Minimally Invasive Surgery for the achilles tendon represents a novel approach to treatment of orthopedic problems in the Achilles tendon. The gradual change of philosophy in the management of ankle surgery means that patients require a less invasive approach to surgery and a consequent improvement in recovery time. Describing the techniques and, importantly, the indications for minimally invasive procedures for the management of achilles tendon ailments, this book explains the management of various conditions and how they can be approached using minimally invasive techniques.This handbook provides an instant reference source for specialists and trainees alike, for those needing a 'to the point' companion when performing when treating disorders of the achilles tendon.

Among all the extensor mechanism pathologies, lateral patellar instability is of great interest not only for the knee specialist, but also for the general orthopedic surgeon and trainee. The procedure that is most frequently performed to treat lateral patellar instability is the medial patellofemoral ligament (MPFL) reconstruction. The reason for this great interest in this procedure is obvious. Medial patellofemoral ligament reconstruction is the most frequently performed procedure in the extensor mechanism. It also is the most predictable and has the best clinical results of all the procedures in the extensor mechanism. In this handbook we analyse the different reconstruction techniques, step by step, for the MPFL reconstruction, as well as other techniques less frequently used in the patient with lateral patellofemoral instability. We also analyse the treatment of medial patellofemoral instability. It is a very practical book, aimed at the general orthopedic surgeon and also the ones specialized in the knee.

Adventure and extreme sports are increasing in popularity and it is not surprising that commercial adventure tourism and the accompanying life style and fashion, have become increasingly important to world economy. These unique sports involve not only major physical endurance and mental challenges but interaction and bonding with nature. They also tend to attract and excite audiences, both at the event and in the media. They are exciting to watch and redraw the boundaries of human achievement with the accompanying risks of injury and death. Adventure sports are usually performed in beautiful, exciting and remote locations or in extreme environments far away from medical assistance. Extreme sports usually involve an element of increased risk. These risks are highlighted by the media, usually after a reported accident or fatality but may vary according to the involvement of the participant; the weekend recreational adventure sports athlete or the experienced professional. A wide variety of sports fall into the category of adventure and extreme sports and with an increasing number of disciplines, this field is ever expanding. Sports are performed in contact with the "ground"; mountain running and biking, rock climbing, ice climbing and mountaineering. In the air: skydiving and base jumping. On water: surfing, white water kayaking and rafting, board sailing and diving. And also involve mechanical vehicles and animals! Some sports may be performed as a combination of few disciplines, such as water and air, e.g. kite surfing, and as so involve very unique mechanisms of injury. Sports events can also be merged to form a multi-sport race comprising many disciplines lastly from single to multi day races. Sports may involve competition with others, against the environment or with oneself, frequently the most ferocious adversary. Adventure sports are becoming increasingly popular in the general public and a few take these sports to an extreme level with the accompanying risks. Those that do, bring such time and dedication that they become professional in terms of training, preparation and finance. More and more people are enjoying adventure sports and unfortunately increased numbers are becoming injured as a result. Future research is progressing alongside the sport development, to allow the sport mechanisms, injury patterns and predisposing factors to be better understood. It is the hope of all researchers to make the sports safer without detracting from their adventurous nature. The aim and scope of our book would be to bring the sports medicine involved ineach of these sports into one volume. We would explain each sport including subtle similarities and differences, the common injury mechanisms, patterns of injury and treatment options. Additional chapters would include the mental characteristics of adventure racers and extreme sports athletes, together with the complexities of competing in hot and cold extreme environments. The book will present chapters focussing on the sports listed below, concentrating on published literature and newly formed studies by experts in the fields of injury epidemiology, prevention, management and rehabilitation.

