The idea for this treatise on the radiological anatomy of superficial and deep spinal cord vasculature evolved from daily routine neuroradiological work. This was also the reason for subdividing the monograph into a postmortem anatomical and a clinical part. The actual importance of a clear conception of radio anatomic fundamentals was made clear by many clinical conferences with neurologists, neurosurgeons and orthopedists, where a lack of knowledge about medullary syndromes of suspected vascular origin became evident. Also among neuroradiologists there is still widespread uncertainty in the interpretation of myelograms and angiographies in such cases. A study of the spinal cord's angioarchitecture is all the more justified and necessary considering the vast number of descriptions of cerebro vascular anatomy and pathology. The clinical challenge posed by patients suffering from partial or complete transverse spinal lesions has grown due to new diagnostic and therapeutic approaches. Myelography using water-soluble contrast media, X-ray computed tomography, magnetic resonance imaging and spinal angiography today allow and require both earlier and topographically and pathogenetically more exact classification of diseases of the spinal cord and its surrounding structures. Due to progress in microneurosurgery and interventional neuroradiology, even intramedullary lesions have become more and more accessible and treatable. Therefore this monograph mainly addresses those concerned with invasive therapeutic techniques and who are familiar with the interpretation of radio anatomic findings. A comprehensive description of medullary vascular syndromes would be beyond the scope of this treatise."

Bone and joint tuberculosis is common in developing countries, and surgeons in these countries are often faced with the dual problem of diagnosing and treating this disease. However, bone and joint tuberculosis has not yet completely disappeared from industrialized countries, either. Therefore, this book is also intended for orthopedic surgeons in industrialized countries, who, faced with the rare but characteristic problems posed by bone and joint tuberculosis, are searching for reliable solutions. The last comprehensive textbook on this subject appeared more than 20 years ago, and that was a third edition of a pre-war work. Advances in chemotherapy had made this edition out-of-date even before it was published. The need for a definite up-to-date textbook has therefore been acute. The present book has been written to fill that need, and is based not only upon 20 years' experience with 700 cases, but also upon the results of clinical, bacteriologic, pathologic, and therapeutic research.

Sonography is an ideal real-time imaging technique for the evaluation of muscles and tendons of the extremities, and this book is a useful reference for both the technique of examination and normal ultrasound anatomy. The first part considers technical aspects of the examination such as sonographic equipment, water-path systems, and dynamic maneuvers. The basic sonographic patterns of normal muscles, tendons, and other components of the extremities are then presented. Emphasis has been placed on pitfalls and artifacts. The other available imaging techniques for muscles and tendons are also discussed. The second part comprises an atlas of normal ultrasound scans of shoulder, arm, elbow, forearm, wrist, hand, thigh, knee, leg, ankle, and foot, with accompanying explanatory line drawings.

Much confusion exists in the accurate identification and classification of the many disorders in infancy which affect the skeleton by producing sclerosing lesions throughout the entire skeleton or in selected areas. A scholarly effort to bring order into this confusing field must be welcomed. Professors Beighton and Cremin have skillfully defined the problem and concisely yet thoroughly have identified the various sclerosing dysplasias. They bring to this task a wealth of clinical experience in their many years in the Departments of Radiology at the University of Cape Town Medical School and the Groote Schuur and Red Cross Children's Hospitals in Cape Town, South Africa. The authors also have had available data from the University of Cape Town Skeletal Dysplasia Registry. Professors Beighton and Cremin have used as a basis for their treatise the Paris Nomenclature (the modified version of 1977). This monograph is a felicitous combination of a working atlas and a scholarly exposition of the various sclerosing bone dysplasias, considering in detail eighteen major entities adopted from the Paris classification. Other disorders which present with osteosclerosis are also described. These include Caffey disease, oculodento-osseous dysplasia, central osteosclerosis with bamboo hair, fluorosis, osteosclerosis associated with renal disease and mastocytosis.

