant-level guide to posterior column and posterior wall acetabular fracture reconstruction through the Kocher–Langenbeck approach, including joint clearance, marginal impaction, column-first reduction, fragment-specific wall fixation and failure rescue
Acetabular Fracture ORIF - Posterior Wall - Consultant-level guide to isolated posterior wall acetabular fractures, from post-reduction CT and dynamic stability examination through marginal-impaction reconstruction, fragment-specific fixation and long-term surveillance
Ankle Fracture ORIF - Weber B/C Fibula with Medial Malleolus - How to perform ORIF of a Weber B/C fibula fracture with a medial malleolus fracture — the lateral fibular and medial malleolar exposures laid out step by step, fibular length and rotation, syndesmotic assessment (Cotton and Hook tests), and the medial malleolar fixation decision.
Antegrade Femoral Nailing - Consultant-level operative guide to antegrade femoral nailing: physiology-led timing, implant-specific trochanteric or piriformis entry, reduction, reaming, locking, rotation control, subtrochanteric variants and failure management
Anterior Column Acetabular Fracture — ORIF - Consultant-level operative guide to anterior-column acetabular fracture fixation: fracture definition, non-operative and arthroplasty thresholds, ilioinguinal versus anterior intrapelvic exposure, corona mortis and obturator safety, reduction of the dome and quadrilateral surface, suprapectineal and infrapectineal fixation, column screws, imaging, closure and failure management.
Both-Bone Forearm Diaphyseal ORIF (Radius & Ulna) - Surgical technique guide for open reduction and internal fixation of adult both-bone forearm diaphyseal fractures - restoring the radial bow and interosseous space, Henry vs Thompson approaches, PIN protection, Galeazzi and Monteggia, and radioulnar synostosis prevention
Calcaneal Fracture ORIF (Extensile Lateral and Sinus Tarsi) - How to fix a displaced intra-articular calcaneal fracture — who to operate on and when, the wrinkle test and timing, extensile lateral versus sinus tarsi approach selection, step-by-step reduction of the posterior facet onto the constant fragment, restoring Bohler's angle, height and width, perimeter plating, Broden-view fluoroscopy, the wound-edge necrosis problem, and salvage with subtalar fusion when the joint fails.
Circular Frame Deformity Correction (Ilizarov and Hexapod) and Bone Transport - How to correct deformity and replace lost bone with a circular frame — the tension-stress law and what a real corticotomy preserves, CORA-based deformity analysis and where the osteotomy must go, classic Ilizarov rings versus hexapod struts with software hinges, rate and rhythm and the latency that starts regenerate, bone transport for segmental defects with docking-site rules, the Paley problem-obstacle-complication vocabulary, pin-site discipline, and the joints, nerves and regenerate that must all be shepherded to frame removal.
Coronoid Process Fracture Fixation - Operative technique guide for coronoid process fracture fixation — Regan-Morrey and O'Driscoll classifications, anteromedial facet buttress restoration, Hotchkiss medial approach, suture lasso versus plate fixation, elbow stability reconstruction after terrible triad injuries
Distal Femur Fracture ORIF - Pattern-led reduction and fixation of isolated native distal femur fractures
Distal Radius External Fixation (Spanning and Non-Spanning) - Operative technique guide for spanning and non-spanning external fixation of distal radius fractures — indications, ligamentotaxis principles, pin placement, frame construction, danger structures, over-distraction avoidance, and post-operative care
Distal Radius ORIF with Volar Locking Plate - Fragment-specific reduction and safe volar locking plate fixation of distal radius fractures
Distal Radius: Closed Reduction, Casting and K-Wire Fixation - How to reduce and wire the displaced distal radius — the acceptable-reduction numbers that define success, haematoma block versus regional anaesthesia, the Charnley reduction manoeuvre and three-point moulding, what the DRAFFT trials actually showed about wires versus plates versus moulded casts, radial styloid and dorsal wire configurations with the Kapandji intrafocal levering technique, superficial radial nerve protection with mini-incisions, and the redisplacement surveillance that catches failure in week one, not week six.
Dynamic Hip Screw (DHS) for Intertrochanteric Fracture - How to fix an intertrochanteric femur fracture with a dynamic hip screw — the direct lateral exposure laid out step by step, the tip-apex distance rule, the DHS-versus-nail decision, and aftercare.
Emergency Four-compartment Fasciotomy of the Leg - Operative guide to diagnosis, two-incision decompression of all four leg compartments, muscle assessment, open wound care and staged closure
Exchange Intramedullary Nailing for Long-Bone Nonunion - Operative decision-making and technique for exchange intramedullary nailing of selected femoral and tibial shaft nonunions, including infection sampling, deformity correction, fixation, adjuncts and salvage
External Fixation Principles - Decision-making, safe pin and wire placement, frame biomechanics, damage-control and definitive external fixation, circular correction, aftercare and conversion
Femoral Head Fracture ORIF (Pipkin) - How to manage the femoral head fracture that arrives with a hip dislocation — the emergent reduction that outranks everything, Pipkin classification as an approach-selector rather than trivia, why infrafoveal fragments tolerate excision and suprafoveal fragments demand anatomical fixation, choosing between the Smith-Petersen anterior approach and the Ganz trochanteric-flip surgical dislocation, headless-screw fixation countersunk below cartilage, the femoral neck fracture (Pipkin III) that changes everything including the arthroplasty conversation, and the AVN and heterotopic ossification arithmetic every consent must carry.
Femoral Neck Fracture - Dynamic Hip Screw (DHS) Fixation - Surgical technique guide for Femoral Neck Fracture - Dynamic Hip Screw (DHS) Fixation
Hemiarthroplasty for Femoral Neck Fracture - Comprehensive surgical technique guide for cemented hip hemiarthroplasty in displaced intracapsular femoral neck fractures — the posterior (Moore/Southern) exposure step by step, third-generation cementing, enhanced soft-tissue repair, and the hemi-versus-THA decision.
Humeral Shaft Fracture Fixation (Plating vs Nailing) - Surgical technique guide for humeral shaft fracture fixation - operative versus conservative (Sarmiento bracing) decision-making, anterolateral/posterior/MIPO approaches, radial nerve protection, and compression plating versus intramedullary nailing
Iliac Crest Bone Graft Harvest (Anterior, Posterior and RIA) - How to harvest autologous bone graft — why iliac crest autograft remains the biological reference standard, choosing anterior crest, posterior crest or reamer-irrigator-aspirator by volume and position, the anterior technique with the lateral femoral cutaneous nerve and ASIS-avulsion rules, the posterior technique with cluneal-nerve and sciatic-notch boundaries, cancellous versus tricortical structural blocks, donor-site morbidity numbers for honest consent, and how RIA changed the volume game.
Iliosacral (Sacroiliac) Screw Fixation - Percutaneous iliosacral screw fixation for posterior pelvic ring injuries — sacral fractures and sacroiliac joint disruptions; fluoroscopic corridor anatomy, dysmorphic sacrum recognition, nerve-root and vascular danger zones, step-by-step percutaneous technique, trans-sacral screws, and post-operative rehabilitation
Local Muscle Flaps for Open Tibia (Gastrocnemius and Soleus) - How to cover the open tibia with the leg's own muscles — the rule of thirds that assigns gastrocnemius to the proximal third and soleus to the middle third with free tissue for the distal third, fix-and-flap timing inside the orthoplastic 72-hour doctrine, medial gastrocnemius harvest step by step from the mid-calf interval to the sural-nerve-protected rotation, the hemisoleus refinement that preserves push-off, why the flap's pedicle anatomy decides its reliable reach, and the graft-over-muscle sequence that finishes the reconstruction.
Masquelet Induced-Membrane Technique for Segmental Bone Loss - Two-stage reconstruction of a segmental bone defect: excision of non-viable tissue, stable fixation and PMMA spacer induction followed by membrane-preserving cancellous autografting
Neck of Femur Fractures - Dynamic Hip Screw and Cannulated Screws - Surgical technique guide for Neck of Femur Fractures - Dynamic Hip Screw and Cannulated Screws
Open Fracture Debridement and Reconstruction - Consultant-level management of open long-bone fractures from first antibiotics and protected transfer through systematic excisional debridement, saline irrigation, skeletal stability, vascular repair and early orthoplastic coverage
Open Reduction and Internal Fixation of Radial Head Fracture - Selection and fixation of reconstructible radial head fractures, including whole-forearm assessment, approach choice, posterior interosseous nerve protection by pronation, headless-screw and safe-zone plate techniques, instability reconstruction and early rehabilitation
ORIF Distal Humerus Fracture — Olecranon Osteotomy Approach - Consultant-level fixation of complete articular distal humerus fractures through a chevron olecranon osteotomy, including ulnar-nerve strategy, articular-first reconstruction, parallel or orthogonal bicolumnar plating, osteotomy repair and early protected motion
ORIF Supracondylar Fracture Humerus - Paediatric - Surgical technique guide for ORIF Supracondylar Fracture Humerus - Paediatric
Osteomyelitis — Surgical Debridement and Dead-Space Management - Operative guide to long-bone osteomyelitis: fracture-related infection diagnosis, microbiological sampling, adequate debridement, implant strategy, dead-space management, skeletal stability and durable soft-tissue coverage.
Paediatric Ankle Fractures — Salter-Harris ORIF - Operative guide to paediatric distal tibial physeal and transitional ankle fractures: CT planning, gentle reduction, fracture-specific approaches, physeal-respecting fixation and growth-arrest surveillance.
Paediatric Monteggia Fracture-Dislocation — Ulnar Fixation and Radial Head Reduction - Decision-led operative guide to acute unstable and missed paediatric Monteggia lesions: restore ulnar alignment, prove concentric radiocapitellar reduction and add radial-head surgery only when required.
Patella ORIF — Tension Band and Screw Fixation - Open reduction and internal fixation of displaced transverse patellar fractures using modified anterior tension band wiring or cannulated screw tension band constructs — indications, midline anterior approach, articular reduction, fixation techniques, complications and rehabilitation
Pelvic Ring External Fixation - Damage-control and temporary pelvic external fixation: pattern selection, supra-acetabular and iliac-crest corridors, fluoroscopic proof, frame reduction and integration with haemorrhage control.
Percutaneous Acetabular Column Screws - How to fix acetabular columns through stab incisions along fluoroscopic corridors — the minimally-displaced and elderly fracture patterns that trade open reduction's perfection for percutaneous fixation's physiology, the anterior column's antegrade and retrograde corridors with the obturator-outlet view that owns them, the posterior column's ischial corridor, why every screw lives between the joint it must not enter and the pelvis's resident structures, the combined-view discipline that proves a corridor before a wire commits to it, and the honest boundaries where displacement or corridor anatomy sends the fracture back to the open guides.
Perilunate Dislocation — Reduction, Repair and Fixation - Acute perilunate and lunate dislocation management: emergency reduction, injury-pattern imaging, dorsal and volar exposure selection, carpal realignment, ligament repair, fracture fixation and protected rehabilitation.
Periprosthetic Distal Femur Fracture — ORIF - Consultant-level operative guide to periprosthetic distal femur fracture fixation above total knee arthroplasty: implant-stability assessment, Rorabeck and Su classification, plate versus nail versus replacement, biological reduction, lateral locked plating, interprosthetic fixation, medial support, weight bearing and failure management.
Periprosthetic Femoral Fracture — Vancouver Classification & Reconstruction - Decision-led operative management of postoperative periprosthetic femoral fractures around a hip stem: stem-stability assessment, Vancouver classification, B1 fixation, B2/B3 revision, Type C fixation, complications and salvage.
Pilon Fracture Reconstruction — Staged Fixation and ORIF - Consultant-level guide to pilon fracture assessment, temporising ankle-spanning fixation, CT-directed reconstruction, definitive ORIF and salvage strategies
Posterior Pelvic Ring ORIF (Sacral and Crescent Fractures) - Open reduction and internal fixation of the posterior pelvic ring for sacral fractures, crescent iliac fractures and SI joint disruptions — posterior and anterior approaches, reduction techniques, spinopelvic fixation and complication management
Preperitoneal Pelvic Packing - How to pack the exsanguinating pelvis — why pelvic haemorrhage is mostly venous and bony and what that means for the packing-versus-angiography debate, the non-negotiable prerequisite of a mechanically stabilised ring, the Denver three-packs-a-side technique through a suprapubic preperitoneal incision kept separate from the laparotomy, the 24-to-48-hour de-packing rules, and how packing and angioembolisation work as partners rather than rivals.
Proximal Femoral Nail (Cephalomedullary Nail) for Intertrochanteric Fracture - How to perform cephalomedullary nailing for an intertrochanteric (peritrochanteric) hip fracture — the fracture-table set-up, percutaneous greater-trochanter entry and the step-by-step nail and cephalic-screw technique, the tip-apex distance rule, short-versus-long nail selection, and the prevention of cut-out.
Proximal Femoral Valgus Osteotomy for Neck Nonunion - How to rescue the femoral neck nonunion in the young hip by changing physics rather than chasing biology — Pauwels' insight that a vertical nonunion fails from shear and a valgus intertrochanteric osteotomy converts that shear into compression, patient selection by head viability and abduction radiographs, calculating the wedge from the Pauwels angle, the 120-degree blade plate technique step by step with the seating-chisel discipline that decides everything, why the nonunion itself is usually left untouched, and the honest ledger against arthroplasty in the older patient.
Proximal Humerus Fracture - Plating vs Hemiarthroplasty - Operative guide for proximal humerus fracture fixation - the deltopectoral exposure laid out step by step, ORIF locking-plate technique versus hemiarthroplasty and reverse shoulder arthroplasty, and rehabilitation.
Proximal Humerus Intramedullary Nailing - Surgical technique guide for antegrade intramedullary nailing of proximal humeral and surgical neck fractures — anterosuperior deltoid-split approach, straight-nail entry biomechanics, proximal and distal locking, tuberosity fixation, and post-operative rehabilitation
Proximal Humerus ORIF with Locking Plate - Surgical technique guide for open reduction and internal fixation of displaced proximal humeral fractures using precontoured locking plates — deltopectoral approach, tuberosity reduction, calcar support, axillary nerve protection, and post-operative rehabilitation
Retrograde Femoral Nailing - Surgical technique guide for Retrograde Femoral Nailing
Retrograde Superior Pubic Ramus Screw Fixation - Surgical technique for percutaneous retrograde medullary superior pubic ramus screw fixation of anterior pelvic ring injuries - corridor planning, multiplanar fluoroscopy, danger structures and combined ring fixation
Reverse Total Shoulder Arthroplasty for Proximal Humerus Fracture - Surgical technique guide for reverse total shoulder arthroplasty as primary treatment of complex proximal humeral fractures in elderly patients — indications, deltopectoral approach, glenoid and humeral preparation, tuberosity reconstruction, complications and outcomes
Septic Arthritis — Arthroscopic Washout and Debridement - Arthroscopic irrigation and debridement for native-joint septic arthritis of the knee, shoulder, hip and ankle — emergency management, portals, synovectomy technique, repeat washouts, role of open arthrotomy, antibiotic strategy, complications and rehabilitation
Shoulder Hemiarthroplasty for Acute Proximal Humerus Fracture - How to perform hemiarthroplasty for an acute 3- or 4-part proximal humerus fracture in the elderly patient — the extensile deltopectoral exposure step by step, prosthetic height determination using the pectoralis major landmark, tuberosity fixation with bone graft and heavy sutures, aftercare, and the modern shift to reverse shoulder arthroplasty.
Subtrochanteric Femoral Fracture Fixation - Surgical technique guide for fixation of subtrochanteric femoral fractures using cephalomedullary nailing, including Russell-Taylor classification, deformity correction, reduction techniques, implant selection, management of atypical bisphosphonate-related fractures, and prophylactic fixation of impending lesions
Supracondylar Humerus Fracture - Closed Reduction Percutaneous Pinning - How to perform closed reduction and percutaneous K-wire pinning of a displaced pediatric supracondylar humerus fracture — the reduction maneuver step by step, the lateral-entry versus crossed-pin decision, ulnar-nerve protection, and the pink pulseless hand.
Symphysis Pubis Plating (Anterior Pelvic Ring ORIF) - Surgical technique guide for open reduction and internal fixation of the pubic symphysis with anterior plating in open-book and combined pelvic ring injuries — Pfannenstiel approach, corona mortis protection, reduction techniques, plate selection, and the critical role of posterior ring stabilisation
Talar Neck and Body Fracture ORIF - Open reduction and internal fixation of talar neck and body fractures — dual-incision approach, Hawkins classification, retrograde blood supply, AVN risk, anatomic reduction to prevent varus malunion, lag-screw and plate fixation, post-traumatic arthritis
Temporary Spanning External Fixation (Knee and Ankle) - How to span the wrecked periarticular limb — the span-scan-plan doctrine for high-energy tibial plateau and pilon fractures, ligamentotaxis and what a travelling traction achieves, knee-spanning frames with femoral and tibial pins kept out of the zone of injury and out of the future plate's territory, the ankle delta frame with the transcalcaneal pin passed medial-to-lateral to protect the neurovascular bundle, foot-plate extensions against equinus, over-distraction and pin-site discipline, and the staged timeline to definitive fixation.
Terrible Triad ORIF - Elbow Dislocation with Radial Head and Coronoid Fractures - How to reconstruct the terrible triad elbow injury — the lateral Kocher exposure step by step, the mandatory coronoid-then-radial-head-then-LCL sequence, the ORIF-versus-replacement and overstuffing decisions, and rehabilitation.
Tibial Intramedullary Nailing - How to perform reamed locked intramedullary nailing of the tibial shaft — infrapatellar versus suprapatellar entry, the correct start point, reamed versus unreamed nailing, blocking (Poller) screws, distal interlocking and fibular fixation.
Tibial Plateau Fracture ORIF - Surgical technique guide for open reduction and internal fixation of tibial plateau fractures - Schatzker and three-column classification, staged management of high-energy injuries, compartment syndrome and vascular assessment, anterolateral and posteromedial approaches, articular reduction and buttress fixation
Transverse Acetabular Fracture ORIF - Surgical technique guide for Transverse Acetabular Fracture ORIF
Traumatic Brachial Plexus Exploration and Reconstruction - Consultant-level guide to adult traumatic brachial plexus exploration: lesion mapping, supraclavicular and infraclavicular exposure, root-avulsion assessment, nerve grafting, nerve transfers, donor selection, microsurgical coaptation and rehabilitation

