Two research centers joined to study the development of numerous malformations of the vertebral column in 30 mutants of the laboratory mouse: the Department of Anatomy of the University of Zurich, that has long been a center of research in vertebral anatomy and pathology, and the Jackson Laboratory in Bar Harbor, Maine, the largest center of research in mouse genetics. This volume describes the normal and abnormal morphogenesis of vertebrae and summarizes the data presently available in order to give better insight into the developmental mechanics of the vertebral column.

This volume reviews the state-of-the-art in osteoarthritis. The pathogenetic roles of mechanical, systemic and inflammatory factors and the importance of neurogenic factors in pain management and in the causes of disease are considered. Of particular value is the review of the implications of pathogenetic mechanisms in future modes of management. The concept of "activated arthrosis" is given special attention. Finally, controversial issues and new areas for investigation are discussed. The book will help the clinician and the investigator consider the importance of addressing different phases and subtypes of osteoarthritis in planning treatment.

There is no more important area of the body for an athlete than the core, the region of our body from our chest to our knees. The core is our engine, our hub of activity. Strength there makes life easier for shoulders and knees. It produces speed and explosiveness. Endurance and grit. The core is so important. So why has it remained such a medical mystery? This book will explain that. Introducing the Core: Demystifying the Body of an Athlete traces the arc of the journey from injury to restoration of power to the return to normal life. Dr. William Meyers is the nation's foremost authority on core health. Along with over 40 world-renowned expert contributors, Dr. Meyers explains how the core functions through stories from his work in locker rooms, the operating room, and the playing fields of elite athletes, giving readers a thorough understanding of the core's widespread influence on athleticism and the human anatomy. The book: Dissects the events that led Dr. Meyers and his team of experts to their new appreciation of this anatomy Brings multiple world-renowned arthroscopists into the overall core picture, providing their perspectives on how the core works, with the pubic bone as "the sun" of the body's universe Offers insight into the many causes of pelvic pain, demonstrating why the term "sports hernia," should be banished forever Emphasizes the fact that a wide spectrum of professionals treat the core -- from traditional surgeons to alternative therapists Brings it all together and proposes a new future, and perhaps a new medical specialty, that is the core "Strength, power, and endurance all flow from the core. This book, and the work Bill Meyers has done in the field, will bring good core health to the forefront and help everyone-elite athletes and others." -Michael William Krzyzewski "Even in baseball, injury patterns in the shoulder and elbow are related to core imbalance. This book has been needed for a long time... Bill has helped the idea of core strength become more popular, and this book could be what is needed to get it more attention." -James Rheuben Andrews, MD "To understand the core, you must put on new eyes." -Marshawn Lynch

The Understanding the Spine chart is an overview of the structure and selected health issues of the vertebral column. Front and side views of the column are shown, along with several views of vertebrae and discs. Heavy gauge 3ml lamination with sealed edges and two metal eyelets for hanging makes chart highly durable. Write-on/wipe-off with dry erase marker (not included).

Clubfoot is a common deformity but remains unsolved. Detailed epidemiology has been described to assess the socio-economic impact. All corrective methods are enumerated, highlighting their efficacy and pitfalls. The importance of each clubfoot case being different and the means of dealing it is emphasized upon. This is a comprehensive book on Clubfoot with the types and their mode of treatment extensively discussed. Also, Clubfoot differences during birth, additional birth defects, weight bearing effect with age, previous scars, trauma and other complications are covered. Key Features A comprehensive book on Clubfoot Explained the different kinds of clubfoot Evidence based description of each clubfoot being different Updated with the latest treatment techniques Comparative analysis of various treatment options

The history of medicine is dotted with the episodic appearance of new discoveries, scientific breakthroughs, and the development of new schools of medicine, and each has contributed to the evolution of the art and science of the practice of medicine. The founding of osteopathic medicine by Andrew Taylor Still was one such event. The development of the craniosacral concept by William G.Suther land was another. Both of these giants of osteopathic medicine en countered the reluctance of their colleagues to accept his contribu tion. Both were able to overcome this reluctance and saw the acceptance of his contribution because of the fundamental anatom ical and physiological truth supporting the concept, and the prag matic fact that their therapeutic applications were successful. Both men attracted to them individuals desirous of learning a new diag nostic and therapeutic procedure. It is fortunate that these individu als have continued to promulgate the contribution to osteopathic medicine of their mentors.

