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In this Atlas I want to share with my fellow clinicians the fascina
tion I experienced while discovering the marvels of embryonic
development. Why haven't these marvels excited me before? I believe
that the use of schemata and drawings or photographs of animal
embryos, commonly used in textbooks of embryology, simply did not
appeal to me as a clinician. Only actual photo graphs of human
embryos can establish the bond necessary for interaction. Just
imagine the excitement when you find out how many struc tures you
can recognize in a 5-week-old embryo, barely measuring 1 cm in
length. But our fascination does not stop here. The pro gression of
changes taking place during the next 3 weeks is so rapid that at
the time when the embryo measures 3 cm, all structures familiar to
us are not only easily recognizable, but also already in their
anatomical position. How can we hide our amazement when we realize
that such a state of perfection is present in an embryo a bit
longer than the distal phalanx of our little finger? At 8 weeks the
embryonic period ends and the fetal one starts. Although the shape
and the relative size of bones, joints, muscles, nerves, and
vessels will undergo changes, the basic elements are all in place.
This implies that major malformations must develop during the
embryonic period."
External fixation is now being used widely to maintain fractures,
osteo tomies, and arthrodeses in a desired position during
consolidation. Whereas external fixation has been readily accepted
in European countries, its use has weathered a rather stormy course
in North America, especially in the treatment of fractures. Only
recently has external fixation found its rightful place on this
continent as well. Many different models are on the market today,
and the practitioner is faced with a difficult decision in
selecting a model. Should he buy a system where the fracture has to
be reduced first, or should he work with a device permitting a
reduction after insertion of the pins? To enable surgeons to study
the different systems, to discuss their advantages and
disadvantages, and to permit them to put their hands on these
devices and inspect them personally, the Division of Orthopedic
Surgery, University of Ottawa organized an applied basic science
course in May 1981, External Fixation of Fractures. During this
course, all major systems were pre sented to the participants. As
happened during the course "Internal Fixation of Fractures" held
two years ago, the rigidity of internal fixation was frequently and
intensively debated. Whereas the rigidity of internal fixation
cannot be altered during the course of healing, the rigidity of
external fixation can be changed. In fact, with progression of
union, rods of increasing elasticity can be used."
"Physiaians have aZways known, though often they are reZuatant to
adrrrit it, that the quaZity of their daiZy praatiae depends on the
resuZts of researah * . . Irvine H. Page * The 1985 App1ied Basic
Science Course distinguished itse1f for three impor- tant reasons.
First, it showed c1ear1y the extent to which biotechnology and
biomechanics have become an integral part of orthopedics. Second,
it emphasized the increasingly important role the orthopedist will
have to play in the treatment of the aging population. Projected
Canadian statistics estimate that the population aged 65 years and
older will in- crease from the current 9. 7% to 13% by the year
2000. Based on the current total population of almost 25 million,
the number of hip fractures caused by age-related bone 1055 will
almost double and will reach approximately 28,000 per year in
Canada. Extrapolation of these figures according to populations in
other countries is easy. The costs in expenditures and human
suffering are inestimable. This is an area where orthopedic
research will have to redouble its efforts in the hope of finding
better preventive measures. Furthermore , knowledge of the
pathogenetic mechanisms of bone 1055 becomes increasingly important
in osteoporosis associated with weightlessness. The third
impressive insight we derived from the presentations at this sym-
posium was the revelations of the latest imaging techniques and
monitoring devices. Nuclear medicine, computer assisted tomography,
and nuclear- magnetic resonance are being applied to bone disease.
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