basic-science (2 procedures)

Bone Grafts - Comprehensive guide to bone grafts including autograft, allograft, ceramics, demineralized bone matrix, and bone morphogenetic proteins.
Targeted Muscle Reinnervation (TMR) & Regenerative Peripheral Nerve Interface (RPNI) - Fellowship-level guide to TMR and RPNI: modern surgical techniques that give a cut nerve 'somewhere to go' to prevent and treat amputation neuroma and phantom limb pain, improve myoelectric prosthesis control, their evidence, and how they differ from traditional neuroma management.

Spine — 34 procedures

spine (34 procedures)

Anterior Cervical Corpectomy and Fusion - Consultant-level guide to cervical corpectomy: indication by retrovertebral pathology, CT and MRI planning, safe anterior exposure, inside-out decompression, OPLL and dural ossification, anterior-column reconstruction, construct selection and complication rescue
Anterior Cervical Discectomy and Fusion (ACDF) - Single Level - How to perform a single-level Anterior Cervical Discectomy and Fusion (ACDF) — the Smith-Robinson approach step by step, the avascular plane medial to the carotid sheath, complete discectomy with PLL removal, cage plus anterior plate fixation, and the structures at risk in each layer.
Anterior Lumbar Interbody Fusion (ALIF) - Consultant-level planning and operative guide to L4-L5 and L5-S1 anterior lumbar interbody fusion: patient selection, retroperitoneal access, vascular and autonomic safety, discectomy, alignment, cage and fixation strategy, complications and revision
Anterior Odontoid Screw Fixation - Selection, reduction and direct anterior screw fixation of a recent odontoid fracture, including fracture-line geometry, trajectory planning, biplanar imaging, lag technique and conversion to posterior C1–C2 fixation
Anterior Spinal Fusion for Scoliosis - How to correct scoliosis from the front — why the anterior column's convex-side compression corrects while saving fusion levels in the thoracolumbar and lumbar curve (Lenke 5's home ground), the crankshaft problem in the young that anterior fusion was built to prevent, thoracoscopic and open thoracotomy or thoracoabdominal exposures with the segmental vessels' ligation debate, disc excision as the correction's engine, single-rod and dual-rod instrumentation, why posterior all-pedicle-screw surgery took most of the territory and what the anterior operation still does better, and the pulmonary and vascular arithmetic every anterior consent carries.
Balloon Kyphoplasty - How to perform balloon kyphoplasty for a painful vertebral compression fracture — bilateral transpedicular cannulation under biplanar fluoroscopy, cavity creation with the inflatable bone tamp, and low-pressure high-viscosity PMMA cement delivery for height restoration and kyphosis correction.
C1–C2 Posterior Fusion (Goel–Harms Technique) - Consultant-level guide to posterior C1–C2 fusion: instability assessment, reducibility, vertebral-artery planning, C1 lateral-mass fixation, C2 pedicle, pars and translaminar options, reduction, grafting, complications and revision
Cauda Equina Decompression - Emergency posterior lumbar decompression for cauda equina syndrome — the midline exposure and step-by-step laminectomy, the timing-of-surgery evidence across CES-R and CES-I, dural tear and wrong-level avoidance, and rehabilitation.
Cervical Disc Arthroplasty - Consultant-level guide to cervical disc arthroplasty, including selection against ACDF, dynamic imaging, anterior exposure, complete decompression, endplate-preserving preparation, device-specific sizing, fluoroscopic placement, complications and revision
Cervical Laminoplasty — Open-Door and French-Door - Consultant-level guide to cervical laminoplasty for multilevel degenerative cervical myelopathy and OPLL, including alignment and K-line selection, muscle-preserving exposure, controlled gutters, hinge protection, fixation, C5 palsy, axial pain and revision
Cervical Spinal Fusion (ACDF) - Comprehensive surgical technique guide for Anterior Cervical Discectomy and Fusion (ACDF) - evidence-based approach for cervical degenerative disease
Cranial Tongs & Halo Application (Cervical Traction and Halo-Vest Immobilisation) - Surgical technique guide for Gardner-Wells tongs cervical traction and halo ring-vest immobilisation - pin safe zones, traction protocols, torque specifications, paediatric considerations and complication management
Early-Onset Scoliosis: Growing Rods - How to control a young child's collapsing spine while the chest still needs to grow — why early fusion trades a straight radiograph for lethal restrictive lung disease and thoracic-insufficiency thinking reframes the whole field, casting and bracing as the delay tactics that sometimes cure, traditional growing rods with their six-monthly lengthening anaesthetics against magnetically-controlled rods lengthened awake in clinic, the dual-rod proximal-and-distal anchor construct step by step, the law of diminishing returns that flattens each lengthening's yield, autofusion and the 'graduation' decision, and the complication arithmetic — implant, wound, junctional — that makes this a programme, not an operation.
Hemivertebra Excision - How to remove the wedge that bends a growing spine — formation-failure hemivertebrae classified by segmentation status and why the fully-segmented lumbosacral hemivertebra is the one that cannot be watched, the VACTERL screen every congenital curve triggers, timing surgery early (age 1 to 5) while the compensatory curves are still flexible and unstructural, posterior-only pedicle-based excision step by step with the convex compression that closes the gap, short-segment fusion that spends only two motion segments, neuromonitoring as a condition of operating, and the crankshaft and junctional problems surveillance exists to catch.
Lumbar Decompression for Degenerative Spinal Stenosis - Operative guide to level selection, central and lateral-recess decompression, facet-preserving laminotomy or laminectomy, durotomy management and postoperative neurological surveillance
Microscopic Lumbar Discectomy - How to perform a microscopic lumbar discectomy for a symptomatic disc herniation — prone positioning with a free abdomen, three-point level verification, the unilateral interlaminar exposure, thin-bone-then-Kerrison laminotomy, limited discectomy with mandatory foramen exploration, and recognition of the postoperative epidural haematoma.
Muscular Dystrophy Scoliosis — Posterior Instrumented Fusion - Decision-led operative guide to posterior instrumented fusion for progressive scoliosis in Duchenne and Becker muscular dystrophy, including cardiopulmonary optimisation, distal-level selection, deformity correction and complication rescue.
Occipitocervical Fusion - How to fuse the skull to the cervical spine and set the head angle a patient must live with — the craniocervical instabilities from rheumatoid cranial settling to condyle fractures and tumours that demand it, why the occipito-C2 angle and gaze position are fixed forever at the moment the rods are locked, occipital keel plating with its venous-sinus depth limits, C1-C2 fixation options beneath it, the vertebral artery's four appearances in one operation, structural grafting for a fusion that cannot be allowed to fail, and the swallowing and gaze complications that come from fusing the wrong angle.
Percutaneous Pedicle Screw Fixation - How to instrument the thoracolumbar spine through stab incisions — the burst fractures, damage-control cases and degenerative constructs where sparing the paraspinal muscles buys real physiology, the owl's-eye anatomy of the pedicle on true AP fluoroscopy and the never-cross-medial rule that keeps Jamshidi needles out of the canal, wire-guided cannulated screws and rod passage beneath the fascia step by step, when a percutaneous construct is internal bracing removed after union versus a fusion's fixation, navigation's honest place, and the boundaries where deficit or deformity sends the spine back to the open operation.
Percutaneous Vertebroplasty - Operative technique guide for percutaneous vertebroplasty in painful osteoporotic and selected pathological vertebral compression fractures — patient selection, transpedicular approach, PMMA cement injection under continuous fluoroscopy, cement leak detection and management
Posterior Cervical Foraminotomy (Keyhole) - Surgical technique guide for posterior cervical keyhole foraminotomy — open and minimally invasive tubular approaches for unilateral cervical radiculopathy, facet-preserving nerve root decompression, step-by-step operative technique, indications, complications and contrast with ACDF
Posterior Cervical Laminectomy - Surgical technique guide for Posterior Cervical Laminectomy
Posterior Cervical Laminectomy and Fusion - Comprehensive surgical technique guide for posterior cervical laminectomy and fusion for multilevel cervical myelopathy
Posterior Lumbar Decompression and Fusion (PLDF) - How to perform posterior lumbar decompression and instrumented fusion — the prone midline exposure step by step, pedicle screw insertion at the Magerl point with five-wall probing, the decompression-versus-fusion decision, dural tear management and rehabilitation.
Posterior Lumbar Interbody Fusion (PLIF) - Operative technique guide for posterior lumbar interbody fusion (PLIF) — indications, posterior midline approach, wide laminectomy with bilateral facetectomy, thecal sac retraction, endplate preparation, dual cage insertion, pedicle screw-rod fixation, complications and post-operative rehabilitation
Posterior Spinal Fusion and Instrumentation for Adolescent Idiopathic Scoliosis (PSF) - Surgical technique guide for Posterior Spinal Fusion and Instrumentation for Adolescent Idiopathic Scoliosis (PSF)
Spinal Epidural Abscess — Surgical Decompression - Surgical technique guide for emergency decompression of a spinal epidural abscess — posterior laminectomy for dorsal collections, anterior debridement for ventral pus with vertebral osteomyelitis, indications, instrumentation, complications and post-operative rehabilitation
Spinal Osteotomy Techniques: PSO, VCR, and SPO - How to perform three-column spinal osteotomies for fixed deformity — Smith-Petersen (SPO), pedicle subtraction (PSO) and vertebral column resection (VCR) — with the posterior exposure laid out step by step, osteotomy selection, complications and the structured response to a neuromonitoring change.
Spinal Tuberculosis — Debridement and Fusion - How to perform radical anterior debridement, anterior column reconstruction and posterior instrumented fusion for Pott disease of the spine — indications, approach selection, step-by-step operative technique, graft and cage options, complications and post-operative management.
Spine Tumour Decompression and Stabilization - Surgical technique guide for metastatic spinal cord compression and primary spine tumour surgery - posterior decompression, separation surgery and pedicle-screw stabilization.
Spinopelvic Dissociation - Lumbopelvic Fixation - Comprehensive surgical technique for lumbopelvic fixation in spinopelvic dissociation - posterior instrumentation for U-type and H-type sacral fractures with Denis zone III involvement
Spondylolisthesis Reduction and Fusion - Surgical technique guide for instrumented reduction and fusion of high-grade isthmic and degenerative spondylolisthesis — posterior approach, wide decompression, pedicle-screw instrumentation, gradual slip reduction, interbody support and L5 nerve-root protection
Thoracic Disc Herniation — Discectomy - Surgical technique guide for discectomy in thoracic disc herniation — approach selection by herniation location, posterolateral (transpedicular/costotransversectomy), lateral extracavitary and transthoracic approaches, cord protection, level localisation, and management of calcified discs
Thoracolumbar Burst Fracture: Posterior Stabilisation - How to stabilise the thoracolumbar burst fracture — TLICS scoring and the PLC as the decision hinge, why the stable burst with intact neurology does as well without surgery, pedicle-screw constructs short versus long with the load-sharing classification deciding, ligamentotaxis reduction through lordosing rods, index-level screws, when to decompress and the lamina-fracture dural trap, percutaneous options and implant removal in the unfused, and kyphosis-recurrence salvage.