This book has been written by established Orthopedic Surgeons who have become dedicated specialists within their particular subspecialty. They have contributed by writing highly detailed chapters that educate the reader with the basic science, accepted fundamentals and most recent trends within the full range of generalorthopedicdisorders. It is intended that this well illustrated and highly informative text book to provide orthopedic surgeons in training with comprehensive and relevant core knowledge on all aspects general orthopedics, and will become an essential guide for surgeons in training, providing step by step approaches to performing initial diagnosis, surgical procedures and post operative management. "

Compared with traditional surgical procedures, wrist arthroscopy reduces the risk to patients and hastens recovery. Nevertheless, in many ways wrist arthroscopy is still in its infancy, and its indications continue to evolve. This book is devoted to the optimal use of arthroscopy in the diagnosis and treatment of wrist pathologies that give rise to ulnar pain. The correct procedure in a wide variety of settings is carefully explained in step-by-step fashion with the help of numerous detailed illustrations. Particular care is taken to cover all the important technical issues. The authors are without exception internationally acknowledged experts who draw on their considerable experience to provide readers with sound guidance on the appropriate use of arthroscopy for each indication.

It is widely recognized that numerical analysis is a useful ta al common ta the fields of engineering, applied mathematics and mechanics, and medical science. Computer simulation and modeling have contributed much ta the understanding of a wide variety of biomedical phenomena. In particular the use of numerical techniques is essential for solving problems involving extremely complex geom- etry and physical properties that arise in a wide range of biomechanics. The increased speed and expanded storage capacity of modern computers, together with newly advanced numerical and programming techniques, have greatly im- proved the potential for studying complicated biomedical processes. Computer modeling techniques and their applications in the field of biome- chanics have shown remarkable development in J apan in the past few years. This book focuses an these advances and shows how computer modeling and simula- tion are being utilized ta aid and assist researchers, scientists, and clinicians in their understanding of biomedical systems from the biomechanical point of view. The papers included in this book falI within three main areas of interest: orthopedic, orthodontic, and skeletal mechanics; circulatory mechanics; and bio- logical and living systems. This book contains highly original papers that have been carefulIy selected from the studies financialIy supported by a 3-year Grant- in-Aid for Scientific Research an Priority Areas (Biomechanics, Nas.

With this proliferation of arthroscopy and other minimally invasive approaches due to the greater demands for day case surgery, there is much interest among orthopedic surgeons for quick reference guides to assist with minimally invasive techniques. Describing the techniques and, importantly, the indications for minimally invasive procedures for the management of forefoot disorders, this book will explain the management of various conditions and how they can be approached using minimally invasive techniques. However, rather than only concentrating on minimally invasive surgery of the forefoot, the book will examine the options open to surgeons operating in this area - both open surgical and arthroscopic - and explaining the benefits of each. Extensive radiographs, diagrams, and intra-operative pictures will illustrate the procedures described.

An in-depth understanding of a comprehensive approach to the management of radius fractures and their complications. The authors -- world renowned experts in the field -- present practical, clinical information from their extensive experience in the treatment of these fractures. Topics include the authors' classification as well as decision- making and tactics in the conservative and operative management of all types of radius fractures. Topics covered include: bending fractures of the metaphysis, shearing and compression fractures of the joint surface, avulsion fractures, radio-carpal fracture and dislocation, combined fractures, high velocity injury and malunions. In addition, chapters deal with surgical techniques and approach as well as with complications. With over 500 illustrations, this is the definitive volume on these challenging fractures, their complete treatment, and the management of complications.

This book reviews the main topics in thromboprophylaxis around orthopedic surgery, from a general scope of the problems with the disease highlighting them in orthopedics to the new specific protocols involving, for example, new oral anticoagulants. The prevalence of the venous thromboembolism in each procedure (from "easy" to "hard" surgeries, with different rates of related thrombosis) and the risk factors to bear in mind in each one (related and non-related with the orthopedic procedure) are also revised. A chapter focus on the diagnosis and treatment of venous thromboembolism, which is commonly "forgotten" in many books addressed to orthopedic surgeons and anaesthesiologists. The methods for thromboprophylaxis have three specific chapters: the most common drugs used and recommended when pharmacological prophylaxis is needed, new drugs which are arising day by day and which management will be of main importance in a close near future, and mechanical methods, recommended both as additional when possible and for sole indications when the risk of bleeding could move us to minimize the real risk of thrombosis. Anaesthetic implications for thromboprophylaxis and, also, main implications of the application of antithrombotic protocols in the anaesthetic practice are covered by another chapter. In our opinion it was very important to divide the orthopedic procedures according to their own thrombotic risk, so having their own protocols for thromboprophylaxis: high risk, day surgery procedures and "special" surgical procedures are included in three different chapters, from three different authors with complementary views. Finally, in a last chapter, we review the problems involving the perioperatory management of antiaggregated and anticoagulated patients, with a special part in hip fracture surgery.

