The Art of Limb Alignment, 11th edition (PDF)

By Shawn C. Standard, John E. Herzenberg, Janet D. Conway, Noman A. Siddiqui, Philip K. McClure, Michael J. Assayag

For more than 30 years, we have taught limb correction surgery at the annual Baltimore Limb Deformity Course (www.DeformityCourse.com). We have used these hands-on experiences with our students to guide us when creating this book. The Art of Limb Alignment is a concise guide for beginners starting on their journey to master the art of limb alignment. Understanding limb alignment and malalignment is a critical task for surgeons who treat lower extremity deformities. The first task is to characterize the deformity: Is the bone angulated? In what direction is the bone angulated? What is the level of the deformity? Where is the apex of the deformity? What is the magnitude of the deformity? Is the bone short? Is it rotated on its axis? All these questions must be answered before correcting the problem.In a new Chapter 3 for this eleventh edition, comprehensive history collection and thorough physical exam are discussed. Instruction and advice are given for both adult and pediatric patients, including practical checklists and a case sheet to use when evaluating new patients. Examination of gait, hip, knee, and ankle are described, as well as tips and tricks for their treatments. The chapter concludes with considerations for skin and soft tissue, as well as notes regarding preparing a patient for surgery.This edition also includes updates to Chapter 6. A section reviewing osteotomy rules and considerations is now included. Locations for the osteotomy and the hinge point are discussed, as well as their impact on appearance and alignment. Multiple placement scenarios are detailed for both the bone cut and thumbtack, and two vital osteotomy rules are proffered. Additionally, there are 11 new original illustrations included to aid understanding of the added osteotomy concepts.Further improvements to this eleventh edition include an update to chapter sequencing, as we have relocated the “Natural History of Malalignment” chapter to an earlier placement within the table of contents. This change was made to enhance the natural reading progression. Lastly, physical copies now have a subject index incorporated into the rear pages of the book.The Art of Limb Alignment is intentionally short, concise, and we hope, easy to master. The theme is that of student and teacher (sensei) embarking on a voyage to master the art of limb alignment.Enjoy the journey!

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