Orthopedic Trauma Call for the Attending Surgeon is a clinically focused book that will help guide the orthopedic surgeon through the most commonly encountered injuries when on call. Drs. David J. Hak, Kyros R. Ipaktchi and Steven Morgan are joined by over 50 leading experts to provide a succinct and quick review of the key points that will allow you to provide patients with expert and immediate care. Inside Orthopedic Trauma Call for the Attending Surgeon each chapter is written in an easy to read bulleted format that will allow for a quick review of the key facts you need to know while taking call. Chapters also cover emergent and definitive management and provide guidelines for when to consider referral to a higher level of care. The authors also share their tips and tricks for successful outcomes, while highlighting potential pitfalls and how to avoid them. Since it can be difficult to find time to read a traditional textbook or review article, Orthopedic Trauma Call for the Attending Surgeon is perfect for orthopedic surgeons, physician assistants, extenders who cover ER call, and orthopedic trainees.

In recent years concern has been growing ab out the preservation ofworld peace, while over the past few decades there has been a vast increase in the amount of international sporting activity and hence more opportunities to advance international understanding and peace. It is this situation which caused the Congress on Sport and International Understanding to be convened, the idea for it ftrst having arisen after the Helsinki Conference on Security and Co-operation in Europe in 1975. The venue for the Congress was, as for the Conference on Security and Co-operation, Finlandia Hall. It was held under the auspices ofthe International Council ofSport and Physica1 Educa tion (ICSPE) and was organised by the Finnish member organisations, the Finnish Society for Research in Sport and Physica1 Education (organising association), Finnish Central Sport Federation (SVUL) and the Workers' Sport Federation (TUL). The aim ofthe Congress was to analyse the role of sport in advancing international understanding and to promote research in this fteld. In addition, the Congress wished to offer researchers and those involved in sporting activities an opportunity to exchange ideas about the themes under discussion. The aim of the Congress was to fmd the answers to the following questions: 1. What forms does international co-operation take in present-day competitive and top-level sport, sports for all and other forms of physica1 culture? What is its histo rica1 background and future? 2."

"Function dictates structure" is a classic paradigm reaffirmed in Wolff's law of the skeletal system. A major question being addressed by current research in biomechanics is whether this doctrine also holds true for the cardiovascular system and connective tissues. Taking a multidisciplinary approach to this question has produced new insights into the sensors, signals, and activators that produce remodeling and functional adaptation in cardiac muscle, blood vessels, and bone, including important new findings on the response of vascular endothelial cells to shear stress. Other work focuses on the extent of remodeling and adaptation processes in tendons, ligaments, and intervertebral discs. Together with two companion volumes, "Computational Biomechanics" and the "Data Book on Mechanical Properties of Living Cells, Tissues, " "and Organs," this monograph will prove invaluable to those working in fields ranging from medical science and clinical medicine to biomedical engineering and applied mechanics.

Different views about the biomechanics of the knee joint and late re construction of ligamentous injuries underline the obstacles impeding the establishment of generally acceptable principles for the treat ment of such lesions. As late as June 1976, HUGHSTON emphasized in the Journal of Bone and Joint Surgery that in spite of excellent anatomic studies, substantial uncertainty still prevails in knee joint surgery. Even the signifi cance of the anterior drawer sign for ruptures of the anterior cru ciate ligament is interpreted quite diversely, as illustrated in a comparison of HUGHSTON, GIRGIS, TORG, and SCHIECK, who give varying opinions concerning the indication related to the age of the patient or possible earlier joint damage as well as concerning the prognosis for untreated knee joints. The question still remains as to how often an intra-articular ligamentous replacement should be carried out in addition to extra-articular techniques (0 'DONOGHUE, SLOCUM, NICHOLAS, HUGHSTON). Lastly the question of synthetic ligament replacement must be clarified. After basic research has well advanced, clinical ex perience must be discussed. Statements concerning the therapeutic value of diverse procedures based solely on knowledge of the literature remain problematic. For this reason a workshop was held at the University of Heidelberg in the Orthopedic Clinic (Head: Prof. Dr. H. COTTA) in June 1977, with the aim of bringing together representatives of the different leading schools in a round table discussion to comment on still unsolved ques tions."

Given the strong current attention of orthopaedic, biomechanical, and biomedical engineering research on translational capabilities for the diagnosis, prevention, and treatment of clinical disease states, the need for reviews of the state-of-art and current needs in orthopaedics is very timely. Orthopaedic Biomechanics provides an in-depth review of the current knowledge of orthopaedic biomechanics across all tissues in the musculoskeletal system, at all size scales, and with direct relevance to engineering and clinical applications.