Hand & Wrist — 64 procedures

hand (64 procedures)

Anterior Interosseous Nerve Exploration and Decompression - Consultant-level operative guide to diagnosing anterior interosseous nerve palsy, localising the lesion, selecting proximal forearm decompression or fascicular surgery, releasing the pronator and FDS arches, and managing recovery or failed reinnervation.
Boutonnière Deformity — Reconstruction - Consultant-level guide to chronic boutonnière reconstruction: staging, Elson assessment, passive correction, central-slip repair or reconstruction, lateral-band balancing, terminal-tendon tenotomy, dynamic testing and hand therapy
Carpal Tunnel Release - Open & Endoscopic - How to perform carpal tunnel release - open and endoscopic - step by step: the ring-finger-axis palmar exposure, identifying and protecting the palmar cutaneous and recurrent motor branches, dividing the transverse carpal ligament distal-to-proximal in the midline, and the open-versus-endoscopic decision.
Carpal Tunnel Release - Open Technique - Surgical technique guide for open carpal tunnel release - advanced orthopaedic practice operative-surgery preparation
Cubital Tunnel Decompression - How to decompress the ulnar nerve at the elbow — the lazy-S medial exposure laid out step by step, identification and protection of the medial antebrachial cutaneous nerve, the systematic release of all four compression sites, the simple decompression versus anterior transposition decision, and rehabilitation.
De Quervain's Tenosynovitis - First Dorsal Compartment Release - Surgical technique guide for De Quervain's Tenosynovitis - First Dorsal Compartment Release
Digit Replantation - Decision-making, microsurgical replantation, monitoring and rehabilitation after complete digit amputation
Distal Radius Corrective Osteotomy - Three-dimensional planning and reconstruction of symptomatic distal radius malunion
DRUJ Procedures — Darrach, Sauvé-Kapandji & Ulnar Shortening - Comprehensive surgical technique guide for distal radioulnar joint procedures including Darrach resection arthroplasty, Sauvé-Kapandji arthrodesis with pseudarthrosis, ulnar shortening osteotomy for ulnar impaction syndrome, and TFCC anatomy
Dupuytren Contracture: Comprehensive Management - Treatment selection and safe limited fasciectomy for primary, advanced and recurrent Dupuytren disease
Dupuytren Limited Fasciectomy - Goal-led planning, exposure, neurovascular protection, selective fascial excision and reconstruction for primary and recurrent Dupuytren disease
EIP-to-EPL Tendon Transfer (EPL Rupture) - Complete surgical technique guide for EIP-to-EPL tendon transfer for EPL rupture after distal radius fracture — includes EPL rupture aetiology, EIP anatomy, transfer technique, tension setting, and post-operative management
Extensor Tendon Reconstruction - Comprehensive guide to extensor tendon reconstruction including zone-specific techniques, tendon transfers, grafting options, and rehabilitation protocols for chronic extensor deficiency.
Extensor Tendon Repair (Zones I-VIII) - Comprehensive zone-specific surgical technique guide for extensor tendon injuries from DIP to forearm, covering acute repair, reconstruction, and zone-specific protocols
Finger DIP and PIP Arthrodesis - How to fuse the small joints of the finger so the hand still works — why fusion remains the honest answer for the painful destroyed DIP and for the PIP in the index and middle fingers that pinch, the position arithmetic that changes digit by digit (DIP 0 to 10 degrees, PIP cascading from 25 degrees radially to 40 degrees ulnarly), cup-and-cone preparation that lets angle be dialled after the cuts, headless compression screw against tension band against interosseous wiring, the mucous-cyst and swan-neck contexts the DIP fusion frequently arrives in, and the nonunion and nail arithmetic of hardware down a 2-millimetre canal.
Finger Fracture Fixation (Phalangeal & Metacarpal) - Surgical technique guide for Finger Fracture Fixation covering metacarpal and phalangeal fractures
Fingertip Amputation Reconstruction - Assessment and reconstruction of fingertip amputations using semi-occlusive care, local advancement, homodigital, cross-finger and thenar flaps, revision amputation and nail-support planning
First CMC Arthroplasty (Trapeziectomy ± LRTI) - How to perform trapeziectomy for basal thumb (first carpometacarpal) osteoarthritis — the Wagner volar exposure step by step, piecemeal trapeziectomy with radial artery protection, the trapeziectomy-alone vs LRTI vs suspensionplasty decision, and rehabilitation.
Flexor Tendon Repairs Across Zones 1–5 - Zone-specific assessment, exposure, tendon reconstruction, combined-injury repair and rehabilitation for flexor tendon injuries from fingertip to forearm
Forearm Fasciotomy: Complete Volar and Dorsal Release - Clinical diagnosis, pressure adjuncts, extensile volar and selective dorsal decompression, viability assessment and staged wound management for acute forearm compartment syndrome
Four-Corner Fusion and Limited Wrist Fusion - How to salvage the SLAC and SNAC wrist with scaphoid excision and four-corner fusion — staging the arthritis, choosing between four-corner fusion and proximal row carpectomy, the dorsal ligament-sparing exposure, correcting the DISI lunate before fusion, preparing and grafting the capitate-lunate-hamate-triquetrum joints, fixation options and the circular-plate problem, plus the STT fusion variant and what to do when a limited fusion fails.
Galeazzi Fracture ORIF - Open reduction and internal fixation of Galeazzi fracture-dislocation — distal-third radial shaft fracture with disruption of the distal radioulnar joint: recognition of DRUJ instability, volar Henry approach, anatomic plate fixation, DRUJ assessment, and staged management of residual instability
Ganglion Cyst Excision - Dorsal Wrist - Comprehensive surgical technique guide for dorsal wrist ganglion cyst excision including stalk identification, scapholunate ligament protection, and superficial radial nerve preservation
Glomus Tumour Excision - How to find and remove the fingertip's smallest tormentor — the classic triad of paroxysmal pain, pinpoint tenderness and cold sensitivity that makes glomus tumour a history-and-examination diagnosis, Love's pin test and Hildreth's tourniquet test performed properly, MRI's role and its honest miss rate, the transungual approach with meticulous nail-bed repair against the lateral subperiosteal alternative that spares the nail, why complete excision cures and incomplete excision recurs, and the years-long diagnostic delay these patients have usually already served.
Hand Corrective Osteotomy (Metacarpal and Phalangeal Malunion) - How to straighten the malunited hand — why rotational malunion is the unforgiving deformity (every 10 degrees of metacarpal rotation scissors the fingertip 2 cm across its neighbour), the scissoring examination that plain films cannot replace, choosing the osteotomy site between the malunion itself and the metacarpal base, step-cut versus transverse rotational correction, apex-directed closing and opening wedges for phalangeal angulation, fixation that permits the early motion the hand cannot heal without, and the stiffness arithmetic that makes patient selection most of the operation.
Hand Fasciotomy (Compartment Syndrome Release) - How to decompress compartment syndrome of the hand — recognising the intrinsic-minus posture and pain on intrinsic stretch when classic signs fail, the ten compartments and the incisions that reach them, dorsal two-incision release of the interossei and adductor, thenar and hypothenar releases, carpal tunnel extension, finger decompression when digits are threatened, second-look and closure strategy, and the Volkmann-type sequelae of the missed case.
Hand Infections — Surgical Drainage - Comprehensive surgical technique guide for hand infection drainage including flexor tenosynovitis (Kanavel's signs), deep space infections, paronychia, felon, web space abscess, and herpetic whitlow — organism selection, incision planning, and post-operative irrigation
Kienböck Disease — Surgical Management - Stage- and cartilage-directed operative management of lunate osteonecrosis, including radial and capitate shortening, vascularised bone grafting, limited fusion, proximal row carpectomy and total wrist fusion.
Mallet Finger — Management and Fixation - Management of terminal extensor tendon (mallet) injuries at the DIP joint - continuous extension splinting for tendinous and most bony mallets, with operative fixation (extension-block pinning, ORIF, pull-out suture) reserved for large bony fragments with volar subluxation or open injuries
Nail Bed & Fingertip Injury Repair - Surgical technique for nail bed and fingertip injury repair — when to trephine versus remove the nail plate, anatomical repair of the germinal and sterile matrix, the Seymour open physeal fracture, and Allen-zone fingertip reconstruction with V-Y advancement and other flaps.
PIP Joint Arthroplasty - How to replace the finger's most motion-hungry joint — why the ring and little fingers' grip role makes them arthroplasty's home while the pinch-loaded index stays fusion territory, silicone spacers against surface-replacing implants argued by evidence rather than novelty, the approach menu (dorsal Chamay, volar A1-sparing, lateral) with the central slip as the decision's hinge, implant technique step by step, the extensor-lag and coronal-drift arithmetic that follows every design, and the revision-to-fusion salvage every consent names.
Pollicization (Index Finger Transfer) - Decision-led operative guide to index-finger pollicization for severe congenital thumb deficiency, including pedicle dissection, skeletal transfer, intrinsic balancing and rehabilitation.
Pronator Syndrome Release - Median Nerve Decompression at Elbow/Forearm - How to decompress the median nerve in pronator syndrome — the volar exposure step by step, the four potential compression sites (ligament of Struthers, lacertus fibrosus, between the pronator heads, FDS arch), protecting the AIN and brachial artery, and rehabilitation.
Proximal Interphalangeal Joint Fracture-Dislocation Fixation - Decision-led operative guide to PIP joint fracture-dislocations: extension-block pinning, fragment fixation, dynamic external fixation, volar plate arthroplasty and hemi-hamate reconstruction.
Proximal Row Carpectomy - How to perform a proximal row carpectomy for the SLAC or SNAC wrist and Kienbock disease — the two joint surfaces that must be intact before you start, the dorsal ligament-sparing exposure, piecemeal excision of scaphoid, lunate and triquetrum while protecting the radioscaphocapitate ligament, styloidectomy and capsular interposition options, why the incongruent radiocapitate articulation still works, early motion aftercare, and the age and stage limits that keep the operation honest.
Radial Styloidectomy - Surgical technique guide for radial styloidectomy — limited dorsoradial excision of the radial styloid process for localised radioscaphoid impingement, as an adjunct in stage I SLAC/SNAC wrist, scaphoid nonunion, and after proximal-row carpectomy — emphasising preservation of the radioscaphocapitate and long radiolunate ligament origins to avoid ulnar carpal translation
Radial Tunnel and PIN Decompression - How to free the posterior interosseous nerve through its five-site gauntlet — the crucial distinction between PIN palsy (motor loss, finger-drop, an EMG-positive lesion) and radial tunnel syndrome (pain without weakness, an EMG-usually-silent diagnosis living in tennis elbow's differential), the arcade of Frohse and its four companion compression sites, the interval approaches (brachioradialis-split, BR-ECRL, and the anterior route) with the superficial radial nerve as the guide, supinator release step by step, why radial tunnel surgery's results are humbler than its anatomy is elegant, and the tumour-and-mimic screen every finger-drop demands before anyone blames a tunnel.
Ray Amputation (Hand & Foot) - Fellowship-level guide to ray amputation/resection - removal of a digit together with all or part of its metacarpal or metatarsal - in the hand (for tumour, trauma, infection, ischaemia or a non-functional digit) and the foot (commonly for the diabetic/ischaemic forefoot) - covering border versus central ray resection, the central-ray reconstruction problem (gap closure to avoid a widened web and digital malrotation), foot-specific biomechanical consequences (transfer lesions), and the functional and aesthetic principles that guide the choice between ray amputation and digit-only or transmetatarsal options.
Rheumatoid Elbow Synovectomy & Radial Head Excision - Surgical technique guide for Rheumatoid Elbow Synovectomy & Radial Head Excision
Rheumatoid Hand Surgery (MCP Arthroplasty, Synovectomy and Tendon Rebalancing) - How to reconstruct the rheumatoid hand — the deformity cascade from MCP synovitis to ulnar drift and volar subluxation, the caput ulnae syndrome and extensor tendon ruptures, operation sequencing rules (proximal before distal, tendons before joints you cannot splint), silicone MCP arthroplasty step by step with crossed intrinsic transfer, extensor tenosynovectomy and rupture reconstruction, and what biologic-era disease has changed about who reaches theatre.
Scaphoid Nonunion — Vascularised Bone Graft (1,2-ICSRA and Medial Femoral Condyle) - Operative technique for vascularised bone grafting of scaphoid nonunion with proximal pole AVN or humpback deformity — dorsal 1,2-ICSRA pedicled graft, volar pedicled and free MFC options, humpback correction, DISI reduction, headless compression screw fixation
Scaphoid ORIF - Dorsal Approach (Proximal Pole) - Surgical technique guide for Scaphoid ORIF - Dorsal Approach (Proximal Pole)
Scapholunate Ligament Reconstruction - Dorsal Capsulodesis - Surgical technique guide for Scapholunate Ligament Reconstruction - Dorsal Capsulodesis
Single-Portal Endoscopic Carpal Tunnel Release - Consultant-level guide to Agee-style single-portal endoscopic carpal tunnel release: selection, anatomy, device-specific setup, ligament recognition, distal-to-proximal division, conversion, complications and rehabilitation
Skin Grafting in the Hand - Fellowship-level guide to skin grafting in the hand: split- versus full-thickness grafts, the stages of graft take and why a well-vascularised bed is essential (grafts fail on bare bone/tendon/cartilage without periosteum/paratenon/perichondrium), donor-site selection (including glabrous skin for palmar defects), the reconstructive ladder, and the causes of graft failure (haematoma, infection, shear).
Swan-Neck Deformity Correction - How to correct swan-neck deformity — finding which of the four engines is driving PIP hyperextension (mallet imbalance, FDS loss, intrinsic tightness, volar plate laxity), the Nalebuff type that decides the operation, FDS hemitendon tenodesis and spiral oblique retinacular ligament reconstruction step by step, Fowler central slip tenotomy for the mallet-driven finger, intrinsic release in the rheumatoid hand, and salvage of the stiff destroyed PIP joint.
Tendon Transfers for Median and Ulnar Nerve Palsy - Operative guide to tendon transfers for irreversible median and ulnar nerve palsies — the Brand EIP opponensplasty (median palsy workhorse) and the Zancolli lasso and FDS four-tail for ulnar claw correction, plus adductor reconstruction for Froment's sign.
Tendon Transfers for Radial Nerve Palsy - Comprehensive operative technique for tendon transfers to restore wrist, finger and thumb extension in irreparable radial nerve or posterior interosseous nerve palsy — classic PT to ECRB, FCR to EDC, PL to EPL transfers, tensioning principles, donor selection and post-operative re-education
Tendon Transfers for Radial Nerve Palsy - Comprehensive guide to radial nerve palsy management including tendon transfer surgery, functional restoration, and operative techniques
Tendon Transfers for Radial, Median and Ulnar Nerve Palsy - Comprehensive exam guide to tendon transfers for radial, median and ulnar nerve palsy covering principles of tendon transfer (one tendon one function, expendable donor, synergy, straight line of pull, supple joints), standard transfers for low and high radial nerve palsy (Pronator teres to ECRB, FCR to EPL, PL to EDC), median nerve palsy (opponensplasty, Camitz, FDS ring transfer), ulnar nerve palsy (claw correction with Zancolli, Stiles-Bunnell, Brand transfers, intrinsic replacement), timing and outcomes
TFCC Repair (Arthroscopic and Open) - How to treat triangular fibrocartilage complex tears — Palmer and Atzei classification-directed decisions, the fovea sign and hook test, arthroscopic debridement of central tears, outside-in capsular repair of peripheral tears, foveal reattachment for the unstable DRUJ, when an ulnar shortening osteotomy does the work instead, rotation-limited rehabilitation, and salvage when the DRUJ stays unstable.
Thumb CMC Arthrodesis - How to fuse the thumb carpometacarpal joint for basal thumb arthritis in the young, high-demand hand — who genuinely does better with fusion than trapeziectomy, why STT arthritis is the gatekeeping check, the Wagner and dorsal exposures, cup-and-cone preparation, the clenched-fist fusion position (palmar and radial abduction with pronation), fixation choices, nonunion and malposition management, and honest counselling about the flat-hand trade-off.
Thumb Metacarpophalangeal Joint Arthrodesis - Surgical technique guide for arthrodesis of the thumb metacarpophalangeal joint for painful arthritis, chronic instability, post-traumatic destruction and rheumatoid Z-collapse deformity — dorsal approach, joint preparation, fixation options, complication avoidance and rehabilitation
Thumb Reconstruction: Pollicization & Toe-to-Hand Transfer - Fellowship-level guide to reconstructing the absent or deficient thumb: the Blauth classification of thumb hypoplasia, the type-IIIA/IIIB pivot on carpometacarpal stability, index-finger pollicization for the high grades, and toe-to-hand transfer for traumatic and congenital thumb loss.
Thumb UCL Repair / Reconstruction (Stener Lesion) - Surgical technique guide for thumb UCL repair and reconstruction — acute Stener lesion repair with suture anchors and chronic reconstruction with free tendon graft
Total Wrist Arthroplasty - How to replace the wrist and who genuinely should have one — the motion-versus-durability trade against total wrist fusion argued honestly, why the low-demand rheumatoid patient with bilateral disease remains the signature indication and the young labourer remains the signature contraindication, fourth-generation implant design and what it fixed about its predecessors, the dorsal approach and carpal-platform preparation step by step, the distal-component fixation that decides survivorship, the functional 'dart-thrower-adjacent' arc a modern TWA actually delivers, and the salvage arithmetic when it fails.
Trigger Finger / Thumb Release (A1 Pulley) - Surgical technique guide for A1 pulley release in trigger finger and trigger thumb - open and percutaneous techniques, digital nerve protection, paediatric considerations
Ulnar Nerve Decompression at Guyon's Canal - Surgical technique guide for Ulnar Nerve Decompression at Guyon's Canal
Ulnar Shortening Osteotomy - How to shorten the ulna for ulnocarpal abutment — confirming that variance is the disease, the neutral-rotation and pronated-grip films, choosing shortening over the wafer procedure, the subcutaneous-border exposure between ECU and FCU, precision oblique osteotomy with lag-screw and compression plating, how much to shorten and the sigmoid-notch caution, plate-irritation and nonunion management, and where the osteotomy fits alongside TFCC surgery.
Upper Limb Amputation - Comprehensive guide to upper limb amputation - level selection, finger to forequarter techniques, prosthetic considerations, targeted muscle reinnervation, replantation decisions for orthopaedic exam
Upper Limb Nerve Transfers (Oberlin and Key Motor Transfers) - How to rewire the paralysed upper limb by lending working fascicles to failed nerves — why distal nerve transfers beat proximal grafts on the motor endplate's 12-to-18-month clock, the Oberlin ulnar-fascicle-to-biceps transfer for elbow flexion step by step with intraoperative stimulation choosing the donor fascicle, the double transfer that adds brachialis, spinal-accessory-to-suprascapular for shoulder external rotation and triceps-branch-to-axillary for abduction, the expendable-donor and synergy rules that make transfers safe, and the motor re-education that converts a rewired nerve into a usable arm.
Wrist Arthrodesis (Total, 4-Corner & PRC) - Comprehensive surgical technique guide for total wrist arthrodesis, 4-corner fusion, and proximal row carpectomy — SLAC/SNAC staging, procedure selection, plate fixation, and outcomes
Wrist Arthroscopy - Comprehensive surgical technique guide for wrist arthroscopy — portals, TFCC repair, SL ligament assessment, ganglion decompression, and carpal instability evaluation
Zone 2 Flexor Tendon Repair - Assessment, exposure, FDP and selective FDS repair, pulley venting, dynamic glide testing and repair-specific early rehabilitation for Zone 2 flexor tendon injury