Apley & Solomon's Concise System of Orthopaedics and Trauma is firmly established as the leading introductory textbook of orthopaedic practice and the principles of fracture and trauma management. Praised in previous editions for the systematic approach, balanced content and easy-to-read style, this fifth edition has been brought fully up to date under the direction of the new and distinguished authorial team, while remaining true to the teaching principles of Alan Apley and his successor Louis Solomon. Key features: Focused - on diseases and clinical signs with additional detail on anatomy where appropriate International - enhanced coverage of 'global orthopaedics' reflect the changing pattern of musculoskeletal disease and trauma around the world Relevant - provides helpful guidance on simple procedures without unnecessary operative detail Readable - increased emphasis on concise presentation Current - updates reflect developments in molecular biology, genetics and imaging technology This fifth edition remains the first choice for medical students, trainee surgeons and other health professionals seeking a convenient introduction to this large and complex subject and is a natural precursor to the more detailed coverage offered by its larger parent, Apley & Solomon's System of Orthopaedics and Trauma.

The importance of osteoporosis in the United Kingdom as a cause of death and disability is now well recognised. There are in excess of 200,000 osteoporotic-related fractures in the UK per annum asso ciated with an estimated cost of GBP942,000,000. Following hip fracture it is known that about 50% of patients are unable to live indepen dently and about 20% of such patients die within the first 6 months. These figures, compelling as they are, reflect poorly on current medical practices which manifestly have failed to identify patients with low bone density at risk of fracture. The hope is that the techni cal advances which have enabled bone mineral density, and other allied indices, to be measured with high precision and accuracy offers the chance of identifying patients at risk of fracture and guiding the clinician to make treatment decisions which may reduce the patients' risk of fracture. In the UK, services for identifying patients at risk of fracture are still in their infancy and are not uniformly available throughout the country. This situation is, however, likely to improve particularly fol lowing the publication of the Royal College of Physicians report "Osteoporosis -clinical guidelines for prevention and treatment" and the recognition in "Our Healthier Nation" that osteoporosis pre vention should be included as a target to achieve a reduction of 20% in accidents by 2010.

Written by an international board of experts, this comprehensive text provides an in-depth review on the treatment and rehabilitation of the most common sports-related injuries according to the latest scientific developments in functional rehabilitation and the most clinically relevant features of pathophysiology of sports lesions. The management of acute and overuse sports lesions are classified by body area -- spine, upper and lower extremity.

Minimally Invasive Surgery in Orthopedics: The Upper Extremity Handbook contains all of the valuable chapters from Section 1 of Scuderi and Tria's 2010 hardcover reference. Newly available in an affordable softcover format, this book covers minimally invasive procedures and techniques for the shoulder, elbow, wrist and other topics applicable to the upper extremity. The book is fully illustrated with more than one hundred pictures and clearly written for ease of understanding. Surgeons, residents, and fellows alike will find this thorough and focused handbook invaluable.

Each year in the United States, an estimated 40,000 persons lose a limb. Of these amputees, approximately 30% lose a hand or an arm. This loss is most frequently related to trauma occurring in the healthy young adult male and is often work related. Approximately 3% of all amputees are born with congenital limb absence. In children, the ratio of congenital to acquired amputation is 2: 1, and the ratio of upper-limb to lower-limb amputees is 1. 2: 1. Therefore, since relatively few amputations result in upper-limb loss, only a small number of health practitioners, even those specializing in amputee rehabilitation, have the opportunity to provide services for a significant number of arm amputees. As a result, clinicians need to share their experiences so that the full range of options for optimum care and rehabilitation of the patient population may be considered. To meet this challenge for wider communication of clinical experience, a group of upper-limb amputee specialists met in Houston, Texas, in 1981 to serve as the core faculty for a course entitled "Contemporary Issues in Upper Extremity Amputation and Prosthetic Function. " This program provided the opportunity for surgeons, physiatrists, engineers, prosthetists, social workers, psychologists, occupational therapists, and physical therapists from the United States and Canada to discuss their extensive experience in working with upper extremity amputees. A second conference continuing the discussion of upper limb amputee rehabilitation was held one year later."