Discussing the relationship between mechanical loading, function, and biological performance, it first reviews basic structure-function relationships for most major orthopedic tissue types followed by the most-relevant structures of the body. It then addresses multiscale modeling and biologic considerations. It concludes with a look at applications of biomechanics, focusing on recent advances in theory, technology and applied engineering approaches.

With contributions from leaders in the field, the book presents state-of-the-art findings, techniques, and perspectives. Much of orthopaedic, biomechanical, and biomedical engineering research is directed at the translational capabilities for the "real world." Addressing this from the perspective of diagnostics, prevention, and treatment in orthopaedic biomechanics, the book supplies novel perspectives for the interdisciplinary approaches required to translate orthopaedic biomechanics to today s real world.

This book brings together the congenital, acquired and traumatic conditions which may affect the child's cervical and thoraco-lumbar spine. The immature spine poses considerable diagnostic dilemmas and radiographs are often difficult to interpret. The aetiology of deformity, its assessment, monitoring and treatment are comprehensively described. Back pain in children receives special attention. Care has been taken to identify symptoms and signs which should raise our level of anxiety and those which are likely to resolve. Where surgery is necessary the principles and risks are defined.

In this updated edition of the German-language title "Neue Techniken - Kniechirugie", Professor Paessler, an experienced knee surgeon, provides a state-of-the-art survey of the field. In doing so he describes, among other techniques, how to reconstruct the anterior cruciate ligament (ACL), perform ACL revision surgery, manage a recent posterior cruciate ligament tear, treat cartilage lesions with microfracturing, reattach/replace detached cartilage fragment, perform a dome high tibial osteotomy. Professor Paessler is author of more than 150 publications (books and journals) and editor-in-chief of the "European Journal of Sports Traumatology and Related Research". An important resource for all trauma and orthopaedic surgeons and trainees.

This book presents an analysis of the stress distribution and contact stresses in severe rheumatoid wrist after total wrist arthroplasty. It assesses and compares the load transfer throughout the joint and contact pressure at the articulations. The data obtained from this study is of importance as this provide greater evidence to the benefits of total wrist arthroplasty in rheumatoid arthritis patients.

Children's upper and lower limb orthopaedic disorders has been written to give orthopaedic practitioners an easily accessible and concise description of regional disease and conditions encountered in the practice of pediatric orthopaedic surgery. The upper limb chapters describe fetal development and how this may go wrong. As always, function dominates our management plans although cosmetic considerations must be borne in mind. Perinatal brachial plexus injury is analyzed and a plea made for early recognition and reconstruction of both plexus lesions and peripheral nerve injuries. The lower limb chapters consider limb deficiency and deformity and how best we should manage them. Those prominent afflictions of the child's hip - dysplasia, Perthes' disease and epiphyseal slipping - are fully discussed. Chapters on the common conditions affecting the knee, foot and ankle complete the book.

Recent radiologic procedures in bone and joints, some of which eliminate the need for surgery are exposed, including: trephine biopsies of the thoracic and lumbar spine, sacro-iliac joints, peripheral bones synovial membrane and soft tissues, using either fluoroscopic echographic or CT guidance - chemonucleolysis - vascular embolization of skeletal tumors and management of vertebral hemangiomas - selective steroid injection in a broad spectrum of diseases including vertebral facet syndrom, cervicobrachial nerve root pain, rotator cuff calcium deposits, bone cysts. This unique volume supplies the reader with complete information regarding the performance of all these techniques.

Foot and ankle surgery has grown rapidly within the last 20 years, due to international collaboration between podiatric, orthopaedic, and trauma surgeons from around the globe. This book aims to provide trainees with a general overview of topics encountered in foot and ankle surgery, by presenting the general surgery section published originally within International Advances in Foot and Ankle Surgery. While this book does not exclude scientific background, it emphasizes a practical, hands-on approach. To meet the demand of all foot and ankle surgeons, the book encompasses forefoot and rearfoot deformities as well as reconstructive surgery of the diabetic foot. This book will appeal to trainees who have yet to specialise, but need access to an easy reference companion within general foot and ankle surgery.