Foot & Ankle — 61 procedures

foot-ankle (61 procedures)

Achilles Tendon Repair - Open repair of an acute Achilles tendon rupture — the posteromedial exposure step by step, Krackow core suture with epitendinous reinforcement, paratenon closure, augmentation for chronic or large-gap rupture, and accelerated functional rehabilitation.
Ankle Arthrodesis - How to perform ankle (tibiotalar) arthrodesis — arthroscopic portal placement and the open anterior and transfibular exposures step by step, the non-negotiable four-point fusion position, screw versus plate versus retrograde tibiotalocalcaneal nail fixation, and the arthrodesis-versus-TAR decision.
Ankle Arthroscopy - Surgical technique guide for anterior and posterior ankle arthroscopy — portal placement, nerve protection, distraction, impingement resection, osteochondral lesion treatment and loose body removal
Ankle Fracture ORIF - Trimalleolar - How to perform ORIF of a trimalleolar ankle fracture — the three-incision fibula-first exposure step by step, posterior malleolus fixation through the posterolateral interval, syndesmotic assessment and fixation, and rehabilitation.
Ankle Syndesmosis Fixation - Surgical technique guide for fixation of the disrupted distal tibiofibular syndesmosis in ankle fractures and high ankle sprains — intra-operative testing, reduction, screw versus suture-button fixation, malreduction recognition, and post-operative rehabilitation
Bunionette (Tailor's Bunion) Correction - Comprehensive surgical technique guide for correction of a bunionette (Tailor's bunion) — Coughlin classification, lateral condylectomy, distal chevron and diaphyseal/oblique rotational osteotomies, fixation, and post-op rehab
Charcot Neuro-Osteoarthropathy — Foot Reconstruction - Consultant-level guide to Charcot foot reconstruction, including active-disease offloading, perfusion and infection work-up, braceability, exostectomy, deformity correction, midfoot superconstruct arthrodesis, hindfoot salvage, protected loading and failure management
Cheilectomy - Cheilectomy for hallux rigidus (Coughlin-Shurnas Grade I–II) — the dorsomedial approach to the first MTP joint step by step, the 30/70/50 resection rule, the intra-operative 70 degree dorsiflexion check, and rehabilitation.
Chevron Osteotomy for Mild Hallux Valgus - Surgical technique guide for Chevron Osteotomy for Mild Hallux Valgus
Chopart Amputation — Transverse-Tarsal Disarticulation - Consultant-level guide to Chopart amputation, including level selection, perfusion and infection assessment, plantar-flap planning, talonavicular and calcaneocuboid disarticulation, tendon balancing, residual-limb protection, prosthetic rehabilitation and failure management
Chronic Achilles Reconstruction with FHL Transfer - Consultant-level guide to chronic Achilles reconstruction with flexor hallucis longus transfer, including functional assessment, defect mapping, FHL harvest, neurovascular protection, calcaneal fixation, adjunctive reconstruction, rehabilitation and failure management
Chronic Achilles Reconstruction: V-Y Advancement and Gastrocnemius Turndown Flap - Operative technique for chronic Achilles tendon reconstruction with a V-Y gastrocnemius advancement slide and a gastrocnemius fascial turndown flap — indications by gap size, harvest, slide and turndown steps, complications and rehabilitation
Common Peroneal Nerve Decompression - Comprehensive surgical technique guide for common peroneal nerve decompression with anatomy, technique, and viva scenarios
Cotton Osteotomy (Medial Cuneiform Opening Wedge) - How to plantarflex the first ray and finish a flatfoot reconstruction — why forefoot varus left uncorrected rocks a beautifully reconstructed hindfoot back into valgus, the tripod concept and the simulated-correction examination that reveal residual first-ray elevation, the dorsal opening-wedge osteotomy of the medial cuneiform step by step with graft sizing from the deformity, its position in the flexible-flatfoot sequence after calcaneal osteotomies and tendon transfer, the alternative first-TMT fusion when the joint itself is unstable or arthritic, and the union and transfer-load arithmetic of a small osteotomy with a large job.
Dwyer Calcaneal Osteotomy - Lateral closing wedge calcaneal osteotomy for cavovarus deformity
First MTP Joint Arthrodesis - Comprehensive guide to first MTP arthrodesis for end-stage hallux rigidus and severe hallux valgus, including fusion position, technique, and complications
First MTPJ Arthrodesis - First metatarsophalangeal joint fusion for hallux rigidus and salvage
Flexor Digitorum Longus Transfer for Progressive Collapsing Foot Deformity - Deformity-led reconstruction for flexible progressive collapsing foot deformity using selective FDL transfer, calcaneal osteotomy, medial-column and ligament balancing
Foot & Ankle Amputation Levels - Fellowship-level guide to partial foot and ankle amputation levels - toe, ray, transmetatarsal, Lisfranc, Chopart, Syme and Pirogoff/Boyd - their biomechanics, muscle-balance pitfalls, and outcomes versus transtibial amputation.
Freiberg Disease: Surgical Management of Lesser Metatarsal-Head Infraction - Procedure selection, dorsal exposure, joint-preserving reconstruction and salvage surgery for symptomatic Freiberg disease of a lesser metatarsal head
Gastrocnemius Recession (Strayer / Vulpius) - Surgical technique guide for gastrocnemius recession (Strayer aponeurotic release and Vulpius-Baker lengthening) for isolated gastrocnemius contracture — Silfverskiöld test, indications, posteromedial approach, sural nerve protection, postoperative rehabilitation and complications
Girdlestone-Taylor Flexor-to-Extensor Transfer (Claw Toe) - Surgical technique guide for the Girdlestone-Taylor flexor digitorum longus to extensor transfer for flexible clawed lesser toes - intrinsic-minus pathomechanics, indications, step-by-step transfer, MTP balancing, K-wire fixation, complications and rehabilitation
Haglund Deformity and Insertional Achilles Correction - Decision-led surgery for symptomatic posterosuperior calcaneal impingement and insertional Achilles tendinopathy: open debridement and reattachment, endoscopic calcaneoplasty, Zadek osteotomy, wound protection and rehabilitation
Hallux Sesamoid Excision - How to remove the most loaded small bone in the body without unbalancing the toe it serves — the sesamoids' pulley-and-shield job under the first metatarsal head and the pathologies that end it (fracture nonunion, avascular necrosis, intractable sesamoiditis, infected ulceration), the bipartite-versus-fracture distinction every consultation must make, the medial approach to the tibial sesamoid with its plantar digital nerve and the plantar-lateral or dorsal-first-webspace routes to the fibular, shelling the sesamoid out of the FHB tendon with the defect repaired, why the other sesamoid is untouchable, and the cock-up and drift arithmetic that makes reconstruction and orthotic aftercare part of the operation.
Hallux Valgus Correction — Chevron, Scarf and Lapidus - Triplanar decision-making and operative technique for symptomatic hallux valgus: distal chevron, Scarf osteotomy, first tarsometatarsal Lapidus arthrodesis, selective soft-tissue balancing, Akin osteotomy and failure management
Jones Fracture Fixation (Proximal Fifth Metatarsal) - How to manage the proximal fifth metatarsal by zone and fix the one that will not heal — the three-zone map that separates the benign tuberosity avulsion from the watershed Jones fracture and the stress-fracture diaphysis, the vascular watershed that explains zone 2's nonunion reputation, operative indications from the athlete's primary fixation to the sclerotic delayed union, intramedullary screw technique with the high-and-inside starting point and the size arithmetic that fills the canal, when to add bone graft and biologics, the cavovarus foot that must be recognised before it refractures the screw, and the return timelines that make this small fracture a career question in sport.
Jones Tendon Transfer (EHL to First Metatarsal) - Operative guide to modified Jones extensor hallucis longus transfer for flexible claw hallux in cavovarus reconstruction, including donor assessment, hallux interphalangeal fusion, first-metatarsal fixation, tensioning and failure management.
Keller Resection Arthroplasty - How to use the oldest operation on the great toe honestly — resecting the proximal third of the proximal phalanx to decompress the destroyed first MTPJ in the low-demand elderly foot, why the fusion is the default answer and the Keller survives only in a defined niche (the frail, the ulcerated diabetic hallux, the shoe-comfort patient), the cock-up and transfer-metatarsalgia physics that follow when flexor continuity is lost, the interposition and pin refinements that tame them, and the boundaries that keep an easy operation from being an easy mistake.
Lapidus Procedure — First TMT Arthrodesis for Hallux Valgus - A triplanar operative guide to first tarsometatarsal arthrodesis for hallux valgus: selection, instability assessment, joint preparation, derotation, fixation, sagittal control and nonunion rescue.
Lateral Column Lengthening - Component-led operative guide to Evans and sinus-tarsi lateral calcaneal lengthening osteotomies for flexible forefoot abduction: selection, facet-safe planning, controlled correction, graft or wedge choice, fixation and failure rescue.
Lateral Ligament Reconstruction - Surgical reconstruction of chronic lateral ankle instability — the modified Broström (direct anatomic repair) with the Gould modification (inferior extensor retinaculum reinforcement) laid out step by step through the anterolateral exposure, plus internal brace augmentation and non-anatomic tenodesis (Chrisman-Snook, Watson-Jones) for salvage.
Lesser Toe Deformity Correction - How to correct hammer, claw and mallet toes — the dorsal PIPJ arthrodesis for rigidity, the Girdlestone-Taylor flexor-to-extensor transfer for the flexible claw toe, and DIPJ fusion for the mallet toe — with the Kelikian push-up test driving the decision.
Lisfranc Amputation - How to amputate through the tarsometatarsal joints and keep the residual foot walking straight — why the Lisfranc level exists between the transmetatarsal and the Chopart on the diabetic and trauma amputation ladder, the equinovarus deformity that unbalanced tendons guarantee and the tibialis-anterior and peroneal insertions that removal of the metatarsal bases threatens, preserving the second metatarsal base keystone or reattaching what its removal strips, percutaneous Achilles lengthening as the near-routine companion, the plantar-flap closure and its perfusion arithmetic, and the footwear and orthotic aftermath that decides daily function.
Medial Displacement Calcaneal Osteotomy (MDCO) - Operative technique for medial displacement calcaneal osteotomy to correct hindfoot valgus in flexible flatfoot and stage II PTTD — lateral oblique approach, osteotomy landmarks, medial translation technique, screw fixation, combination with FDL transfer and lateral column lengthening, complications and rehabilitation
Metatarsal Fracture ORIF - Central Rays - Surgical technique guide for open reduction and internal fixation of displaced central (2nd-4th) metatarsal fractures — the dorsal intermetatarsal exposure step by step, dorsalis pedis and superficial peroneal nerve protection, the plate vs intramedullary screw vs K-wire decision, rotation and the metatarsal parabola.
Morton's Neuroma Excision - How to excise an interdigital (Morton's) neuroma — the dorsal approach laid out step by step, division of the deep transverse metatarsal ligament to expose the neuroma plantar to it, the 3 cm proximal transection that prevents stump neuroma, and the dorsal versus plantar evidence.
Open Reduction and Internal Fixation of Ankle Fracture - Operative technique for ORIF of ankle fractures — the fibula-first fixation sequence, lateral and medial exposures with their danger structures, syndesmotic assessment under fluoroscopy, and posterior malleolar fixation.
ORIF Lisfranc Injury (Tarsometatarsal Fracture-Dislocation) - Consultant-level guide to open reduction and internal fixation of an unstable Lisfranc injury: soft-tissue timing, dorsal exposure, reduction sequence, fixation choice, fluoroscopic checks and aftercare.
Os Trigonum Excision and FHL Release - How to treat posterior ankle impingement at its source — the accessory ossicle behind the talus that dancers and footballers compress with every pointe and every strike, the forced-plantarflexion examination and guided-injection test that make the diagnosis, flexor hallucis longus tenosynovitis as the constant companion sharing one operation, open posteromedial excision with the neurovascular bundle owned before the ossicle, the posterior endoscopic alternative and its two-portal discipline, and the return-to-pointe timeline that decides careers.
Peroneal Tendon Repair & Groove Deepening - Surgical technique for peroneal tendon repair with superior peroneal retinaculum (SPR) reconstruction and selective retromalleolar groove deepening — the lateral approach posterior to the fibula step by step, sural nerve protection, the tendon-repair algorithm, and rehabilitation.
Peroneal Tendon Repair and Reconstruction - Operative decision-making and technique for peroneal tendon tears, rupture and instability: tissue-preserving repair, graft reconstruction, selective tenodesis, superior peroneal retinaculum repair and rehabilitation.
Plantar Fascia Release (Open/Endoscopic) + Baxter's Nerve Decompression - How to release the plantar fascia for recalcitrant plantar fasciitis — the open medial approach at the plantar/non-plantar skin junction step by step, partial (medial one-third to one-half) release only to avoid arch collapse, Baxter's nerve decompression, and rehabilitation.
Posterior Tibial Tendon Dysfunction - Surgical Reconstruction - How to reconstruct the failed posterior tibial tendon — the FDL transfer to the navicular plus medial displacement calcaneal osteotomy (MDCO), the medial exposure step by step, stage-based decision-making (flexible versus rigid), and rehabilitation.
Rheumatoid Forefoot Reconstruction - Comprehensive operative guide for reconstruction of the rheumatoid forefoot — first MTP arthrodesis combined with lesser metatarsal head resection (Hoffmann) or Weil shortening osteotomies and claw toe correction, including immunosuppression considerations and post-operative rehabilitation
Scarf and Akin Osteotomy for Hallux Valgus - How to perform the scarf Z-osteotomy of the first metatarsal with an Akin osteotomy of the proximal phalanx for hallux valgus — the dorsomedial exposure step by step, troughing prevention, the stepwise lateral release, and rehabilitation.
