Every bone fracture must be held rigid and, because of the long healing process, infringes on the individual's life-style. Treatment with ultrasound, however, may reduce the healing time 30-50% since the piezoelectric effect of ultrasound acts as a callus stimulator. This book documents more than twenty years of clinical experience with ultrasound treatment of fractures. The authors give statistical evidence and show numerous X-rays to document their success. They also include a summary of experimental studies. The method is described in detail so that the practicing physician can easily learn how to apply it.

Strongly recommended for the surgical trainee this, the second of a number of atlas-texts describing the anatomical basis of a range of common surgicalprocedures, is a useful aide-memoir to operative surgery

Rheumatoid arthritis demands intensive interdisciplinary cooperation between the orthopaedic surgeon and internist, and this monograph provides all the information necessary for the specialist dealing with inflammatory changes of the hip joint in rheumatoid arthritis. The reaction of the joint to rheumatoid arthritis is generally uniform, but the diagnoses may vary. For this reason, particular attention is paid to the differential diagnosis of the chronic inflammatory changes at the hip joint. The course of the disease is outlined, so that varying treatment approaches can be understood. The book describes the medical and the physical treatment of the hip joint, including discussion of the mechanisms of action and side effects that may occur. The options for conservative orthopedic treatment and for operative intervention are carefully considered. The broad spectrum of treatment principles, courses of action and results that are discussed will aid every physician interested in the rheumatoid hip.

Langzeitergebnisse sind die Basis jeder medizinischen Behandlung und Weiterentwicklung von Therapiemodalitaten. Dies gilt in der Kinderorthopadie in besonderem Masse. Es ist die vordringliche Aufgabe des Behandlers, Wachstums- und Reifungsprozesse zu beurteilen und wenn notwendig zum richtigen Zeitpunkt lenkend und korrigierend einzugreifen. Ein solcher Eingriff kann eine wichtige Weichenstellung zu einer normalen Entwicklung oder aber im ungunstigen Fall bleibender lebenslanger Behinderung sein. Wir leben in einer Zeit stetiger Veranderungen mit taglichen Neuerungen und Fortschritten in der Medizin. Bei aller Euphorie ist jedoch festzuhalten, dass viele neue Methoden ihre Evaluierung durch den Faktor Zeit noch nicht bestanden haben. Die dargestellten Spatergebnisse belegen u. a. den Vorteil, dass durch den Zeitfaktor die subjektive Sicht des initialen Behandlers meist ausgeschaltet war. Langzeitergebnisse sind daher fur die heute so haufig geforderte Evidenz-basierte Medizin von Bedeutung."

Demands on a Neurosurgeon Under Routine Clinical Conditions' "Hardly any other field of surgery requires such meticulous asepsis. No other field requires such a protection of the tissue and such reliable hemostasis. No one will question that neurosurgery makes exceedingly high demands. However, the degree of the demands on the personal ity of the surgeon who has to carry out very serious operations to the exclusion of all others and has little opportuinity to recover psycholog ically by working on simpler cases is concealed from the outer world. The mental strain which the coworkers and staff have to tolerate may not be denied." So wrote Wilhelm Tonnis in 1939. Although fifty years have now elapsed, his appraisal is still relevant today - hence my intention to discuss the everyday demands placed on neurosurgeons. My aim is not self-glorification to engender sympathy; rather it is to highlight the effects and repercussions of such demands for the well-being of the patients entrusted to us. The major onerous demands include: - those in the operating theater - those resulting from staff problems in nursing - those resulting from legal developments - those resulting from the increasing administrative tasks that cost valuable time and energy which are lost to our actual work in look ing after patients: science and research also suffer from this. I shall not go into the latter point within this preface. Let me first turn to the strains occurring in the operating theater."

Translation of: Tumori delle ossa e delle parti molli.

Why and Wherefore? Welcome to our little introductory book It appears in response to be ginning students (i.e., especially general radiology residents) who have sought guidance with the methodology of evaluating positional rela tionships of the feet from radiographs. Since my stepwise "how to" technique has been well received both in the Show-Me state (at the University of Missouri.Columbia) and here in Ohio, it is offered to you as well. To simulate my conventional teaching method, the informal text has an interactive flavor, which I hope makes it useful for you. Please don't be offended by a touch of simplified walking.through of material here and there. After all, this is a "primer," not a dignified postgraduate treatise. Comments from readers would of course be appreciated by the author. The majority of illustrations are the result of the collaboration with my dear colleague Tamar, in which she artistically interpreted repre sentative radiographs for you to my specifications. The guidelines I gave her included line drawing outlines of the most pertinent bones, to which straight lines were added as appropriate. As a result certain bones, for example the fibula and many phalanges, are omitted if they are unlikely to enhance the impact of the illustrations. Often, too, the cuneiforms and cuboid remain undifferentiated as one bony element, or only a few of them are drawn, so that attention remains with the key bones involved."