Sharmila Majumdar In the area of osteoporosis and skeletal changes, it is currently accepted that bone mineral density (BMD), widely used for screening, monitoring and assessing therapeutic efficacy, does not adequately explain the pathogenesis of osteoporosis, the process of aging, or the therapeutic efficacy of various treatments. In this context, trabecular micro- architecture has enormous potential to contribute to understanding the pathophysiology of osteopor.osis and therapy assessment. The use and value of noninvasive imaging and quantitative image analysis and processing of trabecular bone micro-architecture have increased dramatically due to recent advances in instrumentation and software. This emerging field is diverse, interdisciplinary, and encompasses many different imaging modalities. Interested researchers include those involved in technique development, basic science and animal studies, as well as clinical researchers and practicing physicians. With the growth of this area of research, a group of investigators at the 11th Interna- tional Workshop of Bone Densitometry, 1 concluded that a forum dedicated to this matter was urgently needed. With this agenda, Dr. Peter Ruegsegger organized the first sympo- 2 sium on conjunction with the 10th Conference of the European Society of Biomechanics. The symposium on Bone Architecture and Competence was a two-hourlong event which resulted in five chapters in Bone Research and Biomechanics, edited by G. Lowet, P. Ruegsegger, H. Weinans, and A. Meunier, published by lOS Press, 1997. The second symposium was held as a pre-symposium to the 12th Workshop on Bone Denistometry,3 and flourished as a daylong event.

Avascular Necrosis (AVN) is a disease resulting from temporary or permanent loss of blood supply. It frequently affects the femoral head and in this area, if left untreated, routinely causes premature joint destruction.

In the USA, 5 to 10% of cases of hip osteoarthritis requiring total hip replacement are primarily caused by AVN. In 33 to 72% of patients, the disease is bilateral. The peak incidence is between 30 and 60 years of age, and the social costs of this pathology are remarkable. There is therefore increasing interest in hip joint preserving techniques such as conservative treatment through electromagnetic fields and shockwaves as well as joint preserving surgical techniques. This volume aims to present a complete overview of the current knowledge on AVN including therapeutic options.

In many cases of neuromuscular disorders the physician is faced with a complete lack of therapeutic approaches. This helplessness places the doctor in a position of conflict between his desire to help and his awareness that there is no treatment. In this situation it is tempting to indiscriminately use any procedure that avoids an admission of medical helplessness while satisfying the patient's demand for treatment. Electrical interventions are often used to avoid this situation. Due to the random use of therapeutic approaches it is not known what really happens. Presumptions and biased empirical observations have led to the exten sive use of different forms of electrical stimulation regimes in neuromuscular diseases. Due to this unsatisfactory situation it is necessary to know more about appropriate methods that are being used in particular disorders. The search for a better understanding of nerve-muscle interaction has shown that certain activity patterns can influence muscle. These experi mental results provide a rational basis for a possible therapeutic use of electrical stimulation of nerve and muscle. Previously most research has been conducted in normal tissue, and little is known regarding the re sponses of diseased muscle. In an interdisciplinary approach to this, it is our intention to present the current knowledge about basic principles of electrical stimulation in normal muscle. Before electrical stimulation can be accepted as a therapeutic tool, we felt it necessary to summarize the effects of activity in normal and diseased muscle and nerve."

The first part of this manual deals with the experimental and scientific basis and the principles of the AOjASIF method of stable internal fixation. It deals with the function and main use of the different AO implants, the use of the different AO instruments, and with the essentials of the operative technique and of postoperative care. It also discusses the handling of the most important postoperative complications. The second part deals at length with the AO recommendations for the operative treatment of the most common closed fractures in the adult. This has been organized in anatomical sequence. The discussion of the closed fractures is followed by a discus sion of open fractures in the adult, then by fractures in children and finally by pathological fractures. The third part presents, in a condensed fashion, the application of stable internal fixation to reconstructive bone surgery. 1 GENERAL CONSIDERATIONS 1 Aims and Fundamental Principles of the AO Method The Chief Aim of Fracture Treatment is the Full Recovery of the Injured Limb In every fracture there is a combination of damage to both the soft tissues and to bone. Immediately after the fracture and during the phase of repair, we see certain local circulatory disturbances, certain manifestations of local inflammation, as well as pain and reflex splinting. These three factors, that is, circulatory disturbances, inflammation and pain, when combined with the defunctioning of bone, joints and muscle, result in the so-called jl'acture disease.