Scarf Osteotomy for Moderate-Severe Hallux Valgus - Surgical technique guide for Scarf Osteotomy for Moderate-Severe Hallux Valgus
Subtalar Arthrodesis - Isolated subtalar joint fusion via the lateral sinus tarsi approach — exposure and operative steps, the 0–5 degree valgus heel-alignment target, screw fixation, complications and viva points.
Supramalleolar Osteotomy (Distal Tibia Realignment) - Joint-preserving realignment osteotomy of the distal tibia for asymmetric varus or valgus ankle osteoarthritis — indications, pre-operative planning, medial opening-wedge and lateral closing-wedge techniques, fibular osteotomy, plate fixation, complications, and rehabilitation
Syme Amputation (Ankle Disarticulation) - Surgical technique guide for Syme ankle disarticulation for unsalvageable hindfoot/forefoot disease, detailing the exposure, subperiosteal calcaneal dissection, heel pad preservation and anchoring, and prosthetic fitting.
Tarsal Navicular Fracture ORIF - Open reduction and internal fixation of tarsal navicular fractures — Sangeorzan body fractures, tuberosity avulsions, and high-risk stress fractures in athletes — recognising the navicular as the keystone of the medial longitudinal arch and its watershed central blood supply that predisposes to avascular necrosis and nonunion
Tarsal Tunnel Release (Posterior Tibial Nerve Decompression) - How to perform a complete tarsal tunnel release — the medial curvilinear exposure from 8 cm above the malleolus to the navicular tuberosity, division of both layers of the flexor retinaculum, the critical abductor hallucis release, the three nerve branches, and evidence-based outcomes.
Tarsometatarsal (TMT) Arthrodesis - Isolated or Multi-Ray - How to perform tarsometatarsal (Lisfranc) arthrodesis - isolated or multi-ray - via dual dorsal longitudinal incisions with meticulous dorsalis pedis and deep peroneal nerve protection, fish-scale joint preparation, tripod foot alignment, and selective fusion that preserves the mobile lateral column.
Tendo-Achilles Lengthening - Tendo-Achilles lengthening — the percutaneous Hoke triple hemisection, the Vulpius V-Y gastrocnemius recession, and the open Z-plasty — for equinus contracture in cerebral palsy, the diabetic foot, clubfoot and Charcot. Silfverskiold-guided technique selection, the full step-by-step operative sequence, sural-nerve protection, and over-lengthening avoidance.
Tibialis Anterior Tendon Transfer (Whole / Split) - Surgical technique guide for whole and split anterior tibial tendon transfer — SPLATT for relapsed idiopathic clubfoot after Ponseti correction and for dynamic supination in cerebral palsy and stroke, harvest of the TA insertion, rerouting and bony fixation under tension, concurrent tendo-Achilles lengthening
Tibialis Posterior Tendon Transfer for Foot Drop - Surgical technique guide for tibialis posterior tendon transfer through the interosseous membrane to the dorsum of the foot for foot drop from common peroneal nerve palsy, leprosy, or irreversible anterior compartment loss
Tibiotalocalcaneal Arthrodesis (Hindfoot Nail) - Surgical technique guide for tibiotalocalcaneal (TTC) arthrodesis using a retrograde hindfoot intramedullary nail for combined tibiotalar and subtalar arthritis, failed total ankle replacement, Charcot hindfoot, avascular talus and severe hindfoot deformity
Total Ankle Replacement (Tibiotalar Arthroplasty) - Surgical technique guide for total ankle replacement in end-stage tibiotalar arthritis — anterior approach, mobile-bearing versus fixed-bearing designs, alignment, gutter management, complications and registry outcomes
Transmetatarsal Amputation - How to perform a transmetatarsal amputation that heals and keeps working — the diabetic forefoot indications and the perfusion arithmetic that predicts healing, staged debridement before closure in the septic foot, the long plantar flap and the metatarsal parabola with plantar-bevelled cuts, why equinus is the mode of failure and how Achilles lengthening prevents the transfer ulcer, rocker-sole rehabilitation without a prosthesis, and the honest healing rates with BKA as the fallback.
Triple Arthrodesis - Triple arthrodesis (subtalar, talonavicular, calcaneocuboid) — the dual-incision Ollier lateral plus medial exposure step by step, joint-by-joint cartilage removal and fixation, the 0-5 degree valgus alignment target, and the long-term outcome evidence.
Turf Toe Repair (Plantar Plate, First MTPJ) - How to repair the hyperextended great toe that ends seasons — the plantar plate-sesamoid complex as the first MTPJ's undercarriage and the forced-dorsiflexion mechanism that tears it, grading that separates the strapped grade 1 from the operative grade 3, the diastasis and proximal-migration radiographic signs read against the contralateral foot, the medial-plantar approach protecting the plantar digital nerve, direct plantar-plate repair with sesamoid series decisions from fracture fixation to excision-with-reconstruction, and the push-off rehabilitation timeline that returns athletes without re-tearing the repair.
Weil Osteotomy for Lesser Metatarsalgia and Metatarsal Length Abnormalities - Oblique metatarsal neck osteotomy parallel to the weight-bearing surface for transfer metatarsalgia, plantar plate insufficiency and metatarsal length discrepancy

Sports Medicine — 33 procedures

sports-medicine (33 procedures)

ACL Reconstruction - Bone-Patellar Tendon-Bone (BTB) Autograft - Surgical technique guide for ACL Reconstruction - Bone-Patellar Tendon-Bone (BTB) Autograft
ACL Reconstruction - Hamstring Autograft (4-Strand) - How to perform arthroscopic anatomic single-bundle ACL reconstruction with a 4-strand hamstring autograft via the trans-anteromedial portal — hamstring harvest, anatomic femoral and tibial tunnel placement, suspensory fixation, tensioning and criteria-based return to sport.
ACL Reconstruction Technique - How to perform anatomic ACL reconstruction — the arthroscopic exposure and portal setup, femoral and tibial tunnel placement at the native footprints, graft selection (BTB, hamstring, quadriceps, allograft), fixation and tensioning, rehabilitation and complications.
ACL Reconstruction with Quadriceps Tendon Autograft - Consultant-level guide to ACL reconstruction with quadriceps tendon autograft, covering graft selection, MRI planning, soft-tissue and bone-block harvest, anatomic tunnel creation, fixation, rehabilitation and failure management
Arthroscopic Partial Meniscectomy - Surgical technique guide for Arthroscopic Partial Meniscectomy
Autologous Chondrocyte Implantation (ACI) - Comprehensive guide to autologous chondrocyte implantation and MACI - two-stage cartilage repair, indications, surgical technique, and outcomes for orthopaedic examination
High Tibial Osteotomy (HTO) - Medial Opening Wedge - Comprehensive surgical technique guide for medial opening wedge high tibial osteotomy, including planning, fixation, and lateral hinge fracture management,
High Tibial Osteotomy with Concurrent ACL Reconstruction — Medial Opening Wedge - Patient-specific planning and operative technique for combined medial opening-wedge high tibial osteotomy and ACL reconstruction in the unstable varus knee.
Hip Arthroscopy for Femoroacetabular Impingement (FAI) - Consultant-level operative guide to hip arthroscopy for femoroacetabular impingement syndrome, including selection, imaging, postless and post-assisted traction, portal strategy, labral preservation, selective rim correction, femoral osteochondroplasty, capsular management, rehabilitation and revision planning.
Lateral Extra-Articular Tenodesis and ALL Reconstruction - How to augment an ACL reconstruction against rotatory failure — the anterolateral complex and why the pivot shift is not an ACL-only sign, who genuinely benefits (the STABILITY trial numbers and the consensus indications), the modified Lemaire tenodesis step by step with the ITB strip passed deep to the LCL, anatomic anterolateral ligament reconstruction as the alternative, the fixation position that avoids over-constraining the lateral compartment, and rehabilitation that follows the ACL.
Lateral Retinacular Release - Surgical technique for open and arthroscopic lateral retinacular release of the knee - the narrow modern indication for isolated excessive lateral patellar tilt, the lengthening alternative, and the danger of iatrogenic medial instability
Medial Collateral Ligament Repair and Reconstruction - Decision-making and operative technique for acute medial-sided repair and anatomic reconstruction of chronic valgus or anteromedial rotatory instability
Meniscal Allograft Transplantation - Arthroscopic-assisted meniscal allograft transplantation for the symptomatic meniscus-deficient knee, including selection, sizing, root fixation, graft passage, peripheral repair and concurrent correction
Meniscal Repair - All-Inside and Inside-Out Techniques - Surgical technique guide for Meniscal Repair - All-Inside and Inside-Out Techniques
Meniscal Root Repair - How to repair a meniscal root tear — why root detachment is functionally a total meniscectomy and how it fast-tracks arthritis, the middle-aged medial posterior root versus the young traumatic lateral root with ACL injury, the ghost sign and extrusion on MRI, LaPrade classification, transtibial pull-out repair step by step with cinch-stitch fixation over an anterior cortical button, when to add high tibial osteotomy or choose non-operative care, and the slow flexion-limited rehabilitation that lets the root heal.
Microfracture and Bone-Marrow Stimulation for Osteochondral Lesions of the Talus - Surgical technique guide for arthroscopic microfracture and marrow stimulation of osteochondral lesions of the talus (OLT) — indications by lesion size, anterior arthroscopic approach, debridement, microfracture technique, fibrocartilage formation, medial malleolar osteotomy considerations, complications and rehabilitation
Microfracture Technique - Comprehensive guide to microfracture for articular cartilage repair — marrow-stimulation technique, patient selection, operative steps, rehabilitation and outcomes for the orthopaedic exam
MPFL Reconstruction - Surgical technique guide for Medial Patellofemoral Ligament (MPFL) Reconstruction
Multiligament Knee Reconstruction (Knee Dislocation) - Decision-led operative guide to multiligament knee injury: emergency reduction and vascular assessment, pattern definition, timing, repair versus reconstruction, tunnel planning, graft fixation and rehabilitation
Osteochondral Allograft (OCA) - Comprehensive guide to fresh osteochondral allograft transplantation - indications, storage, surgical technique, and outcomes for orthopaedic examination
Osteochondral Autograft Transfer (OATS) - Comprehensive guide to osteochondral autograft transfer system - mosaicplasty technique, indications, donor sites, and outcomes for orthopaedic examination
Osteochondritis Dissecans of the Knee — Fixation - A lesion-led operative guide to knee osteochondritis dissecans: stability assessment, fragment salvageability, drilling, arthroscopic or open reduction, fixation, bone grafting and failure rescue.
Patellar Tendon Repair - Comprehensive surgical technique guide for acute patellar tendon repair — the midline anterior-knee exposure laid out step by step, transosseous versus suture-anchor fixation, the essential augmentation that protects the repair, patellar-height restoration, and the chronic-rupture reconstruction options.
PCL Avulsion Fracture Fixation - How to fix a posterior cruciate ligament tibial avulsion — why the bony avulsion is a different disease from the midsubstance tear, the dashboard mechanism and the posterior sag that must not be missed, the prone Burks–Schaffer posteromedial approach with the medial gastrocnemius protecting the popliteal vessels, lag-screw fixation of the large fragment and suture techniques for the comminuted one, arthroscopic transtibial alternatives, and the hamstring-avoiding rehabilitation that protects the repair.
PCL Reconstruction - How to reconstruct the posterior cruciate ligament — the dashboard-injury injury, the posterior drawer and grading, the transtibial 'killer turn' versus the tibial inlay, single versus double bundle, graft choice and the combined PCL-plus-posterolateral-corner case.
Posterolateral Corner (PLC) Reconstruction of the Knee - Surgical technique guide for anatomic posterolateral corner reconstruction — LaPrade fibular-and-tibial-based technique, common peroneal nerve protection, combined cruciate and osteotomy considerations, graft selection and fixation
Primary Quadriceps Tendon Repair with Suture Anchor Technique - Complete surgical technique guide for Primary Quadriceps Tendon Repair using suture anchors - exam preparation with anatomy, Krackow suture technique, rehabilitation protocol, and viva scenarios
Proximal Hamstring Repair - How to reattach the hamstrings to the ischial tuberosity — the waterskiing-lunge mechanism and the bruise-down-the-thigh presentation, the operative rule of thumb (two or three tendons retracted over two centimetres in an active patient, repaired inside four weeks), the prone gluteal-crease approach with the posterior femoral cutaneous nerve above and the sciatic nerve lateral, suture-anchor footprint repair step by step, the chronic retracted tear that needs sciatic neurolysis and sometimes Achilles allograft, and the hamstring-bracing rehabilitation that guards the repair for twelve slow weeks.
Quadriceps Tendon Repair - Complete surgical technique guide for Quadriceps Tendon Repair including transosseous technique, augmentation strategies, and rehabilitation - exam preparation
Remplissage for Engaging Hill-Sachs Lesions - Arthroscopic remplissage technique for engaging Hill-Sachs lesions in anterior shoulder instability — glenoid track concept, combined Bankart repair, infraspinatus tenodesis and posterior capsulodesis, indications relative to glenoid bone loss thresholds, complications and rehabilitation
Revision ACL Reconstruction - How to perform revision ACL reconstruction — failure analysis, CT tunnel assessment, the one-stage versus two-stage decision, graft selection, anatomic tunnel drilling through the anteromedial portal, and anterolateral augmentation.
Tibial Spine (Intercondylar Eminence) Fracture Fixation - Arthroscopic-assisted reduction and fixation of tibial spine avulsion fractures — Meyers and McKeever classification, physeal-sparing techniques, suture versus screw fixation, complications and rehab
Trochleoplasty for Patellar Instability - Surgical technique guide for sulcus-deepening trochleoplasty in severe high-grade trochlear dysplasia (Dejour B/D) for recurrent lateral patellar instability