This book has become necessary as a consequence of the rapid expansion of the surgical procedures and implants available for spinal surgery within the "AO Group". We have not attempted to write an in-depth book on spinal surgery, but one which will help the surgeon in the use of AO concepts and implants. We con sider the practical courses held all over the world essential for the teaching of sound techniques so that technical complications and poor results can be avoid ed for both the surgeon and, in particular the patient. This book is a practical manual and an outline of what is taught in the courses. It is intended to help the young spinal surgeon to understand the correct use of AO implants. The indi- tions given will aid the correct use of each procedure. . It must be strongly emphasized that surgery of the spine is technically de manding. The techniques described in this book should only be undertaken by surgeons who are trained and experienced in spinal surgery. Certain techniques, in particular pedicle screw fIxation and cages, have not yet been fully approved by the FDA in the United States. However, throughout the rest of the world, the use of pedicle screws has become a standard technique for the spine surgeon, since it has been shown to improve fIxation techniques and allow segmental correction of the spine. The use of cages has become more and more popular, specifIcally as a tool of minimally invasive spinal surgery.

LA WRENCE G. RAISZ, MD Division of Endocrinology and Metabolism, University of Connecticut Health Center. Farmington. CT The rapid transfer of new knowledge concerning the pathogenesis, diagnosis, preven tion, and treatment of disease into clinical practice has always been a major challenge in medicine. This challenge is particularly difficult to meet in osteoporosis, not only because has been so much new knowledge generated in recent years, but also because this there disorder has not caught the attention of many practicing physicians. The goal of this volume is to help primary care physicians develop a better understanding of osteoporosis and a more effective approach to diagnosis, prevention, and treatment. As primary care physicians become more and more responsible for the maintenance of health and the prevention of disease, osteoporosis must become one of their important concerns. The magnitude of the problem of osteoporosis has been widely publicized. Within the next 30 years, the cost of hip fractures alone is expected to exceed $40 billion a year in the United States and will be a major cause ofincreased mortality. In addition, vertebral crush fractures will cripple more and more of our elderly population, both men and women. This enormous toll is not inevitable. Current methods of identifying individuals at risk and applying preventive programs could reduce the incidence offractures by 50% or more. This should be the minimum goal of clinicians."

With the technical advances made in MRI technology and the wider availability of MRI units, this diagnostic modality has by now - doubtedly gained a crucial role in joint imaging.The excellent detail recognition of MRI provides views of the various joint structures once only available through direct arthroscopic and surgical pro- dures. The acceptance, usefulness, and role of any diagnostic modality, however, critically relies on the experience, clinical expertise, and dedication of those who use it.With this in mind, a renowned int- disciplinary team of authors have brought together expert kno- edge from their respective fields in compiling this MRI atlas. Peter Teller and Hermann Konig are two highly experienced MRI radiologists with backgrounds in both clinical work and research. Ulrich Weber and Peter Hertel are two leading orthopedic surgeons and traumatologists in the fields of joint surgery/microsurgery and sports injuries. It is the vast radiologic experience in the interpretation of c- plex image information - an experience that takes into account the clinical requirements from the perspective of orthopedic surgeons and traumatologists - as well as the authors'didactic approach that make for the singular character of this book. Berlin, November 2001 Bernd Hamm, MD Professor and Chairman Department of Radiology Charite Medical School Humboldt-Universitat zu Berlin Preface MRI of diseases and injuries of the head, neck, and spinal column has become firmly established as a diagnostic tool since examiners could easily apply their previous experience gained in CT to MRI in these areas."