I am proud that this study of the hand appears in the series Exercises in Radiological Diagnosis founded by A. WACKEN HEIM. From time eternal, man has tried to explain the numerous configurations and lines of the hand in order to reveal the true character of a person and to display his life. The importance of the symbolism of the hand is reflected in its role in the cultural life of the old world. Therefore, it is not astanishing that the first book about the hand, by Johannes Hartlieb, was devoted to Chiromancy, and that it was so successful that it went through four editions since the second half of the fifteenth century. When Wilhelm Rontgen in 1895 asked his wife to lay her hand on a photographic plate covered with black paper and exposed it to the radiation he had just discovered, it marked the beginning of radiology. Today the study of the hand concerns only 2%-4% of the activity of radiology. It nevertheless reveals an amazing quantity and variety of pathology. That is the reason for this work. - The authors wishes to thank his friends Y. DIRHEIMER, rheumatolog1st, J. C. DoscH, traumatologist, and G. Fou CHER, surgeon, who provided some of the material for the illustrations. P. BouRJAT VII Contents Part One: Iconography . . . . . . . . . . . . . . . . 1 Part Two: Commentary with Corresponding Schemata 117 Subject Index . . . . . . . . . . . . . . . . . . 203 . . ."

Congenital and acquired bone defects constitute a central problem of traumatology and orthopedics. In order to cure these defects it is often necessary to fill up the bones operatively with suitable substances. Recently, so-called bone substitutes (collagen, gelatine, bone matrix, calcium phospate, hydroxyapatite) have also been recommended. Following an introductory presentation of bone regeneration and transplants, these substitutes are discussed here in a comprehensive survey of the literature. Particular attention is given to the significance of mineral substance such as hydroxyapatite, which will undoubtedly find a place in bone surgery owing to its outstanding bioactivity and biotolerance. The implants examined are also of significance for maxillofacial surgery and dentistry. The histologic techniques in the staining of undecalcified bone preparations and in histomorphometry are presented in a special chapter.

Nel corso della (TM)accrescimento la (TM)apparato muscolo-scheletrico va incontro a profonde e continue modificazioni che riguardano non soltanto la forma, la struttura e le dimensioni dei singoli costituenti, ma anche la capacitA di resistenza allo stress e la forza muscolare espressa, le influenze ormonali e metaboliche.

Le caratteristiche anatomiche e funzionali che rendono lo scheletro pediatrico diverso da quello della (TM)adulto condizionano anche la differente modalitA di realizzarsi del danno traumatico, alla quale contribuisce anche il diverso stile di vita e le differenti occasioni di trauma, dalla frattura da parto alla "sindrome del bambino battuto."

Le fratture incomplete, le fratture osteo-cartilaginee, i distacchi apofisari e le osteocondriti sono alcune delle specificitA del trauma osteo-articolare in etA pediatrica, cosA� come la (TM)elevata velocitA di consolidazione e la (TM)elevata attivitA di rimodellamento ne caratterizzano la distinzione rispetto ai corrispettivi quadri patologici nella (TM)adulto.

In questo volume vengono rappresentate le caratteristiche anatomiche peculiari della (TM)apparato muscolo-scheletrico in etA evolutiva, le lesioni traumatiche acute e croniche tipiche della (TM)etA e le modalitA di imaging di volta in volta piA idonee per la loro diagnosi e il loro follow-up.

Osteoarticular pathology is a very frequent motive for consultation. Very often, the diagnosis relies upon symptomatology, and the physi cian requires confirmatory radiological investigations. Whatever the clinical indication, the interpretation of radiological data must be very rigorous. On the basis of a complete description of the radiographic images, according to a systematic analysis plan, a certain number of diagnostic hypotheses may be proposed. Selection of the most likely hypothesis requires the correlation of clinical, biological, and radiological data, and may sometimes necessi tate additional investigations, such as tomograms, scintigrams, and computed tomography (CT). 1 Part One Iconography 3 3 1 2 4 5 5 6 6 7 8 b a 8 a 9 10 11 12 10 13 14 11 15 a b 12 a c 13 17 b a c 14 15 c 16 17 23 21 a 22 b 18 19 20 21 22 23 33 34 24 25 37 38 26 27 40- 43 28 29 46 30 48 47 31 49 50 32 33 52 a b c 34 53 a b d c 35 54 a b 36 37 55 a 38 55 b c 39 56 57 40 58 41 60 61 42 43 63 64 44 65 66 45 67 68 46 69 a b 47 70 71 48 73 49 74 75 50 76 77 51 78 79 52 80 a b c 53 81 82 54 83 84 55 85 86 S6 87 88 57 89 90 58 91 92"