Shoulder & Elbow — 49 procedures

shoulder (49 procedures)

ACJ Reconstruction / Stabilisation - Surgical technique guide for acromioclavicular joint reconstruction and stabilisation — Rockwood classification, Weaver-Dunn, suspensory fixation (Dog-Bone/TightRope), and acute vs chronic management
Adult Monteggia Fracture-Dislocation — ORIF - Operative management of adult Monteggia fracture-dislocations: pattern recognition, CT planning, anatomical ulnar reconstruction, radial-head and coronoid management, stability testing and rehabilitation
Anatomic Total Shoulder Arthroplasty - Consultant-level guide to patient selection, three-dimensional glenoid planning, deltopectoral exposure, humeral and glenoid reconstruction, subscapularis repair, rehabilitation and revision after anatomic total shoulder arthroplasty
Arthroscopic Bankart Repair for Anterior Shoulder Instability - Surgical technique guide for Arthroscopic Bankart Repair for Anterior Shoulder Instability
Arthroscopic Capsular Shift / Plication for Shoulder Instability - Consultant-level operative guide to arthroscopic capsular plication for symptomatic multidirectional shoulder instability: diagnosis, rehabilitation failure, bone-loss exclusion, direction-specific tensioning, axillary-nerve safety, selective interval closure, rescue and criteria-based recovery
Arthroscopic Posterior Labral Repair (Posterior Shoulder Instability) - Arthroscopic reverse Bankart repair and posterior capsular plication for posterior shoulder instability - indications, portal placement, anchor technique, bone loss assessment, complications and rehabilitation
Arthroscopic Rotator Cuff Repair - Single Row Technique - Surgical technique guide for Arthroscopic Rotator Cuff Repair - Single Row Technique
Arthroscopic Rotator Cuff Repair — Double Row / Transosseous-Equivalent Suture Bridge - Consultant-level operative guide to double-row transosseous-equivalent rotator cuff repair: reparability, tear-pattern reduction, layered cuff anatomy, medial and lateral fixation, bridge tension, failure rescue and criteria-based rehabilitation
Arthroscopic SLAP Repair (Shoulder) - Consultant-level guide to arthroscopic superior-labral repair: diagnosis, normal variants, repair-versus-tenodesis selection, portal and anchor safety, dynamic stability, failure rescue and return-to-throwing rehabilitation
Arthroscopic Subacromial Decompression (Acromioplasty) for Impingement Syndrome - Comprehensive surgical technique guide for arthroscopic subacromial decompression - evidence-based approach for external shoulder impingement
Biceps Tenodesis / Tenotomy (LHB) - Surgical technique guide for Long Head of Biceps Tenodesis and Tenotomy
Calcific Tendinitis of the Shoulder - Barbotage and arthroscopic excision of calcific tendinitis of the shoulder — the subacromial exposure and portal anatomy laid out step by step, the barbotage versus arthroscopic decision, the greater-than-50% rotator cuff repair threshold, and rehabilitation.
Capitellum and Coronal Shear Fracture ORIF - Consultant-level guide to capitellar and trochlear coronal shear fracture fixation: CT classification, approach selection, fragment-specific reduction, headless screws, posterior-column reconstruction, associated injuries and rehabilitation
Clavicle ORIF (Midshaft & Distal) - Surgical technique guide for Clavicle ORIF covering midshaft (Allman Group I) and distal (Neer IIA/IIB) fractures
Distal Biceps Tendon Repair - How to repair a distal biceps tendon rupture — the single anterior (modified Boyd-Anderson) exposure laid out step by step with the radial tuberosity approach, cortical-button fixation, the supination manoeuvre that protects the posterior interosseous nerve, single versus two-incision decision, and rehabilitation.
Distal Clavicle Excision (Mumford Procedure) - Open and arthroscopic distal clavicle excision (Mumford procedure) for ACJ osteoarthritis, post-traumatic arthritis, and distal clavicle osteolysis
Distal Humerus ORIF - Distal humerus ORIF — intra-articular bicolumnar fracture fixation
Elbow Arthrodesis - How to fuse the elbow when nothing else is left — why the elbow tolerates fusion worse than any major joint and there is no position that serves both the face and the world, the salvage indications after infection, trauma and failed replacement, choosing the angle for one patient's life, posterior compression-plate technique with the ulnar nerve transposed and the olecranon worked into the construct, grafting the notoriously nonunion-prone interface, and the honest functional contract signed before the saw.
Elbow Arthroscopy - Elbow arthroscopy — portals, OCD, loose bodies, contracture release
Elbow Contracture Release (Open and Arthroscopic) - How to release the stiff elbow — the functional arc that defines the indication, extrinsic versus intrinsic contracture, the lateral column procedure step by step, the Hotchkiss over-the-top medial release, when heterotopic ossification is excised and how recurrence is prevented, the ulnar nerve rule that prevents the operation's signature complication, arthroscopic release selection, and the static-progressive splinting programme that holds the gain.
Frozen Shoulder: MUA and Arthroscopic Capsular Release - How to treat refractory adhesive capsulitis — staging the disease and exhausting the injection-and-therapy pathway first, what the FROST trial actually showed, manipulation under anaesthesia with the short-lever technique and its fracture-avoidance rules, arthroscopic 360-degree capsular release starting at the rotator interval and coracohumeral ligament, the axillary nerve corridor at the inferior capsule, the diabetic caveat, and the immediate-motion aftercare that decides the result.
Irreparable Rotator Cuff Salvage: SCR and Tendon Transfers - What to do when the cuff cannot be repaired — defining irreparability by retraction, fatty infiltration and the acromiohumeral interval rather than by tear size alone, the decision tree that sends the arthritic and pseudoparalytic to reverse replacement, superior capsular reconstruction technique and its honest prerequisites, latissimus dorsi and lower trapezius transfers for the posterosuperior deficit with the vector argument between them, pectoralis major for the failed subscapularis, and the humbler options — partial repair, biceps tenotomy, debridement — that serve the pain-dominant low-demand shoulder.
Latarjet / Coracoid Transfer for Anterior Shoulder Instability - Surgical technique guide for the Latarjet coracoid transfer procedure for anterior shoulder instability with significant glenoid bone loss
McLaughlin Procedure for Locked Posterior Shoulder Dislocation - Open subscapularis or lesser-tuberosity transfer for an engaging reverse Hill-Sachs lesion after posterior shoulder dislocation, with defect, glenoid and soft-tissue decision-making
Medial Epicondylitis Release - How to operate on golfer's elbow when a year of proper non-operative care has failed — separating true flexor-pronator tendinosis from its two great mimics at the medial elbow (ulnar neuritis and MCL insufficiency), the mini-open debridement of the pathological common flexor origin, why the ulnar nerve makes this operation more dangerous than its lateral cousin, handling coexisting cubital tunnel symptoms at the same sitting, and the slow tendon-rehabilitation contract that follows.
Mini-Open Rotator Cuff Repair - Surgical technique guide for Mini-Open Rotator Cuff Repair
Open Bankart Repair for Anterior Shoulder Instability - Surgical technique guide for Open Bankart Repair for Anterior Shoulder Instability - deltopectoral approach, subscapularis takedown, capsulolabral repair.
Open Debridement of Elbow OA (Outerbridge–Kashiwagi Procedure) - How to debride the arthritic elbow — why primary elbow OA is an impingement disease of the fossae and process tips with a preserved mid-arc, the Outerbridge–Kashiwagi ulnohumeral arthroplasty step by step through a triceps split with fossa fenestration, olecranon and coronoid tip excision and loose-body clearance, the arthroscopic osteocapsular alternative, the same ulnar nerve rule as every stiff-elbow operation, and where interposition and total elbow replacement take over.
Open Rotator Cuff Repair - Comprehensive surgical technique guide for Open Rotator Cuff Repair including deltoid-splitting and deltopectoral approaches
ORIF Olecranon - ORIF olecranon fracture — tension band wiring and plate fixation
Pectoralis Major Tendon Repair - Acute and Chronic Reconstruction - How to repair a pectoralis major tendon rupture - the deltopectoral exposure step by step, mobilising the retracted sternal head, preparing the lateral lip of the bicipital groove, suture-anchor fixation at the 45-degree 'deadman' angle, augmentation in chronic and high-demand cases, and the strict 6-week protection protocol.
Posterior Bone Block / Posterior Shoulder Instability - Posterior Bankart repair, bone block (Eden-Hybinette), and posterior capsulorrhaphy for posterior shoulder instability
Radial Head Arthroplasty (RHA) - Surgical technique guide for Radial Head Arthroplasty (RHA) — Kocher approach, terrible triad and Essex-Lopresti. advanced orthopaedic practice operative-surgery preparation.
Radial Nerve Exploration - Radial nerve exploration — humeral shaft, posterior interosseous nerve (PIN)
Reverse Shoulder Arthroplasty (RSA) - How to perform reverse shoulder arthroplasty through the deltopectoral approach — the Grammont design rationale, inferior glenoid exposure and baseplate positioning step by step, scapular notching prevention, and rehabilitation.
Reverse TSA Revision - Surgical technique guide for Reverse TSA Revision
Revision Shoulder Arthroplasty to Reverse - Comprehensive surgical technique guide for revision of failed shoulder arthroplasty to reverse total shoulder replacement
Scapula Fracture ORIF - How to fix the scapula that actually needs fixing — why over 90 percent of scapular fractures are treated in a sling and the displacement thresholds (glenopolar angle, medialisation, angulation, intra-articular step) that define the operative minority, the high-energy company this fracture keeps and the chest injuries that outrank it, the Judet posterior approach and its muscle-sparing windows through the infraspinatus-teres minor interval, glenoid fossa fixation by fragment pattern, the floating shoulder decision, and the branch-by-branch protection of the suprascapular and axillary nerves.
Scapular Winging: Tendon Transfers - How to treat the winged scapula — telling medial (serratus, long thoracic) from lateral (trapezius, spinal accessory) winging at the couch, why most long thoracic palsies recover and deserve 12 to 18 months before any transfer, pectoralis major transfer with graft prolongation to the inferior angle for serratus palsy, the Eden-Lange lateralisation of levator and rhomboids for trapezius palsy, the iatrogenic accessory nerve injury that deserves early repair instead, and scapulothoracic fusion as the honest answer in dystrophic muscle.
Shoulder Arthrodesis - Glenohumeral arthrodesis for brachial plexus palsy, failed arthroplasty, irreparable rotator cuff with deltoid loss, infection, and flail shoulder
Shoulder Arthroplasty Revision - Comprehensive surgical technique guide for revision shoulder arthroplasty including anatomic TSA and conversion to reverse shoulder arthroplasty
Shoulder Hemiarthroplasty - Deltopectoral Approach - Comprehensive surgical technique guide for shoulder hemiarthroplasty via deltopectoral approach for proximal humerus fractures and glenohumeral arthritis
Sternoclavicular Joint Reconstruction - How to manage the unstable sternoclavicular joint — why posterior dislocation is a mediastinal emergency reduced with cardiothoracic cover, the physeal fracture masquerading as dislocation in patients under twenty-five, closed reduction technique with the towel-clip rescue, figure-of-eight hamstring reconstruction through clavicular and manubrial tunnels for the chronically unstable joint, medial clavicle excision for the arthritic variant with the costoclavicular ligament preserved, why transfixing pins are banned by the weight of migration fatalities, and the innominate vein that sits one drill-plunge behind everything.
Subpectoral Biceps Tenodesis - Open subpectoral biceps tenodesis technique for long head of biceps tendinopathy, instability and partial tears — axillary-fold incision, groove debridement, interference screw or cortical button fixation, length-tension restoration, nerve protection
Suprascapular Nerve Release - How to decompress the shoulder's most entrapped nerve at its two notches — why suprascapular-notch compression weakens both spinati while spinoglenoid-notch lesions silently waste infraspinatus alone, the volleyball player's ganglion and the labral tear that fills it, EMG and MRI convicting the level before any release, arthroscopic transligamentous release of the superior transverse scapular ligament step by step, the open posterior alternative, when the paralabral cyst is drained by fixing the labrum instead of opening the notch, and the recovery arithmetic of a nerve released before its muscle is fat.
Tennis Elbow Release - Lateral epicondyle release (open + arthroscopic) for tennis elbow
Total Elbow Replacement - Total elbow replacement (linked, unlinked, semiconstrained) — the Bryan-Morrey triceps-on exposure and operative sequence step by step, linked versus unlinked implant selection, lifetime activity restrictions, complications and revision.
Triceps Tendon Repair - How to repair a distal triceps tendon rupture — the posterior exposure step by step, suture-anchor versus transosseous tunnel fixation, tensioning at 30–40° flexion, augmentation for chronic tears, and rehabilitation.
Ulnar Nerve Anterior Transposition (Subcutaneous / Submuscular) - Surgical technique guide for anterior transposition of the ulnar nerve in cubital tunnel syndrome where simple in-situ decompression is insufficient — subcutaneous, intramuscular and submuscular (Learmonth) techniques, nerve mobilisation with blood supply preservation, and management of revision and complex cases