Physicians are under increasing pressure to provide quality health care in the most cost-effective way possible. The escalating costs of orthopedic care are driving the need to base clinical decision making on evidence-based data that will help physicians provide optimal care to every patient. Evidence-based medicine is the future of orthopedic surgery. In a world where the quality of surgical outcomes will be increasingly measured, evidence-based data will heavily guide decision making in orthopedic trauma. Orthopedic Traumatology: An Evidence-Based Approach provides the reader with a focused and comprehensive review of the literature surrounding the management of the orthopedic trauma patient. The book centers around clinical scenarios with each chapter based on a specific case. Renowned orthopedic trauma surgeons from across the country serve as contributing authors, writing based on these scenarios and giving their expert opinions on management while using data as their guide. Each chapter describes and summarizes the data, but achieves this objective in a case-based format. Each case is brief, but includes relevant imaging. The case scenarios are heavily weighted toward treatment of more controversial injuries. As there is currently no book on the market that focuses solely on orthopedic trauma and evidence-based medicine, this book is sure to be a useful reference for residents and practicing physicians alike.

Sports Medicine is now a specialty in its own right. The Olympics are coming to the UK which has focused interest in the field, and pain in elite sport is an unresolved issue. Sports Medicine is an area that has expanded dramatically in the last 5 years, and demand for educational materials to help bridge the gap in the literature are highly sought-after. This book utilises the excellent sports medicine section originally published within International Advances in Foot and Ankle Surgery and present it in a quick reference format for residents and trainees in orthopedic sports medicine. The information presented covers current accepted techniques with scientific rationale and will appeal to all surgeons and health care professionals with an interest in sports medicine. This is a truly international, multidisciplinary manual of foot and ankle surgery in sports medicine by the specialty's leaders and most experienced surgeons. Current up to date trends and techniques using a scientific approach including evidence based guidelines where applicable are included. The reader will be exposed to a step-by-step approach to each procedure presented.

The global burden of geriatric hip fractures is enormous. From both the patient's and physician's perspective, the injury is complex. A hip fracture often changes a patient's life and/or the life of the patient's family permanently. From the physician's perspective, care of geriatric hip fracture patients requires a multidisciplinary team, which is led by the surgeon and which includes internists and other subspecialists within internal medicine, anesthesiologists, nurses, operating room technicians, social workers, physical therapists, and rehabilitation center coordinators and staff. Nowhere in the orthopedic literature is there a text that guides care for these complex patients from injury through recovery. This text is the first to do so by organizing and synthesizing a large body of literature. Its main themes include pre-operative, operative, and post-operative care of the patient who sustains a geriatric hip fracture. Its main objective is to organize the current body of literature into a cohesive whole so that the busy orthopedic surgeon does not have to undertake a literature search each time he or she wants an answer to the myriad questions that characterize a patient's injury, treatment, and recovery course. With regard to pedagogy, because orthopedic surgeons in training will utilize this book, and because the case study is the central pedagogical tool in the field of orthopedic surgery, this book includes case studies within each chapter, with the author's preferred treatment and decision-making rationale for each case. Selected video supplements reinforce real-world application of knowledge. Practicing orthopedic surgeons, as well as orthopedic residents and fellows in training, will find Geriatric Hip Fractures: A Practical Approach a highly useful and informative resource.

As it is quick, inexpensive, and non-invasive, ultrasound is the modality of choice for guidance of interventional procedures in the soft tissues. Furthermore, the rising mean age of the general population is being accompanied by increasing demand among patients for minimally invasive procedures to treat painful chronic and degenerative syndromes of the musculoskeletal system. This handbook is a clear, practical guide to ultrasound-guided minimally invasive treatments of musculoskeletal pain in the upper limb. Each chapter is clearly structured, with brief but comprehensive descriptions of the disease to be treated and of the materials and drugs needed. High-quality images and easy-to-follow schemes explain the best approach in each situation, and practical tips and tricks of value in daily clinical routine are provided.