Like my first book of exercises in radiological diagnosis con- cerning the vertebrae in adults, the first part of this book consists of an atlas of images ready for immanent reading. The images are numbered, each number corresponding to a case. The second part comprises the corresponding comments, critical interpretations, and drawings (using the same num- bers as the corresponding radiographs in the first part). I hope that this second booklet will be as appreciated as was the first, which was published in four languages (Radio- diagnosis of the Vertebrae in Adults. Springer, Berlin Hei- delberg New York 1983). My own documentation having proved deficient in some fields, I had recourse to the didactic collections oimy collea- gues, friends, and students. Special thanks are due to Prof. J. F. Bonneville, and to Drs. J. L. Dietemann, Y. Dirheimer, J. C. Dosch, and J. Vignaud. AUGUSTE WACKENHEIM VII Contents Introduction ...1 Part One: Iconography 5 Part Two: Commentary with Corresponding Schemata. 107 References . . 189 Subject Index 191 IX Introduction The analysis or the reading of an X-ray picture proceeds from struc- turalistic rules, such as the immanence, the synchronism, the significa- tion (signifiant and signifie of a sign), first from the semeiologic and then from the semantic point of view. In a simpler way, one can say that it is necessary to distinguish the signifiant, the signiGBPie, the comment, the interpretation, and the radiobioclinical confrontation. The signifiant or character is a normal or pathological "characteris- tic" part of the image.

The observations made by Paracelsus concerning the dose-effect relationship of poison are generally just as applicable to health threatening vibration. With regard to kind, intensity, and duration of the vibration, the "dose" is decisive as to whether the conse quences are detrimental, unmeaningful, or tolerable with respect to health. This law of nature determines the tasks and goals of those whose aim is to safeguard health. Researchers worldwide have been occupying themselves with this many-faceted question for some time: how mechanical vibration affects the human organism and at what point damage occurs. If prevention in occupational medicine is to succeed, it is most important that the gaps in our present knowledge be closed, for if technical preventive measures are to be effective and preventive means in occupational medicine successful, they must be based on reliable and complete findings. Whenever many independent researchers have worked in a given field for a long period, a comprehensive intermediate as sessment is appropriate to evaluate the level achieved and the direction the research is going. In the area of hand-arm vibration, this evaluation has already been carried out, and the response aroused by this particular research report had led to a demand for a comparable evaluation of the research results on whole-body vibration. This report presents clearly and exhaustively the current status of international knowledge, as well as the questions that remain to be answered.

This atlas is a histological reference for surgical pathologists not familiar or comfortable with the diagnosis of non-tumorous diseases of bones and joints. One in three physician office visits are due to bone or joint complaints, yet only one in thirty thousand orthopaedic patients has a bone tumour. The diagnosis of orthopaedic diseases is a complex enterprise requiring cross specialty cooperation. While contributions from orthopaedic surgeons, radiologists, and rheumatologists have been included to provide more clinical relevance to this work, the emphasis is on surgical pathology of bone and joint diseases. The original and comprehensive photographs, illustrations, and tables in this reference enhance clinicopathologic correlation and diagnostic application in a way seldom provided by previous pathology resources.

The Racehorse: A Veterinary Manual has become the definitive text for primary care of the Thoroughbred racehorse. Written by one of the world’s leading racehorse veterinary clinicians, it sets out best practice standards of diagnosis and management of all the major conditions likely to be encountered in racehorse clinical practice, as well as comprehensively reviewing subjects as diverse as pre-purchase assessment and exercise physiology. This second edition has been thoroughly updated and introduces new chapters on a range of topics including injury risk assessment and electrolyte and fluid therapy, expanded sections on nutrition, rehabilitation and sales radiography as well as an array of new images and ready reference charts. The Racehorse: A Veterinary Manual remains an invaluable resource for both clinicians and non-veterinarians in the racing industry.