Paediatrics — 40 procedures

paediatric (40 procedures)

Boyd Amputation - How to perform the calcaneotibial-fusion amputation and why it exists — the heel-pad problem every ankle-level amputation must solve and Boyd's answer of fusing the retained calcaneus to the tibia so the pad cannot migrate, its home territory in fibular hemimelia and paediatric limb deficiency where preserving the calcaneal apophysis protects growth and end-bearing, the operative sequence from talectomy through forward-translated calcaneotibial fusion, the comparison with Syme's amputation argued honestly, and the prosthetic realities that make these end-bearing stumps lifelong walkers.
Brachial Plexus Birth Injury — Reconstruction - Decision-making and operative technique for primary microsurgical reconstruction, nerve transfers and secondary shoulder reconstruction after brachial plexus birth injury
Camptodactyly Correction - How to manage the congenitally bent little finger with proportionate care — the PIP flexion contracture whose usual author is an abnormal FDS or lumbrical insertion, the infancy and adolescent-growth-spurt presentation peaks, why stretching and splinting is the first and often only treatment with surgery reserved for severe progressive contractures, the exploration that inventories every abnormal structure from skin to volar plate, FDS release or transfer as the operative core, the bony changes that mark the point of no full return, and the honest counselling that surgical fingers improve but rarely straighten completely.
Cerebral Palsy — Open Adductor Release for Hip Displacement - Consultant-level guide to open sequential adductor longus, gracilis and selective adductor brevis release for early cerebral-palsy hip displacement, including surveillance, route selection, obturator-nerve protection, iliopsoas decisions, rehabilitation and failure management
Cerebral Palsy — Open Medial Hamstring Lengthening for Flexed-Knee Gait - Consultant-level guide to selecting and performing open medial hamstring lengthening for cerebral-palsy flexed-knee gait, including gait analysis, surgical dose, semitendinosus and semimembranosus technique, neural protection, rehabilitation and failure management
Clubfoot (CTEV) — Ponseti Method & Posteromedial Release - Surgical technique guide for congenital talipes equinovarus - Ponseti manipulation and casting, percutaneous Achilles tenotomy, foot abduction bracing, tibialis anterior transfer, and posteromedial release for resistant deformity
Congenital Muscular Torticollis - Sternocleidomastoid Release - Surgical technique guide for sternocleidomastoid release in congenital muscular torticollis - unipolar and bipolar release, danger structures, paediatric considerations and the exclusion of non-muscular torticollis
Congenital Pseudarthrosis of the Tibia: Surgical Management - How to manage one of paediatric orthopaedics' hardest problems — the anterolateral bowed tibia that must never be osteotomised, the NF-1 association that shapes counselling from the first visit, bracing to protect the pre-fracture bow, the surgical triad of radical hamartoma excision, intramedullary rodding and biological augmentation, when circular frames and vascularised fibula transfers earn their complexity, cross-union techniques that changed the union arithmetic, and the honest amputation conversation that a minority of these legs eventually require.
Congenital Vertical Talus — Minimally Invasive Correction - Consultant-level guide to diagnosis, reverse-Ponseti casting, limited talonavicular reduction and fixation, Achilles tenotomy, bracing, recurrence and salvage for congenital vertical talus.
Cubitus Varus Correction — Supracondylar Osteotomy - Consultant-level guide to three-dimensional assessment and corrective distal-humeral osteotomy for cubitus varus, including closing-wedge, dome and step-cut planning, fixation, neurovascular safety and failure management.
Curly Toe Correction (Flexor Tenotomy) - How to manage the child's curly toe with proportionate surgery — why most curly toes never need anything but reassurance, the flexion-adduction-supination deformity of the third and fourth toes and the flexor tightness that drives it, the evidence that strapping does not work, open percutaneous-style flexor tenotomy through a tiny plantar incision after age three for the persistent symptomatic toe, why tenotomy alone equals flexor-to-extensor transfer in the randomised comparison, and the Butler racquet operation for the different problem of the overlapping fifth toe.
DDH Open Reduction (Medial & Anterior Approaches) - Surgical technique guide for open reduction of developmental dysplasia of the hip in infants and young children - medial (Ludloff/Ferguson) versus anterior (Smith-Petersen/bikini) approach selection, obstacles to reduction, capsulorrhaphy, concurrent femoral and pelvic osteotomy, spica casting and avascular necrosis
DDH: Closed Reduction, Arthrogram and Spica - How to reduce the dislocated infant hip closed — the 6-to-18-month window after Pavlik failure, examination and arthrography under anaesthesia, reading the dye pool and the obstacles to reduction, the safe zone of Ramsey and why adductor tenotomy widens it, the human position that protects the femoral head from AVN, spica application and in-cast MRI confirmation, the twelve-week cast programme, and the surveillance to maturity that catches residual dysplasia while it can still be steered.
Epiphysiodesis for Leg-Length Discrepancy - Operative-surgery guide to permanent growth-plate arrest for leg-length discrepancy — timing and growth prediction (Green-Anderson, Moseley, Paley), the percutaneous drill-and-curette exposure step by step, Phemister and PETS alternatives, and complications.
Femoral Varus Derotation Osteotomy (VDRO) - Surgical technique guide for proximal femoral varus derotation osteotomy - correction of excessive femoral anteversion and coxa valga to improve hip containment in DDH, Perthes, and neuromuscular hip subluxation
Guided Growth / Hemiepiphysiodesis (Tension-Band Plating) - Surgical technique guide for temporary hemiepiphysiodesis with tension-band plating (eight-Plate) for paediatric coronal and sagittal angular deformity - growth-plate principles, CORA planning, overcorrection avoidance, reversibility and rebound
Hip Spica Cast Application - Surgical technique guide for Hip Spica Cast Application
Limb Lengthening with Magnetic Intramedullary Nails - How to lengthen a limb from the inside — who genuinely needs lengthening and the discrepancy thresholds, magnetic nail versus circular frame trade-offs including the weight-bearing restriction and the STRYDE withdrawal told honestly, pre-operative planning of canal, nail and osteotomy, the ream-vent-osteotomise sequence with a low-energy percutaneous osteotomy, external remote controller programming at Ilizarov's rates, the joint-protection physiotherapy that femoral and tibial lengthening each demand, congenital-limb caveats about unstable hips and ACL-deficient knees, and regenerate surveillance to consolidation and implant removal.
Paediatric ACL Reconstruction (Physeal-Sparing) - How to reconstruct the ACL in a knee that is still growing — why the old advice to wait for maturity traded growth plates for menisci and cartilage, staging skeletal age (Tanner, bone age, growth remaining) as the operation-selector, the Micheli-Kocher iliotibial-band combined intra- and extra-articular reconstruction for the youngest knees, all-epiphyseal socket techniques for the middle years, transphyseal soft-tissue grafts with the vertical-central-tunnel rules for adolescents nearing maturity, the growth-disturbance surveillance every family signs up to, and the re-rupture arithmetic that makes rehabilitation and return-to-sport gating half the operation.
Paediatric Both-Bone Forearm Fracture — Flexible Intramedullary Nailing - Surgical technique guide for flexible intramedullary nailing of displaced paediatric both-bone forearm fractures — antegrade ulnar and retrograde radial insertion, radial bow restoration, physis protection, and complication avoidance
Paediatric Femoral Shaft Fracture — Flexible Intramedullary Nailing - How to perform titanium elastic (flexible) intramedullary nailing of a paediatric femoral shaft fracture — the retrograde distal-entry exposure step by step, pre-bent nail and balanced three-point fixation principles, length-stable fracture selection, end-cap use, and complication avoidance.
Paediatric Lateral Humeral Condyle Fracture ORIF - Open reduction and internal fixation of displaced paediatric lateral humeral condyle fractures — Kocher lateral approach, posterior soft-tissue preservation, K-wire or screw fixation, Milch and Weiss classification, nonunion risk and complications
Paediatric Medial Epicondyle Fracture ORIF - Open reduction and internal fixation of displaced paediatric medial humeral epicondyle (apophyseal avulsion) fractures - absolute and relative indications, the medial approach with ulnar nerve protection, single cannulated screw fixation, and the displacement-threshold controversy
Paediatric Radial Neck Fracture Management - Surgical technique guide for management of paediatric radial neck (proximal radial physis) fractures — Judet classification, closed reduction manoeuvres (Patterson, percutaneous push), Métaizeau intramedullary elastic nailing, open reduction, AVN prevention, and rehabilitation
Pelvic Osteotomies — A Comparative Overview - Comparative overview of pelvic osteotomies for hip dysplasia - redirectional (Salter, triple, periacetabular/PAO), reshaping (Pemberton, Dega) and salvage (Chiari, shelf/Staheli) procedures, with selection by triradiate status, congruity and age
Pemberton & Dega Acetabuloplasty - Surgical technique guide for incomplete pericapsular acetabular reshaping osteotomies in developmental dysplasia of the hip - Pemberton (triradiate hinge) and Dega (posterior cortex hinge), indications, anatomy, technique, complications
Perthes Containment Surgery (Femoral & Pelvic Osteotomy) - Surgical technique guide for containment surgery in Legg-Calvé-Perthes disease - femoral varus osteotomy, Salter pelvic osteotomy, combined and salvage procedures, prognostic factors and the containment principle
Physeal Bar Resection - Selection, three-dimensional mapping and operative technique for physeal bar resection, interposition and deformity management in a growing child.
Polydactyly Correction - How to correct the duplicated digit properly — why thumb duplication is a reconstruction and never a simple excision, Wassel-Flatt classification as the operative map with type IV as the commonest examination case, preserving the ulnar thumb and rebuilding the radial collateral ligament and thenar insertions onto it, the Bilhaut-Cloquet combination and its nail-and-physis caveats, postaxial polydactyly's spectrum from suture ligation of the pedunculated type B digit to formal reconstruction of type A, and the growth-length surveillance that follows every duplicated thumb to maturity.
Salter Innominate Osteotomy - Surgical technique guide for the Salter innominate osteotomy - redirectional single pelvic osteotomy for developmental dysplasia of the hip and residual acetabular dysplasia, with operative steps, danger zones and comparison with Pemberton and Dega osteotomies
SCFE — Modified Dunn Procedure (Surgical Hip Dislocation and Subcapital Realignment) - Operative technique guide for the modified Dunn procedure in moderate-to-severe and unstable slipped capital femoral epiphysis — Ganz surgical hip dislocation, retinacular flap development, subcapital realignment, and epiphyseal blood supply protection
SCFE Deformity Correction: Imhäuser / Southwick Osteotomy - How to correct the healed slipped epiphysis that leaves the head pointing backwards — the retroversion-varus-extension deformity a moderate-to-severe SCFE builds into the proximal femur and the impingement it grinds into the acetabular rim, why the intertrochanteric level trades correction perfection for vascular safety against the subcapital osteotomy's opposite bargain, the Imhäuser flexion-internal-rotation osteotomy planned from the slip angle, Southwick's triplane geometry distinguished, blade-plate execution on the trochanteric table, the modified Dunn alternative argued honestly for the unstable acute slip, and the arthrosis clock all SCFE corrections race.
Selective Dorsal Rhizotomy (SDR) for Spastic Cerebral Palsy - Surgical technique guide for Selective Dorsal Rhizotomy (SDR) for Spastic Cerebral Palsy
Septic Hip: Open Washout (Paediatric and Adult) - How to decompress the septic hip — why hours matter for cartilage and the femoral head's blood supply, Kocher and Caird criteria against transient synovitis, ultrasound and aspiration, the anterior Smith-Petersen arthrotomy step by step with pus sampled before a drop of saline, why the anterior route protects the retinacular vessels, the neonatal caveats and the medial and arthroscopic alternatives, drain-and-loose-closure logic, antibiotic duration, and the AVN and growth-arrest surveillance that follows every case.
Sprengel Deformity Correction - Operative technique guide for surgical correction of Sprengel deformity (congenital elevated scapula) - the Woodward and Green procedures, omovertebral bone excision, supraspinous resection, clavicular osteotomy, brachial plexus protection, and paediatric considerations
SUFE Pinning - In Situ Fixation with Single Central Screw - Comprehensive examination guide to in situ screw fixation for slipped upper femoral epiphysis (SUFE/SCFE), including Loder classification, Southwick angle measurement, screw positioning, and AVN prevention strategies
Supracondylar Humeral Osteotomy for Cubitus Varus - Comprehensive surgical technique guide for corrective osteotomy of cubitus varus deformity following malunited supracondylar fractures
Syndactyly Release - How to separate webbed fingers — simple versus complex and complete versus incomplete classification, why border digits are released early and only one side of a digit is ever operated at a time, the dorsal commissural flap and interdigitating zigzag design, why skin is always deficient and where the full-thickness graft comes from, nail-fold reconstruction with pulp flaps in complete syndactyly, the common neurovascular bifurcation that sets the release's depth, web creep surveillance through growth, and the syndromic hand's different rules.
Tarsal Coalition Resection - Calcaneonavicular and Talocalcaneal - Comprehensive surgical technique for resection of calcaneonavicular and talocalcaneal coalitions with muscle interposition to restore subtalar motion in symptomatic rigid flatfoot
Triple Pelvic Osteotomy (Steel / Tönnis) - How to redirect the adolescent dysplastic acetabulum when the triradiate cartilage bars a PAO and a Salter cannot swing far enough — cutting all three bones (ilium, ischium, pubis) to free the acetabular fragment completely, the Steel and Tönnis variants distinguished by their ischial cuts, who sits in the window between the young child's single-cut Salter and the mature adolescent's periacetabular osteotomy, the sciatic nerve at the ischial cut and the obturator structures at the pubic cut, correcting coverage without retroverting the socket, and the fixation and union arithmetic of a free acetabular fragment in a growing pelvis.