In this issue of Hand Clinics, guest editors Drs. Phillip Ross and Sarah E. Sasor bring their considerable expertise to the topic of the Thumb CMC Joint. Top experts in the field discuss different strategies for the management of problems with the thumb carpometacarpal (CMC) joint, as well as treatment options. Contains 14 relevant, practice-oriented topics including joint-preserving treatments for thumb CMC osteoarthritis; thumb CMC implant arthroplasty; revision CMC arthroplasty; diagnosis and treatment of CMC instability; and more. Provides in-depth clinical reviews on the thumb CMC joint, offering actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.

In medical writing brevity is the kiss of life. Nevertheless most articles are unnecessarily lengthy and publications continue to multiply. Pity the poor reader! A succession of unduly long articles is bad enough, but if each is followed by a plethora of references the effect is positively daunting. Even the reader who is impressed by the length of a list may question the author's discrimination. Were all those references needed? Were they helpful? Has the authorreally read every one? All too often we look in vain for evidence of selectivity. Here lies the strength of this book. The authors have combed the literature and culled it ruthlessly, selecting just a few hand-picked references on every important aspect of orthopaedic trauma. They have ranged widely but chosen narrowly, and with a sense of balance. And having selected, they have also distilled, adding a brief and thoughtful commentary on each group of entries. The four authors, of varying vintages, met at frequent intervals to discuss each section in tum and to debate the value of every inclusion. I can almost hear the cut and thrust as well-informed views were exchanged, and also the sighs of relief as differences were resolved. The authors compare their meetings with those of the Editorial Board of the IBIS; since these are a delightful mixture of conflict, entertainment and enlightenment, what a marvellous time they must have had.

In this significantly expanded "Alumni" edition, graduates of the Orthopaedic Trauma program at the University of Washington's renowned Harborview Medical Center provide succinct and novel tips and tricks gleaned from their years of professional practice. Focusing specifically on the technical aspects of fracture treatment, Harborview Illustrated Tips and Tricks in Fracture Surgery, Second Edition takes a unique issue/solution approach, offering up-to-date guidance you can apply quickly to a care situation with the full trauma team. New chapters touch on fractures of the femur, hardware removal, and navicular and cuboid fractures. Expanded with significantly more tips than the previous edition-all contributed by graduates of Harborview's Orthopaedic Trauma Fellow program. Features to-the-point instructions on the latest techniques to treat fractures of the neck, arm, wrist, ankle, foot, knee, and leg in a fast-paced trauma setting. Chock full of tables and annotated illustrations for a visual context to techniques and the underlying anatomy. Concise bulleted format and standardized organizational structure help you grasp critical material quickly. Topics cover required instruments, optimal patient positioning, imaging, hardware and implants, fixing and setting, and fracture reduction. Perfect for orthopaedic surgeons, trauma surgeons, and orthopaedic surgery residents learning to treat patients in a trauma setting. Enhance Your eBook Reading Experience Read directly on your preferred device(s), such as computer, tablet, or smartphone. Easily convert to audiobook, powering your content with natural language text-to-speech.

Das Buch enthalt Beitrage uber die funktionelle Anpassung des Knochens an seine mechanischen Beanspruchungen, neuere Resultate der Forschung uber genetische Erkrankungen des Skeletts, die Fortschritte in der Diagnostik und Therapie primarer Knochentumoren und Neues aus der Prothesenforschung. Die vorgelegten Ergebnisse aus den vielschichtigen Bereichen der Osteologie zeigen, dass sich ein so weites Feld der wissenschaftlichen und klinischen Medizin nicht einem einzigen Fachgebiet zuordnen lasst, sondern nur interdisziplinare Teamarbeit die besten Forschungsresultate zu bringen vermag.

Abundant evidence indicates that TENS can be used effectively to alleviate certain pain syndromes. For patients suffering from chronic musculo-skeletal pain in particular, TENS offers an alternative means of pain management. This book addresses the need among physiotherapists for a practical manual on the application of this relatively new technique. Numerous illustrations provide guidelines for the choice of stimulation parameters, the selection of electrode positions, as well as other aspects related to technique. A brief introduction to the neurophysiological mechanisms of pain and the pain-relieving effects of TENS is also given. These special features make this comprehensive presentation of particular interest to physiotherapists and clinicians actively engaged in the management of patients suffering from pain.

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.

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.

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.

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"

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 . . ."

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.

Falls, fractures, frailty, osteoporosis and sarcopenia are highly prevalent in older persons. While the concept of osteosarcopenia is new, it is a rapidly evolving and cross-disciplinary problem. Prevention and treatment are challenging and a combined therapeutic approach is needed. Osteosarcopenia provides evidence-based information on how to prevent and treat these conditions at multiple settings, including multiple illustrations, care pathways and tips to easily understand the pathophysiology, diagnostic methods and therapeutic approach to these conditions. This work evaluates the potential for a link between osteoporosis, sarcopenia and obesity.

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.

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.

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.