Dimethylsulfoxid (DMSO) istalsSubstanzkeine Unbekannte: seitJahrzehntenwird es als Lt!sungsmittel fUr bestimmte organische Verbindungen in der chemischen Industrie benutzt. Erst in den letzten Jahren ist DMSO als Arzneimittel (wieder) entdeckt worden. Nachdem erste Versuche bald nach dem 2. Weltkrieg mit unzureichend reinem DMSO aufgrund ihrer Nebenwirkungen eingestellt wurden, begann die systemati- scheUntersuchungvonDMSO spaternochmals- mitderhochgereinigtenSubstanz. Aufgrund der Vorgeschichte - in den USA war DMSO zeitweise unter dubiosen Umstanden in Verkehr gebracht worden - galt es, vieI MiBtrauen und Vorurteile abzubauen. Heute, nach zahlreichen toxikologischen Untersuchungen und jahrelangen Erfah- rungen am Menschen kann diese Substanz als ausreichendsicherbetrachtetwerden. In der Bundesrepublik Deutschland gehOrt das DMSO-haltige Dolobene Gel heute zu den fUhrenden Externa im Sport- und Rheumabereich. Diewissenschaftlicheund klinische Erforschung von DMSO und seinen Kombinationen zusammenzufassen und anzuregen, warZieldiesesWorkshops. Heutekonnenwirsagen, daB dieErwar- tungen weit ubertroffen wurden, daB bereits Neuentwicklungen auf der Basis von DMSO in der klinischen Prufung sind. BesondererDankgilt allen Tagungsteilnehmern, besonders aber den beiden Vorsit- zenden, Herrn Dr. Jacob und Herrn Herschler, Portland (USA) sowie Frau Bauer, Frau Eckleund Herrn Dr. Rubsamen von der Abt. Med.-Wiss. undHerrnWandals Organisationsleiter. Blaubeuren, im September 1985 Dr. med. Michael Herschel (LeiterBereich Medizin, Merckle GmbH) Preface Physicalpaincanbeaseriousburden,andreliefofincapacitatingpainmustbeviewed as a great blessing; any degree ofreliefcontributes to the overall quality oflife.

Aus dem wissenschaftlichen Interesse einzelner sportbegeisterter Arzte verschiedenster Fachrichtungen hat sich die Sportmedizin in den letz- ten Jahrzehnten zu einem Forschungsbereich entwickelt, dessen Eigen- standigkeit durch die Errichtung von sportmedizinischen Institutionen an den meisten Universitaten der Bundesrepublik Rechnung getragen wur- de. Die Inbetriebnahme des neuen Institutsgebaudes flir Sportmedizin an der Universitat Tlibingen war 1983 der AnlaB flir das 2. Symposion der Sektion "Sportmedizinische Forschung und Lehre an den Hochschulen" des Deutschen Sportarztebundes e.V., das sich die Aufgabe stellte, den heutigen Stellenwert des Fachgebiets zu erarbeiten. Anerkennung und Wertschatzung durch die offentlichkeit gingen aus den GruBadressen des Ministerprasidenten des Landes Baden-Wlirttemberg Lothar Spath, des Ministers flir Wissenschaft und Kunst Prof. Dr. Helmut Engler, des Ministers flir Kultus und Sport Gerhard Mayer-Vorfelder, des Oberblirgermeisters der Universitatsstadt Tlibingen Dr. Eugen Schmid und aus der Eroffnungsrede des Staatssekretars des Ministeriums flir Wissenschaft und Kunst Norbert Schneider hervor. Auf die zunehmende Bedeutung einer effektiven sportmedizinischen Forschung und Lehre zur Bewaltigung anstehender gesundheits- und auch gesellschaftspolitischer Probleme wiesen der Prasident der Eberhard-Karls-Universitat Tlibingen Dr. Adolf Theis und der Dekan der Medizinischen Fakultat (Klinische Medizin) Prof. Dr. Dr. Walter Frommhold in der BegrliBung hin. Der derzeitige Erkenntnisstand mit theoretischen, besonders aber prak- tischen Konsequenzen flir viele Gebiete der Medizin, der Sportwissen- schaft und des Sports wurde in tibersichtsreferaten und zahlreichen Einzelbeitragen des Symposions dokumentiert. Das breite Spektrum der Referate vom Hochleistungssport bis zum Behindertensport, von der Grundlagenforschung bis zur Therapie zeigte aber auch Problemfelder, Richtungen und Ansatze zuklinftiger wissenschaftlicher Arbeit auf.

