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Professor B.G. WEBER has once again and in a very timely fashion
produced a superb book on an orthopaedic subject of great
importance. "The Extemal Fixator" is the most comprehensive text on
the subject in orthopaedic literature to date. Professor WEBER
thoroughly discusses extemal fixation with c1arity, organization,
profuse illustrations and roentgenograms. Professor WEBER
acknowledges that the use of extemal fixation in orthopaedic
surgery is not newand traces its history over the years. He points
out c1early the fact that though at various times the "method" has
experienced periods of disrepute, modem sophistication, improved
technology and a better understanding of its philosophy have given
the system a newand perhaps permanent place in the armamentarium of
the orthopaedic surgeon. All methods of treatment have critics as
well as supporters, and not infrequently the strongest criticisms
are the result of poor understanding of the philosophy proposed and
its proper implementation. Professor WEBER, in his carefully
detailed and well illustrated book, has made it abundantly c1ear
that the use of extemal fixators in the treatment of fractures must
be c1early understood by the orthopaedic surgeon in order to obtain
satisfactory clinical results. His discussion of its philosophy,
pathomechanics and technology are most comprehensive and leave "no
stone untumed" and because of this the book represents a most
comprehensive text on the subject.
This book has become necessary as a consequence of the rapid
expansion of the surgical procedures and implants available for
spinal surgery within the "AO Group". We have not attempted to
write an in-depth book on spinal surgery, but one which will help
the surgeon in the use of AO concepts and implants. We con sider
the practical courses held all over the world essential for the
teaching of sound techniques so that technical complications and
poor results can be avoid ed for both the surgeon and, in
particular the patient. This book is a practical manual and an
outline of what is taught in the courses. It is intended to help
the young spinal surgeon to understand the correct use of AO
implants. The indi- tions given will aid the correct use of each
procedure. . It must be strongly emphasized that surgery of the
spine is technically de manding. The techniques described in this
book should only be undertaken by surgeons who are trained and
experienced in spinal surgery. Certain techniques, in particular
pedicle screw fIxation and cages, have not yet been fully approved
by the FDA in the United States. However, throughout the rest of
the world, the use of pedicle screws has become a standard
technique for the spine surgeon, since it has been shown to improve
fIxation techniques and allow segmental correction of the spine.
The use of cages has become more and more popular, specifIcally as
a tool of minimally invasive spinal surgery.
Die Stabilisierung von Knochenfragmenten mit Hilfe eines Fixateur
externe geht wa- scheinlich auf LAMBOTTE (1902) zuruck. Der
Fixateur externe ist jedoch noch nicht im gleichen Masse zum
Durchbruch gekommen, wie die geschlossene Frakturenbehandlung nach
BoeHLER, W ATSON-JONES, SARMIENTO und die stabilen Osteosynthesen.
Aber auch die operative Frakturbehandlung hat erst 1958 durch die
Schweizerische Arbeitsgemeinschaft fur Osteosynthesefragen AO
weltweite Verbreitung gefunden. Dabei ist die AO-Technik von deren
Autoren MuLLER, ALLGOEWER und WILLENEGGER zu keiner Zeit etwa als
allein richtige Methode verstanden worden, und in ihrem Buch
"Technik der operativen Frakturenbehandlung", Springer-Verlag 1963,
steht im Vorwort: "Wir koennen nicht genug warnen vor
Osteosynthesen, die ohne entsprechende Schulung des Chirurgen und
ohne notwendige technische Voraussetzungen bezuglich
Instrumentarium und Asepsis im Operationsbetrieb durchgefuhrt
werden ... ". Die Gefahren der direkten Osteosynthese haben die
konservative Behandlung in modifizierter Form reaktiviert, so dass
heute das "functional bracing" nach SARMIENTO vielerorts genauso
oft Anw- dung findet, wie die AO-Technik.
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