Bone Metastases brings together the many recent developments that are gradually improving the prospects for patients with secondary involvement of the skeleton in a primary cancer elsewhere. The morbidity from bone metastases is extensive, and the palliative and supportive treatment that sufferers require for many months or even years constitutes a major health problem. A multidisciplinary approach is essential since a variety of specialists are involved: radiation and medical oncologists, general and orthopaedic surgeons, general physicians, radiologists and nuclear medicine physicians, symptom control and terminal care specialists. The book's editors, themselves authorities in the fields of oncology and bone disease respectively, have brought together experts from all these disciplines to provide comprehensive coverage of metastatic bone disease. They cover the biology and pathophysiology, hypercalcaemia, imaging, assessment of response to treatment, types of treatment (systemic, radiotherapy, surgery), and symptomatic and supportive care. Particularly new approaches included are magnetic resonance imaging, the assessment of skeletal response and isotope therapy.

More than ten years have elapsed since the publication of the first edition of Tumors and Tumorlike Lesions of Bone and Joints in 1981. During this period significant progress has been made in diagnosis, and particularly in staging and treatment of bone tumors. In most centers, limb-sparing surgery has replaced the more radical ablative surgery, with or without preoperative chemotherapy. This became possible due to the introduction and increased application of newer high-quality imaging techniques (CT and MRI) and in particular the use of new cytomorphologic methods of diagnosis, especially immunohisto chemistry. These advances in diagnosis and treatment have been reflected by the publication of new editions of several important text books, since their authors - pathologists, orthopedic surgeons, and radiologists - felt the necessity of updating their works in recent years. However, in these publications different criteria of classification were adopted. The number of cases compiled at the Latin American Registry of Bone Pathology increased from 4913 primary bone tumors and more than 1100 tumorlike lesions at the time of publication of the first edition of this book, to 5274 bone tumors and 1665 tumorlike lesions by the end of December 1985, when I finished my work as head of the Registry and occupied the positions of Professor of Orthopedic Pathology at St. Louis University Medical Center and Distinguished Visiting Professor at Rush-Presbyterian-St. Luke's Medical Center in Chicago.

Edited by the respected pediatric orthopaedic surgeon Ali Kalamchi, M.D. with contributions from other experts in the field, Congenital Lower Limb Deficiencies is a single source reference guide for rare complex congenital defects of the lower limb. The text is divided into three sections. The first section discusses normal limb development; the genetic, familial, and historical nature of lower limb defects; and the evaluation and categorization of such defects in pediatric patients. The second section characterizes and classifies the congenital defects and covers early long-term planning of patient management based on clinical and radiographic findings. The third section analyzes the treatment modalities, including several chapters on the relationship of sports therapy to the treatment plan. In addition, the authors contribute their wealth of expertise by sharing their experiences and preferences in the treatment of congenital lower limb defects. The team approach for geneticists, pediatricians, orthopedists, therapists, prosthetists and other health care professsionals involved in each case is emphasized.

The widespread occurrence of the various forms of arthritis not only results in a great waste of manpower, but also causes immeasurable pain and suffering for the patients. Due to the limited understanding of its etiology, the currently available treatments are directed at the effects of the disease rather than its causes. The solutions available to the clinician at the advanced stages of arthritis are frequently surgical and include prosthetic replacement arthroplasty. Many advances have been made in the last decade in the basic understanding of the kinematics and kinetics of anatomical joints, as well as in the technology of joint replacement. The NATO Advanced Study Institute held in Portugal during June 20-July 1, 1983 addressed these topics and provided instruction on the advances in biomechanics of diarthrodial joints. The proceedings of this Institute are presented in this volume. Many different areas of specialization contribute to the field of joint biomechanics. Due to the complexity of each individual topic, it was not attempted here to present a complete treatise of each of these areas. Each chapter typically gives a review and a flavor of the subject matter, as well as discussing the state-of the-art advances in general or in specific research areas. Some of the chapters, such as those on lubrication and muscle mechanics, are more mathematically oriented than the others. Nevertheless, the reader with a non-engineering background, I trust, would still find most of the book informative and easy to read."