Oncology — 24 procedures

oncology (24 procedures)

Allograft-Prosthetic Composite (APC) Reconstruction - How to perform an allograft-prosthetic composite reconstruction after bone-tumour resection — cementing a long-stem prosthesis into a structural allograft, the step-cut and plate host-allograft junction, the abductor and patellar-tendon reattachment that is the biological advantage over a megaprosthesis, junction nonunion and allograft fracture management, and the APC-versus-megaprosthesis-versus-osteoarticular decision.
Amputation for Tumour (Forequarter, Hindquarter & Rotationplasty) - Surgical technique guide for amputation in musculoskeletal oncology - oncological principles, forequarter (Berger), hindquarter (external hemipelvectomy), transfemoral/transtibial amputation, and Van Nes rotationplasty
CT-Guided Radiofrequency Ablation of Osteoid Osteoma - Operative guide to CT-guided radiofrequency ablation of osteoid osteoma, including diagnostic confirmation, biopsy strategy, trajectory planning, coaxial nidus access, device-specific thermal dosing, protection of skin, cartilage and nerves, difficult-site techniques, recurrence and rehabilitation.
Curettage, Local Adjuvant & Reconstruction (GCT and benign-aggressive bone lesions) - How to perform intralesional extended curettage of benign-aggressive bone lesions — the cortical window, high-speed burr, local adjuvants (phenol, cryotherapy, PMMA), cavity reconstruction, and giant cell tumour specifics including denosumab.
Distal Femoral Replacement (Megaprosthesis) - Multidisciplinary planning, oncologic resection, modular rotating-hinge reconstruction, fixation, soft-tissue restoration and failure management for distal femoral replacement
Endoprosthetic Reconstruction (Tumour Megaprosthesis) - Surgical technique guide for modular endoprosthetic replacement after segmental bone resection for primary bone sarcoma and metastatic disease - proximal femur, distal femur, proximal tibia, proximal humerus, Henderson failure modes, soft-tissue reconstruction
Expandable (Growing) Endoprosthesis in the Skeletally Immature - How to reconstruct a periphyseal bone sarcoma in a growing child with an expandable endoprosthesis — distal femoral resection and hinged reconstruction step by step, minimally invasive versus non-invasive electromagnetic lengthening, predicting and managing limb-length discrepancy, and the decision against rotationplasty and amputation.
Forequarter (Interscapulothoracic) Amputation - How to perform a forequarter (interscapulothoracic) amputation for an unresectable shoulder-girdle or proximal-humeral tumour — the clavicle-first anterior (Berger) exposure, early subclavian vascular control, brachial-plexus division, scapular detachment and chest-wall flap cover, with phantom-pain management and the limb-salvage (Tikhoff-Linberg) contrast.
Hindquarter Amputation (External Hemipelvectomy) - How to perform an external hemipelvectomy (hindquarter amputation) for an unresectable pelvic or proximal-thigh sarcoma — the classic posterior gluteal flap and the anterior quadriceps flap alternative, iliac vessel control, division of the pubic symphysis and sacroiliac joint, durable flap cover, complications and contrast with internal hemipelvectomy.
Hip Disarticulation - How to remove the limb through the hip joint when nothing distal can be saved — the tumour, infection and vascular catastrophes that reach this level and the hindquarter alternative above it, the posterior gluteal flap that becomes the sitting and socket surface, the racquet incision and vessel-first sequence at the femoral triangle, muscle-group management from the psoas to the short external rotators, why the prosthetic reality (high energy cost, low long-term use) must be spoken before consent rather than after rehabilitation, and the phantom-pain and wound arithmetic of amputation at its most proximal ambulatory level.
Intercalary Resection and Reconstruction for Diaphyseal Tumours - How to perform an intercalary (joint-preserving) resection and reconstruction for a diaphyseal bone sarcoma — wide en-bloc resection with the adjacent joints preserved, the four reconstructions (structural allograft, vascularised fibula, Capanna composite, intercalary spacer), fixation and the dominant complications of nonunion, graft fracture and infection.
Internal Hemipelvectomy (Periacetabular / Enneking Type II Resection) - How to perform a limb-sparing periacetabular (Enneking Type II) internal hemipelvectomy for pelvic sarcoma — the ilioinguinal/utilitarian exposure with iliac-vessel and femoral-nerve control, the pubic, ischial and supracetabular osteotomies, en-bloc resection, reconstruction options (saddle, custom/3D-printed endoprosthesis, hip transposition, allograft-composite, flail hip) and the high blood-loss and infection burden.
Musculoskeletal Tumour Biopsy — Principles & Technique - Surgical technique guide for biopsy of bone and soft-tissue tumours - core needle vs open incisional vs excisional biopsy, tract planning, sarcoma centre principles, and the consequences of poorly-executed biopsy
Osteochondroma Excision - How to remove the commonest benign bone tumour properly — the cartilage-capped exostosis growing away from the physis on its own marrow-continuous stalk, the symptoms that earn surgery from bursae and snapping tendons to nerve and vessel compression, the malignant-change surveillance arithmetic (cap thickness over 2 centimetres in the adult is the number that matters), extraperiosteal excision at the stalk's base taking the entire cartilage cap and overlying perichondrium in one piece, hereditary multiple exostoses with its higher transformation rate and forearm deformity problems, and why leaving cap behind is the recurrence mechanism.
Prophylactic Fixation of Metastatic Bone Disease (Impending Fracture) - How to prevent a pathological fracture — the Mirels score and the threshold to fix, the whole-bone fixation principle (long cephalomedullary nail spanning the femur), cement augmentation of lytic defects, pre-operative embolisation of vascular metastases, the fixation-versus-endoprosthesis decision, and adjuvant radiotherapy plus bone-targeted systemic therapy.
Proximal Femoral Endoprosthetic Replacement for Tumour - How to perform a modular proximal femoral replacement (megaprosthesis) after wide resection of a proximal femoral tumour — biopsy-tract planning and Enneking margins, the extended lateral exposure and the structures at risk, modular implant assembly with a bipolar or dual-mobility articulation, abductor and capsule reconstruction to restore abduction and cut the high dislocation rate, complications and adjuvant therapy timing.
Proximal Humeral Endoprosthetic Replacement for Tumour - How to perform a proximal humeral endoprosthetic replacement after wide tumour resection — the deltopectoral or extended exposure step by step, the critical decision to preserve or sacrifice the axillary nerve and deltoid, modular cemented prosthesis with synthetic mesh soft-tissue reconstruction, allograft-prosthetic composite as an alternative, and the functional outcome (stable shoulder, functional hand, limited active elevation).
Proximal Tibial Endoprosthetic Replacement for Tumour - How to perform a wide resection of the proximal tibia for an osteosarcoma and reconstruct it with a modular endoprosthesis — the two signature problems (extensor-mechanism reconstruction and soft-tissue cover), the medial gastrocnemius flap that solves both, the rotating-hinge articulation, protection of the neurovascular bundle and common peroneal nerve, complications and rehab.
Rotationplasty (Van Nes) for Distal Femoral / Knee Tumours - How to perform a Van Nes (Borggreve) rotationplasty for a distal femoral or proximal tibial sarcoma in a skeletally immature child — wide resection of the tumour and knee, 180-degree rotation of the distal limb so the ankle becomes a knee, with sciatic nerve and vessel preservation, femorotibial fixation and prosthetic rehabilitation.
Sacral and Pelvic Tumour Resection (Internal Hemipelvectomy) - Operative technique guide for internal hemipelvectomy and sacrectomy for primary pelvic and sacral tumours — Enneking zones, staged anterior-posterior approaches, margin planning, neurovascular control, reconstruction options and functional trade-offs
Structural Allograft Reconstruction after Bone Tumour Resection - Consultant-level guide to intercalary, osteoarticular and allograft-prosthesis composite reconstruction after bone tumour resection, including graft matching, fixation, vascularised-fibula augmentation, junction biology, rehabilitation and failure management
Total En-Bloc Spondylectomy for Spinal Tumour (Tomita Technique) - How to perform total en-bloc spondylectomy for an isolated primary or solitary metastatic spinal tumour — the piecemeal-versus-en-bloc oncological principle, WBB staging and the Tomita score, the posterior-only Tomita technique with pediculotomy and the threadwire saw (T-saw), cord and great-vessel protection, anterior column reconstruction, and the local-control rationale.
Wide / Compartmental Excision of Soft-Tissue Sarcoma - How to perform a wide excision of an extremity soft-tissue sarcoma with an oncological margin — image-guided core biopsy along a resectable tract, the en-bloc principle of taking a continuous cuff of normal tissue (and why historical compartmentectomy is now largely replaced by wide margins plus radiotherapy), neurovascular preservation versus sacrifice and reconstruction, clipping the tumour bed for adjuvant radiotherapy, flap cover, margins and local recurrence.
Wide Local Excision & Limb Salvage — Surgical Margins in Sarcoma - Surgical technique guide for wide local excision and limb salvage in bone and soft-tissue sarcoma - Enneking margins, R0/R1/R2 classification, limb salvage versus amputation, biopsy tract excision, and reconstruction options

Approaches & Principles — 14 procedures

surgical-approaches (8 procedures)

Anterior Approach to the Cervical Spine - Comprehensive exam-focused review of Anterior Approach to the Cervical Spine including clinical presentation, investigation, management, and key exam points
Kocher-Langenbeck Approach to the Posterior Acetabulum - Comprehensive exam-focused review of Kocher-Langenbeck posterior approach to the acetabulum including surgical anatomy, technique, indications, and key exam points
Surgical Approaches to the Ankle, Hindfoot and Foot - Advanced orthopaedic guide to surgical approaches around the ankle, hindfoot and foot, including anterior ankle, posterolateral ankle, medial ankle, sinus tarsi, extensile lateral calcaneus, dorsal midfoot and medial first-ray exposures.
Surgical Approaches to the Cervical and Thoracolumbar Spine - Advanced orthopaedic guide to cervical, thoracic, thoracolumbar and lumbar spine surgical approaches, including anterior cervical, posterior cervical, posterior thoracolumbar, anterior thoracic, lateral retroperitoneal, LLIF, OLIF and ALIF exposures.
Surgical Approaches to the Forearm, Wrist and Hand - Advanced orthopaedic guide to surgical approaches in the forearm, wrist and hand, including Henry, Thompson, carpal tunnel, scaphoid, flexor tendon and extensor tendon exposures.
Surgical Approaches to the Hip and Pelvis - An advanced orthopaedic guide to choosing and describing surgical approaches around the hip, acetabulum and pelvis, including relevant anatomy, imaging, exposure selection, operative steps and complications.
Surgical Approaches to the Knee - Advanced orthopaedic guide to surgical approaches around the knee, including medial parapatellar, subvastus, midvastus, lateral parapatellar, posteromedial and posterolateral exposures.
Surgical Approaches to the Shoulder and Elbow - An advanced orthopaedic guide to choosing and describing surgical approaches around the shoulder, proximal humerus and elbow, including anatomy, exposure selection, operative steps, complications and evidence.

general-ortho (5 procedures)

Above-Knee Amputation (Transfemoral) - Surgical technique guide for Above-Knee (Transfemoral) Amputation
Amputation Surgical Principles - Comprehensive guide to amputation surgical principles - level selection, myodesis vs myoplasty, bone handling, nerve management, prosthetic considerations, phantom limb pain for orthopaedic exam
Below-Knee Amputation (Transtibial) - Surgical technique guide for Below-Knee (Transtibial) Amputation
Lower Limb Amputation Levels - Comprehensive guide to lower limb amputation levels - toe, ray, transmetatarsal, Chopart, Lisfranc, Syme, transtibial, knee disarticulation, transfemoral, hip disarticulation. Energy expenditure, prosthetic outcomes, healing considerations for orthopaedic exam
Through-Knee Amputation (Knee Disarticulation and Gritti-Stokes) - How to amputate through the knee and when to prefer it — the non-ambulator for whom it is the best level in surgery, end-bearing and muscle balance versus the prosthetic knee-centre problem, Bowker's sagittal-flap disarticulation with gastrocnemius cover step by step, patellar tendon to cruciate anchoring, traction neurectomy of the tibial nerve, the Gritti-Stokes variant and its patellar nonunion problem, and rehabilitation from immediate transfer-friendly stumps to polycentric prosthetic knees.

general (1 procedures)

Hip Arthrodesis - Consultant-level operative planning, technique, complications and conversion principles for the exceptionally rare contemporary hip arthrodesis.

Procedure guides.

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Procedure guides.

Start with the setup

Know the danger structures

Preparation

Technique

Aftercare

Browse by operative region

Arthroplasty

Trauma

Spine

Hand & Wrist

Foot & Ankle

Sports Medicine

Shoulder & Elbow

Paediatrics

Oncology

Approaches & Principles