Primary care providers (physicians, nurse practitioners, physician assistants) make decisions on a daily basis regarding treatment for musculoskeletal problems, including referrals to orthopedic surgeons and other specialists. Despite the large number of patients presenting with musculoskeletal complaints, primary care providers often feel poorly educated about how to assess and manage these conditions. Now in its fully revised second edition, Principles of Orthopedic Practice for Primary Care Providers continues to be a go-to resource for clinicians interested in the effective treatment of musculoskeletal disorders. Written by expert orthopedic, physical medicine and pain management specialists at major Harvard teaching hospitals, the second edition of Principles of Orthopedic Practice for Primary Care Providers represents a high-yield and succinct resource on the assessment and management of musculoskeletal conditions. Chapters overview specific body parts, typical presentations of disease, options for diagnostic testing, treatment paradigms, and anticipated outcomes of management both in the primary care setting and following specialist consultation. The text offers suggested pathways for working up and treating these problems with an emphasis on when referral to a specialist, or surgical intervention, is needed. While all previous chapters have been fully revised, this edition also includes nine brand new chapters, including chapters on pain management, hip-spine syndrome, adult spinal deformity, sports-related injuries, and cost and quality in musculoskeletal care.

The theme of this work is the application of the engmeermg theory of frictional torque to total hip replacement. The author adhered tenaciously to this theory, involving the use of a small-diameter femoral head, throughout the epoch when the large-diame ter, metal-to-metal design dominated the field. During that considerable period general satisfaction with the early results rendered criticisms of the large-diameter head unwelcome. There was a formidable array of counter criticism: the small head would pierce a film of synovial fluid; the small head would wear the socket too rapidly; the small head would always have a high risk of dislocation; detachment of the trochanter, to achieve precise orientation for the small head, was unacceptable. But all these objections have now been largely overcome. Lubrication of high molecular weight polyethylene (HMWP) on metal is now accepted as being mainly by the boundary regime with thick fluid films playing no part. We now know that HMWP can indeed tolerate the very high stresses imposed by the small head and in tribological theory there may even be some advantage in high stress. Dislocation is now known not to be an automatic sequel to the small head.

The First International Symposium on "Pain and Kampo (Japanese Herbal Medicine)" took place in Tokyo in October, 1992. More than 700 registrants participated, with 12 registrants from seven overseas countries. This book contains summaries of the presentations at this meeting and is published in order to provide up-to-date information to a much wider audience. In China, traditional herbal medicine has been used for more than 3000 years while in Japan, its use has been documented for more than 1000 years, albeit with some changes to the original Chinese formulations. Recently there has been a revival of interest in herbal medicines for several reasons. There is a rapid growth in the number of senior citizens who frequently require the attention of modern medicine. In particular, there has been an increase in the number of patients who suffer from chronic diseases which are difficult to treat, e.g., arteriosclerosis, Alzheimer's disease, chronic pain syndromes, etc. It has become evident that traditional Oriental herbal medicines could playa role in the management of these and other conditions.

The contents of this book are based almost exclusively on purely anatomical researches. These were stimulated by questions posed in clinical practice. The results are directed to practicing surgeons. Their chronological sequence leads to a step by step development of theoretical bases and to a progressive rejection of old conceptions. Especially in the field of orthopaedic surgery, a responsible attitude is possible neither without solid anatomical knowledge, nor without an idea of functional relationships. W. Roux had already demonstrated this and he wanted his works of functional anatomy to be considered from this point of view. He above all preoccupied himself with a uniform theory of functional adaptation. Thus it is understandable that the theories ofRoux formed the basis from which to start. Our own researches seemed at first to corroborate the ideas of Roux, at least in part. This is still evident in the monograph concerning fractures of the femoral neck. Later it appeared that ST. KROMPECHER had made a step forwards in the matter of chondrogenesis when he abandoned the shear theory postulated by Roux and held that compression was the only effective stimulus for the forma tion of cartilage. The research concerning the healing of fractures relies partly on the theory of KROMPECHER which was new at that time. But ultimately more and more discoveries could no longer be explained by this conception which was only slightly different from the older theories (1. WOLF, W. Roux, W."