As modern science and medical technology increase the life span of man, the human skeleton is required to function for longer periods of time. Many skeletal problems that besiege the adult stem from abnormalities that exist during infancy and adoles cence. These may be congenital problems or acquired problems due either to a child's environment or to some injury sustained during the growth years. Adolescents today are extremely active; many sports and hobbies subject them to an infinite array of traumatizing episodes that may result in injuries and diseases. When I wrote the first edition of The Adolescent Spine in 1976, I felt it pertinent to produce a work which would help medical students and practitioners alike. That edition was extremely successful, not only in this country, but also in many foreign countries. For a medical text, the number of copies purchased was overwhelming certifying that the adolescent spine is of serious interest to pediatricians, orthopaedists, physical therapists, physiatrists, medical students, and other allied health practitioners. This new edition has been revised and considerably expanded with this audience in mind. Four chapters have been contributed by authorities with special expertise."

Cannulated Screw Fixation is the first volume of its kind to provide both the biomechanics of these screw systems as well as complete operative techniques. This book teaches the orthopaedic surgeon and resident all aspects of cannulated screw fixation from principles (biomechanics, design, materials, manufacturing) to clinical uses including anatomy, imaging techniques, advantages, complications and outcomes. This comprehensive text includes chapters written by well-known orthopaedists in their respective anatomical areas with material on preferred operating techniques and uses in more specialized clinical situations for both upper and lower extremities. Edited by pioneers in the development of the cannulated screw this volume is a "must have" for all orthopaedic surgeons and residents.

In orthopaedic surgery, the study of the foot has a special place. Familiarity with the congenital and acquired problems of in- flammation and arthrosis must be blended with an understand- ing of the mechanics of support and propulsion before a sure choice of effective treatment can be made. There is involvement of bones, joints, tendons, ligaments, soft tissues and integument, none of which can be treated in isolation. Superficial appraisal can lead to the cardinal error of facile diagnosis, and ignorance of the physiology of the organ and of the differences of expert opinion with respect to pathogenesis and basic therapeutic con- cepts invites inevitably poor management. In this book, I have attempted to interpret pathology, clinical presentation and treatment in the light of practical experience. I do not presume to be original, for many distinguished authors on the subject already. Lelievre (1952), Viladot et have written al. '1956), de Doncker and Kowalski (1970) and many others, preceded by Hohmann (1951), Morton (1935), Hauser (1950) and Boehler (1944), have all contributed significantly to our ba- sic knowledge and opened the way to understanding. The philosopher Alain wrote succinctly: "When it is fully com- prehended that there is no knowledge without experience and that one cannot conceive an idea unless there already exists a thought, no more need be said".

During the past 30 years, the Study Group for the Problems of Osteosyn thesis (AO) has made decisive contributions to the development of osteo synthesis as a surgical method. Through close cooperation among special ists in the fields of orthopedic and general surgery, basis research, metallurgy, and technical engineering, with consistently thorough follow up, it was possible to establish a solid scientific background for osteosyn thesis and to standardize this operative method, not only for the more ob vious applications in fracture treatment, but also in selective orthopedics where hardly any problems relating to bone, such as those with osteoto mies can be solved without surgical stabilization. Besides the objective aim, the AO was additionally stimulated by a spirit of open-minded friendship; each member of the group was recruited according to his pro fessional background and position, his skills, and his talent for improvisa tion. Against this backdrop without even mentioning the schooling program well known throughout the world I should like to add some personal and general comments. This book is written for clinicians, instructing them how to perform osteo synthesis with special reference to plating in all its varieties and in strict accordance with the biomechanical and biological aspects and facts. From this point of view, the chapter on preoperative planning merits par ticular emphasis. Not only is it conductive to optimal surgery, it will also contribute to self-education and may found a school."