Manipulation as a treatment modality dates at least to the time of Hippocrates, (Schiotz and Cyriax, 1975). It has continued to be used intermittantly thereaft- er. In the late nineteenth century manipulation became a fundamental part of a new school of medicine founded by Andrew Taylor Still, M. D. (Northup, 1966). Osteopathy was presented to the medical world in 1874, and the first for- mal education began in 1892 in Kirksville, Missouri. Another school of prac- tice, chiropractic, was founded in 1896 by D. D. Palmer in Davenport, Iowa (Janse, 1975). While both of these new professions utilized structural diagnosis and manipulative therapy, osteopathic medicine sought to incorporate these di- agnostic and therapeutic tools within the practice of medicine and surgery, while chiropractic limited its practice to spinal analysis and adjustment. Orthodox medicine has also had its advocates for the use of manipulation (Mennell, James, 1948; Mennell, John, 1964; Cyriax, 1978; Maigne, 1972; Bourdillon, 1973). In the mid 20th century formalized organizations of individ- uals interested in manipulation were formed throughout the world. The Inter- national Federation of Manual Medicine, a confederation of associations of manual medicine from 20 countries, holds an international congress every three years. The North American Academy of Manipulative Medicine was founded in the early 1960s and sponsors conferences and conventions through- out the United States and Canada.

Mehr als 40.000 Behandlungsfehler werden Medizinern jedes Jahr vorgeworfen - Tendenz steigend. Die Auswirkungen koennen gravierend sein. Umso wichtiger sind detaillierte Kenntnisse uber das richtige Vorgehen nach einem Vorfall. Das Werk zeigt anhand von Fallbeispielen aus der Praxis, wie AErzte sich im Schadensfall richtig verhalten. Erlautert werden u. a. der Umgang mit Angehoerigen, die aussergerichtliche Einigung, die zivil-und strafrechtliche Auseinandersetzung vor den Gerichten sowie die Rolle von Versicherungen, AErztekammern und Krankenhausern.

Functional morphology seeks to establish the relationship between form and function: the description of anatomic phenomena is used as a basis for defining functional factors which themselves, long term, affect the development of the form. This kind of basic study is essential for our understanding of quadruped and human motion and has been discussed by Pauwels (1948,1955, 1960) and Kummer (1956, 1959, 1962, 1978). Biomechanical analysis of human upper and lower limb joints has resulted in causal therapy in cases of joint disease (Pauwels 1935, 1961, 1976; Maquet 1976). Studies of the functional strain on the shoulder joint socket and the elbow joint have been carried out by Pauwels (1955, 1959, 1963) and Tillmann (1971, 1978). Joints of the human hand and wrist have been discussed from a phylogenetic, onto genetic, anatomic-descriptive, and clinical point of view (Thilenius 1895; Corner 1898; Zrubecky 1960; Lewis 1970; Blauth and Schneider-Sickert 1976; et al.), but so far no studies of these joints have been undertaken with a view to investigating the functional connection between morphology and specific strain. This study aims to establish the relationship between the form and the normal or disturbed functioning of three important joints of the human hand: the proximal wrist joint, the saddle joint of the thumb, and the metacarpophalangeal joints, and to evaluate the findings biomechanically and clinically."

This book is intended for beginners and for those who want to refresh their knowledge of the elementary radioanatomy of the vertebrae, particularly their pathological radioanatomy. I do not pretend, as does Roger Martin du Gard's hero, that one always must begin with a radiographic examination, but I do believe that a student, especially one interested in radiology, must be able to apprehend an image isolated from its clinical context. To optimize memorization of the image I have selected unmistakable cases with marked, well-evolved lesions. This will enable the studentlater to recognize less distinct images of the same kind. The first section of the book is exclusively iconographic. After studying an image, the reader will find in the second section, under the appropriate reference number, a commen tary illustrated with a realistic drawing by my friend Dr. Csaba Hethalmi. Attention to the following points will assist a fruitful reading: 1. Cases 1-5 involve normal subjects; all other cases are pathological. 2. The reader must imagine that he is conducting a routine examination and draw on his resources to make a practical analysis of an image. As a matter of fact, all the films (except that in case 46, which is the radiograph of a specimen) were -indeed taken under routine conditions using standard pro jections. 3. The cases are in no systematic or nosological order. Each case is illustrated with one, two, or (rarely) three images.