It is a great pleasure to introduce this book and its writer to the reader. Dr. Thijn has been interested in double contrast studies since he wrote his thesis on the double contrast examina tion of the colon. It would sound facetious to state that after he exhausted this field, he was in need of some other area where the same technique could be used. However, in the same exact and thorough way as in his colon studies, he has examined the knee joint. Considering that the knee is one of the most heavily taxed joints in man, with a multitude of afflictions, many of them closely connected with the age of the individual, radiological investiga tion has shown very few innovations over the decades. The true anteroposterior and lateral projections were ~ and still are ~ the mainstay of the investigation. Projections of the intercondylar fossa, and true patellar projections were used incidentally. Just prior to World War II the advent of arthrography as a double contrast investigation, as promoted by Oberholzer, was a real breakthrough.

In this book we discuss how children grow, how to measure this and how to decide whether development falls within normal parameters. It is important not to over-investigate, but, if necessary, which tests and imaging should we choose? We consider how best to look after our patients in hospital, out-patients departments and at home. This leads us to consider problems with the norm, including the more generalised bone and cartilage disorders, most now genetically determined. The section concludes with chapters on infection, arthritis and that most emotive of topics, the tumours of childhood.

Progress in traumatology of the vertebral spine has been restrained for a long time by two hindering factors. The first obstacle is presented by the differences in approach and a conflict of competences. The neurosurgeons, considering only the spinal chord, have confined themselves to indications for laminectomy, an insufficient and usually ineffective intervention. The orthopedic surgeons, on the other hand, obsessed by the fear of medullary lesions, have long hesitated to apply the fundamental rules for the treatment of fractures, namely precise reduction followed by strict immobilization, thus depriving themselves of the efficacy of radiculomedul lar decompression and of the protection this procedure affords to these structures when they are themselves involved in the trauma. Taking these facts into account, together with the rather poor results of laminectomy, the specialists have wisely and successfully recommended that one should abstain from treating the initial lesion, but rather attenuate the damage by appropiate nursing care and adequate reeducation. The second hindering factor was the insufficient knowledge of the extreme complexity of the anatomic lesions. This explains the orthopedists' relative caution; one only treats well what one knows well. More precise analysis of the lesions, not only of the bones but also of the joints, i. e., the osteofibrous involvement, is mainly based on strict radiologic semiology, which is rendered difficult because these structures are simultaneously affected. We are greatly indebted to Dr. DOSCH, radiologist at our Center, for having untertaken this difficult task, using all available conventional radiologic techniques."

The second common meeting of the European Section and the Cervical Spine Research Society took place in Marseille (France) from June 12 to 15, 1988 and was organized by Rene Louis. More than 130 specialists from every part of Europe, from America and Asia participated, representing, among others, the fields of Orthopedics, Neurosurgery, Traumatology, Neurology, Anatomy, Rheumatology and Radiology. This meeting again was convincing proof of the growing interest which exists in Europe in research into injuries and diseases of the cervical spine. The main topics of this meeting were the subluxation of the lower cervical spine (chapter 1) and the infectious diseases of the cervical spine (chapter 2). Chapters 3 and 4 of this volume deal with degenerative lesions and the upper cervical spine. In chapter 5 experimental reports are presented, so that a good synopsis is provided of our present state of knowledge of diseases of the cervical spine. The European Section of the Cervical Spine Research Society was founded by Mario Boni in 1984, who unfortunately died in 1986 and was proclaimed Honory President of the European Section. There is a European meeting every summer and one every three years with our colleagues from the United States of America, Canada and Japan organized in Europe. The first combined meeting was organized by Pierre Kehr in Strasbourg (France) in 1985 and the presented papers were published in Cervical Spine I (Springer, Wien-New York, 1987).

Surgeons differ in their enthusiasm for autografts, allografts and metallic implants, nevertheless, all have their place in orthopedic surgery. For some defects in the skeleton, bone grafting may be the only solution. The pros and cons of bone grafting are thoroughly discussed by eighteen distinguished authorities in this book. Their exchange of views and experiences reflects the diversity of thinking worldwide and points to exciting possibilities for future improvements. The twenty-eight chapters describe: the natural history and immunology of auto and allografting; innovative surgical techniques together with results, whether successful or not; and bone banking and its related problems, especially HIV.

A rapid reference guide to the approach and management of orthopaedic emergencies, this book provides quick differential diagnosis and treatment guidance for the emergency physician and orthopaedic resident and trainee. Chapters detail the initial management of musculoskeletal injuries, including reduction, splinting, and casting techniques for specific fractures and soft tissue injuries. A stepwise, how-to approach ensures easy learning, and an abundance of images provide clarity in instruction. This book also helps the reader identify those patients who can be appropriately treated as outpatients and patients who require urgent and emergent orthopaedic consultation.