This book has been written in response to the many physicians and scien tists working on the development of biological approaches to providing therapies for many orthopaedic disorders as well as to improving the healing of many tissues of the musculoskeletal system. The first goal of this book is to make the language compatible between the bench scientist and the clinician working in orthopaedic and sports medicine in order to cover specific areas of the orthopaedic discipline where the treatment can be improved and/or changed by the advancements in molecular medicine. Advancements in molecular biology, which encompass the study of the genetic basis of disease, have produced new diagnostic methods and drug therapies for genetic diseases and acquired disorders. The growth in the understanding of human genetics has also led to the initiation of many human gene therapy experiments. Although many approved therapeutic clinical trials using this new technology have been performed in the last ten years, the first clinical trial using this technology in the area of orthopaedics was performed at the University of Pittsburgh."

The hand commonly is considered to have exerted great influence on the evolution of typically human characteristics, like upright posture, stereoscopic vision, "manipulative" handling of parts of the environment. The German term "Begreifen", which is commonly used for the understanding of complex relationships in a generalised, abstract sense, always implies the original meaning of seizing objects with the aid of the hands. The hands are also of greatest importance for the survival of the other, non-human primates. Hands are absolutely essential for locomotion in an arboreal habitat, and the intake of food is dependant on the use of the hands as well: primates very rarely take in food directly with their mouths, in the wast majority of cases they seize food items with their hands. Even drinking is often performed by dipping the hand into the water and licking the drops from hand and forearm. An organ of such importance will very probably be "adapted" to its "function". This statement is made so often, that any further considerations seem superfluous. Nobody doubts, that the hands of primates are highly adaptive organs, the general form and internal structure of which are closely related to the necessities of life. However, if one tries to go beyond this general statement, he finds himself confront ed with several problems: First of all, a point which W. GUTMANN has emphasized repeatedly: according to the results obtained by genetics, the first thing to appear is the mutated character.

It is matter of some surprise that this treasury of information concerning the centres of gravity of various parts of the human body has remained hidden not only from the English speaking world for obvious reasons, but also to some degree from the Ger mans themselves. What is less surprising is t 1at this work is a monument to the renouned German thoroughness as demon strated by the relentless pursuit of data and the meticulous ac curacy of the conclusions. However, these scientific investigations carried out in Leipzig must be viewed in the intellectual climate of the time. In the lat ter half of the nineteenth century, and later, Germany underwent an intellectual explosion. It was the age of Rhumkorff, Max Planck, the Weber brothers and Gottingen University. It was said that science came to life during discussions on the train be tween Gottingen and Berlin. So the scene was set and Braune and Fischer made good use of it and fulfilled their role as mem bers of the Royal Scientific Society of Saxony. When Pauwels (1935) analysed the static and dynamic forces exerted on the hip joint when standing and when walking, he needed data concerning the centres of gravity of the human body and of its different segments. I was faced with the same pre requisite when I studied the forces acting on the knee (1976)."

Spinal Fusion: Science and Technique puts the experience of top professionals into your own hands. Drs. Jerome M. Cotler and Howard B. Cotler and their impressive group of contributors, including researchers, educators, and clinicians, have joined together to bring you this concise, comprehensive reference. Sections relating to history, basic science, surgical indications and techniques, complications, postoperative management, as well as a philosophical chapter on the future of spine surgery are presented. With the help of over 250 superb illustrations, Spinal Fusion: Science and Technique contains the most current and authoritative compilation of knowledge relating to surgical management of disorders of the spine. It is destined to become an essential tool in your working library.