Rheumatoid arthritis is a common disease, an estimated 1. 5% of the population being under medical treatment for it in European countries and elsewhere. However, to date the origin of this chronic inflammatory disorder has not been elucidated. Evidence for the involvement of microbial agents is still tenuous, the rea- son for the defective control of inflammation is still unknown, and the disease all too of- ten progresses to crippling stages despite long-term treatment. As T. McKeown recently stated with regard to rheumatoid arthritis, "not enough is even known to indicate which is the more promising approach, and the pru- dent course is to investigate both origins and mechanisms". While working on animal model diseases as well as on aspects of rheumatoid arthritis and related disorders in man, the members of the Special Research Area on patho- physiology of rheumatoid inflammation in man and. animals (Sonderforschungsbereich 54 "Pa- thomechanismen der rheumatoiden Entztindung bei Mensch und Tier"; maintained by the Deut- sche Forschungsgemeinschaft) at the Veterinary and Medical Schools, Hannover, have been guided by the concept that by studying clinically and morphologically similar diseases in several species, mutually stimulating results might lead to improved knowledge of the pathophysio- logy of rheumatoid arthritis. In particular, from working with model diseases in animals new approaches to the etiology of rheumatoid arthritis might be derived, while detailed knowledge of pathogenetic processes in rheu- matoid arthritis could further research in chronic stages of pertinent animal diseases.

Operation on fractures of shafts and joints is chiefly indicated in the upper arm, forearm, femur and tibia. Injuries in these areas can almost always be successfully treated by the techniques described in the "AS IF Manual of Internal Fixation," followed by early exercises. The fixation of small fragments which are of such biomechanical importance, has hitherto given indifferent results, especially when the distal parts of the hand and foot are involved. The implants and instruments developed by Dr. Heim and tried out by AS IF members during recent years have now been assembled into a "small fragment set," which is now available. These implants have significantly expanded the scope of AS IF instrumentation for internal fixation. Pannike first compared the application of the small fragment set with the conventional methods used in hand surgery. Heim and Pfeiffer in cooperation with Meuli, illustrate in this Volume the small fragment set, elucidating in a didactic manner the composition of the set, the indications for its use, and its method of application to all suitable fractures. Enough good results have been secured to establish the usefulness of this development. The following volume may therefore be regarded as an important supplement to the ASIF Manual. It makes it clear again that every internal fixation requires a high level of technical skill, a sense of responsibility, and very gentle handling of the soft tissues.

Der kA1/4nstliche HA1/4ftgelenkersatz zAhlt zu den erfolgreichsten Behandlungen im orthopAdisch-unfallchirurgischen Fachgebiet. Nach 10-15 Jahren Prothesenstandzeit kommt es jedoch in 3-8% zu VersagensfAllen, die eine Wechseloperation notwendig machen. Da weltweit hunderttausende HA1/4ftprothesen in den letzten 30 Jahren implantiert wurden und die Lebenserwartung der BevAlkerung stetig wAchst, ist ein erhAhter Bedarf an Wechselendoprothetik, insbesondere der Pfanne, zu verzeichnen. Die Revisionsoperationen benAtigen viel handwerkliche und wissenschaftliche Erfahrung, eine gute Logistik, ein hohes MaA an Prozesskoordination und nicht zuletzt einen hohen finanziellen Aufwand, um ein optimales Ergebnis fA1/4r den Patienten zu erreichen.

Dieses Buch gibt eine Antwort auf die Herausforderung a žPfannenrevision." Dabei wurde darauf geachtet, nicht erneut einen Kongressband mit punktuellen Ergebnissen darzustellen. Stattdessen ist es den Herausgebern gelungen, einen umfassenden Aoeberblick aus der Praxis der Pfannenrevisionen vorzulegen: Wissen zu bA1/4ndeln, echte Behandlungsalternativen zu prAsentieren und dem Operateur das RA1/4stzeug fA1/4r den zielsicheren und bestmAglichen Operationsablauf mitzugeben.