and refinement that exists within the necessarily strict rules of the internal fixation method. In this way we seek to contribute to as weIl as to stimulate the search for rational solutions to surgical problems. It is assumed throughout that the reader is fa miliar with the technical fundamentals of internal fixation, and so these details are omitted. Instead, special indications and technical refinements are presented on the basis of case examples. Because an endless variety of situations can arise in orthopedic surgery (a circumstance that is attracting more and more surgeons to the field), we have taken ca re that our examples can readily be applied to novel situations. We now credit, in alphabetic order, those who contributed most to the techniques presented: R. BLATTER, A. BOITZY, C. BRUNNER, O. CECH, A. DEBRUNNER, F. MAGERL, G. SEGMUELLER, G. STUEHMER, and B.G. WEBER. We thus express thanks to those colleagues in our clinic who agreed to having their ideas published. But we are also grateful to our illustrators, H. and K. SCHUMACHER, our photographer, M. SCHAFFNER, and our chief secretary, U. OETLIKER, who contributed so much to the preparation of the manuscript. Finally, we thank Springer-Verlag for their patience with us and especiaUy for their efficient work in bringing the book to press. St. GaU, Fall 1981 CH.F. BRUNNER B.G. WEBER Contents Lag Screws ............. .

nenkursen und Publikationen m6gen dazu beigetragen haben. Es geht uns hier nicht darum, Erfinderanspruche zu erheben, sondern vielmehr darum, aufzuzeigen, daB innerhalb der richti- gerweise starren Osteosynthesegrundgesetze ein Freiraum fUr Kreativitiit, fUr Varianten und Verfeinerungen besteht. Es erge- ben sich dabei sinn volle operative L6sungen, und der operative Alltag erfahrt anregende Bereicherung. In jedem Kapitel wird die Kenntnis der Grundtechnik als ge- liiufig vorausgesetzt und deshalb darauf nicht niiher eingegan- gen. Vorgetragen werden dagegen jeweils besondere Indikatio- nen und technische Feinheiten anhand von Fallbeispielen. Un- schwer lassen sich un sere Erfahrungen auf andere Situationen ubertragen, denn die Zahl der denkbaren Varianten in der ortho- piidischen Chirurgie ist endlos - ein Umstand, der so viele Chir- urgen verschiedener Schattierungen immer wieder in ihren Bann zieht. In alphabetischer Reihenfolge nennen wir aIle jene, die mit den dargestellten Techniken in Zusammenhang stehen: R. BLATTER, A. BOITZY, CH. BRUNNER, 0. CECH, A. DEBRUNNER, F. MAGERL, G. SEGMULLER, G. STUHMER, B.G. WEBER. Unser Dank richtet sich deshalb an die Kollegen un serer Klinik fUr das Einverstiindnis, ihre Ideen ver6ffentlichen zu durfen. Aber auch an die Zeichner H. und K. SCHUMACHER, an un sere Photographin M. SCHAFFNER, an un sere Chefsekretiirin U. OET- LIKER, welche zur Druckreife dieses Buches soviel beigetragen haben, richtet sich unser Dank. Dem Springer-Verlag dank en wir fUr die Geduld mit uns, dann aber besonders fUr die ziigige und hervorragende Drucklegung. St. Gallen, Sommer 1981 Ch.F. BRUNNER B.G. WEBER InhaItsverzeichnis 1 Zugschraube .......... .

The unique union of a deaf man and a hearing woman presents more than the expected challenge of communication; it offers an uncommon perspective on everyday events. Add durable love and humor, and the result is an extraordinary coupling whose mutual determination defies the odds of unconventional marriage. Dan Brighton, deaf since he was a toddler, is a verbally proficient and charming individual who attains the love of Cara DiSordo. After their marriage, Cara teaches herself the rudiments of sign language to facilitate communication. But she soon recognizes the tough realities of marriage to a deaf partner. Dan's internal struggle and quiet shame of his disability manifests itself in angry and peculiar ways. Cara attributes Dan's dark side to a troubled upbringing involving a father's disappointment, a sister's animosity, and a mother's irresolute love. Under constant strain, but never out of love with her husband, Cara accepts a job promotion that takes her away from Dan for almost four months. During this time, she explores her ability to continue in a difficult marriage. Will Dan and Cara's marriage survive the separation?