This new treatise is the most outstanding piece of work on the knee and its associated ligaments currently available. Never before have I seen such an extensive study of the biomechanics of the knee with such a comprehensive review of the literature. The first section of the book, which deals with the functional anatomy (structure and biomechanics), immediately alerts the reader to the necessity of understanding the natural develop ment and action of the related structures, clearly emphasizing that successful diagnosis and treatment cannot otherwise be expected; the many who want an easy standard approach to each classic problem may find this hard to accept. Study what Werner Muller has written and compare it with your own findings from repeated dissection of anatomical specimens. The author goes on to stress that to have a real grasp of reconstructive surgery of the ligaments, one must be properly acquainted with the pathology and the repair of acute lesions. In no other way can one learn to recognize chronic problems. Once this step has been mastered it can be seen that the reconstructive procedures that Muller advocates do, for the most part, follow the laws of Nature rather than create the kind of abnormalities which often disrupt natural anatomical func tion.

Despite a substantial amount of literature already accumulated on the subject, our understanding of the structure, function, and biology of the cruciate ligaments has yet to reach the point where we can repair this complicated structure. This volume does not attempt to address every aspect of cruciate ligament replacement, but rather chooses to concentrate on the neurological function of the ligaments. It adopts a pragmatic approach to fatigue testing in more physiological conditions, biomimetic designs, European surgical techniques and new approaches derived from tissue engineering. As such, it is the first volume to sufficiently emphasise the progress that has been made outside of North America and follows more closely the SICOT/SIROT philosophy. The first section provides an overview of the increasing amount of knowledge on natural ligaments, while the second one reviews - using a biomimetical approach - the different concepts and designs of artificial ligaments developed over the last few decades. The final section presents new directions to expand our present understanding and suggests future approaches.

Methyl methacrylate (MMA) is the basic component of bone cements. To use it, a dough is prepared from the liquid and powder by mixing right before application, which is normally done by the operating team. During its working phase the dough is then inserted into the tissue where polymerization is completed. Thus, the final implant polymethyl methacrylate (PMMA) is only created at the implantation site. Besides methyl methacrylate, bone cements sometimes contain other methacrylates, such as butyl methacrylate. To achieve X-ray opacity, radiopacifiers (zirconium dioxide or barium sulfate) are added to the powder. Both the liquid and powder components contain additives (initiator and activator) that launch polymerization and control the set ting when mixed together. Moreover, softener and emulsifiers are some times used. The addition of antibiotics to the powder component in order to prevent or treat infections has become especially important. Commercial bone cements differ in composition and the course of curing. Some are designed for high and others for low viscosity. The way the user handles and applies the cement always crucially influences the quality of the implant. This is why clear and comprehensive information about the cements should be available to show the user how all the relevant factors work It should also be possible together and how they depend on each other."

This volume is the work product of an international group of authors who are experienced in the field of musculoskeletal allografts. The chapters are written by experts in many differing areas of allografting and represents the current knowledge in this rapidly changing dynamic field. The reconstructive community and their patients owe a significant debt of gratitude to Doctors Czitrom and Winkler for this volume. William F. Enneking, M. D. Preface What follows is the result of a timely project bringing together the newest ideas of top experts worldwide in a rapidly growing technology: Orthopaedic Allograft Surgery. The title of the book reflects a method rather than a speciality. It transgresses well established subspecialities of orthopaedic surgery such as joint replacement, oncology, spine, trauma and sports medicine. The technology encompasses knowledge of tissue banking, biology and biomechanics, both in a research and clinical sense. The common denominator for those interested is the need and ability to provide or use allogeneic tissues in orthopaedic applications. Inherent to a multiauthored text based on chapters written by authors from many parts of the world is a variety in format and style. While we tried to some extent reducing large discrepancies, there was no attempt made to eliminate dissimilar ities. We did not aim for a homogeneous textbook. Rather, we asked for originality, novelty, individuality in the presentation of data and concepts. Consequently, chapters vary in format from that seen in a scientific article to that of a descriptive essay."