After 20 years of intense and gradual improvements in the practice of craniofacial surgery, the International Society was born in Montreal (June 1983) and I. Munro was selected as general secretary. Its first meeting was held in La Napoule (Sep tember 1985) under the chairmanship of D. Marchac. In the meantime, the Euro pean group of the Society had held a session in Stockholm (June 1985) with B. Jo hanson acting as chairman. This now belongs to the history of our specialty, as does the course organized by E. Caronni in Rome (March 1982). These four landmarks in such a short time show the lively interest in craniofacial malformations and all their correction involves: - Syndrome delineation - Evaluation of the components of the malformations - Anatomy of the malformations - Imaging and measurement - Strategies and tactics in very different syndromes - Follow-up with reference to growth patterns in patients subjected to surgery or merely kept under observation - Implications of orbitocranial procedures for routine maxillofacial surgery - The interdisciplinary approach involving pediatricians, anesthesiologists, n- rosurgeons, ophthalmologists, orthodontists and speech specialists - The theories in vogue and those revised for some of the abnormalities All this could not be resolved in a 2-day meeting and probably will not be solved in the next generation."

In recent years wrist problems have increasingly attracted the attention of orthopaedic and hand surgeons. Numerous advances have been achieved in functional anatomy, biomechanics, diagnosis, and treatment. There are, however, many controversial aspects to these problems. Many clinical and associated investigators from around the world have attempted to increase our knowledge of the wrist with enthusiastic and devoted studies. An international symposium was held at the Nagoya Castle Hotel, Nagoya, Japan from March 6th through March 8th, 1991 to further understanding and promote discussion of wrist problems among a representive international group. Approximately 300 participants from 16 different countries assembled for these discussions. This monograph consists of 40 selected papers based on presentations given at the international symposium. The topics are divided into six chapters: Functional Anatomy, Diagnosis and Basic Studies; Kienbock's Disease; Scaphoid Fracture, Distal Radius Fracture; Carpal Instability and Wrist Pain; and Wrist Arthroplasty. A number of unique observations as well as detailed surgical techniques were presented. These include topics such as the vascularity of the triangular fibrocartilage, radial wedge osteotomy and vascular bundle implantation into the lunate for Kienbock's disease, Herbert screw insertion though a minimal exposure for acute scaphoid fracture, and closing wedge oseotomy of the radial styloid for the early stage of the SLAC wrist. It is hoped that this monograph will be of benefit to surgeons interested in not only achieving more satisfactory clinical outcomes, but also in stimulating further contemplation and research about these difficult wrist problems.

Fundamentals of Revision Hip Arthroplasty: Diagnosis, Evaluation, and Treatment is a unique and very timely book designed for surgeons who are beginning to more commonly encounter hip revisions in their practice. Unlike many traditional books on revision, Fundamentals of Revision Hip Arthroplasty does not focus on the most difficult and challenging of cases. Rather, Fundamentals of Revision Hip Arthroplasty is intended to guide the surgeon in the evaluation of the failed or painful total joint replacement, review basic tenants and surgical principles of revision arthroplasty, and guide the surgeon in determining whether a given case is one that should be managed or is best referred to a tertiary orthopedic center. Along with their 32 contributors, Dr. David J. Jacofsky and Dr. Anthony K. Hedley provide detailed information inside Fundamentals of Revision Hip Arthroplasty, including appropriate preoperative evaluation, equipment requirements, surgical planning, need for augments and allograft, and surgical techniques. Surgeons will be tackling hip revision surgery more frequently as the number of these cases is exponentially increasing. Fundamentals of Revision Hip Arthroplasty provides a "go-to" resource to turn to for guidance by community arthroplasty surgeons, arthroplasty fellows, and residents.

The Clubfoot: The Present and a View of the Future is a monumental source book of far greater magnitude and scope than has previously been written on this subject. It disseminates recent advances in basic and clinical research on the clubfoot. The introduction places the progress of the last 20 years in perspective. Papers present and evaluate the latest surgical techniques and the management of newly understood complications. The editorial comment section at the end of each chapter offers comparative analysis of the topics discussed in that chapter. This volume is a superb tool for pediatric orthopedists and orthopedists specializing in foot and ankle surgery who want to advance their knowledge of research, clinical management, and operative techniques in patients with clubfeet.