For more than 100 years, congenital dislocation of the hip has been an area of concern in orthopedics. This publications on the subject are al most too numerous to count. Yet our knowledge of the basic principles of congenital hip dislocation and its management is constantly being expanded by new research. In Germanspeaking countries, Kaiser pub lished the last comprehensive textbook on congenital hip dislocation in 1958, and Schlegel followed with a comprehensive handbook in 1961. In the Angloamerican world, Coleman's monograph was pub lished in 1978, Somerville's in 1982, and Wilkinson's in 1985. In 1982 Tachdjian compiled a volume on congenital hip dislocation that con tained contributions from 44 authorities. The purpose of the present book is to provide an overview of our pre sent state of knowledge of congenital hip dislocation, covering basic principles, diagnosis, methods of closed and open treatment, and indi cations. In the process, an attempt is made to trace progress in the field from its beginnings to the present time. Many authors describe the diagnosis and treatment of congenital hip dysplasia and dislocation in terms of specific age groups. We believe it is more prudent to take an individualized approach based on arthro graphic findings and the degree of severity of pathologic changes. Less emphasis is placed here on the management of patients by age group."

As in any multiauthored textbook penned by When I was first approached by the publisher of this volume, Martinus Nijhoff, Boston, I writers of diverse backgrounds and interests, explored the possibility of writing a personal Modern Stereotactic Neurosurgery to some monograph on contemporary stereotactic extent suffers from incompleteness. Future surgery. After a review of available literature, volumes no doubt will include many additions several aspects became apparent. First, no cur from other authors who also are important rent, readily accessible, multiauthored text de specialists in the field. Because not all authors signed to survey the field was available. Those write in the same style (or even language), we books that were available tended to heavily have attempted to achieve a more cohesive text emphasize theory, physiology, and anatomy. in the editorial process. Each chapter has been Second, stereotactic surgeons were considered subdivided into pertinent headings for easier abstruse and for too long were relegated to a reference. Because of my own background, status outside of the mainstream of neuro some readers will note an Americanization (as surgery. This attitude probably reflected the opposed to anglicization) of the chapters. insufficient explanation of the practical uses While many chapters comprise primarily sum and advantages of stereotactic technique. maries of the authors' work within the field, Third, in recent years, the field has expanded each author was encouraged to review the liter so rapidly that it has become a major compo ature in that discipline if appropriate."

In recent years, arthrography of the knee, this area, defining for the reader the intricacies shoulder, and hip has become increasingly of the radiologic studies and detailing the important in the evaluation of the numerous nuances of technique which may expedite the disorders which affect these major joints. The quality of the examination and enhance the radiologist has assumed the essential role not diagnostic acumen of the radiologist. This only in providing for the orthopedic clinician work, in addition to its other many valuable an accurate diagnosis of abnormalities of these features, is truly a "how to do it" treatise for joints, but also in defining anatomical details in the radiologist. a manner hitherto unavailable and even un Of great interest are the chapters which deal suspected. In fact, it may be stated that the with arthrography in joints and areas often not developing radiologic techniques in arthrog considered an important part of the diagnostic armamentarium of the radiologist or even raphy have in part rewritten the anatomical texts relating to the normal joints. thought of by the orthopedic clinician. These In this excellent work by Murray K. Dalinka, include the ankle, hindfoot, elbow, wrist, and M. D., arthrography of a number of major joints small joints of the hand and foot. The chapter is considered in detail. Dr. Dalinka, a recog on arthrotomography of the temporomandib nized authority in skeletal radiology and par ular joint by Dr."