Since 1958 the Association for the Study of Internal Fixation (ASIF) has worked to establish the experimental and biomechanical prin ciples of the operative treatment of fractures. It has been proven that immediate, pain-free mobilization, made possible by stable internal fixation, is the key to restoring function in a fractured extremity. The same principles were applied in 1972173 by Roland Schmoker, who developed a universal plate and sophisticated instrument set designed initially for the treatment of comminuted fractures of the mandible. To extend the applications of his plate to reconstructions after ex tensive tumor resections, he supplemented the device with tem poromandibular joint prostheses and anchoring elements for the at tachment of dentures. He first tested the functional stability of these implants experimentally in sheep. Later he found that the minipig had a more human-like jaw shape and masticatory action, and so he tested the implants in 37 mini pigs that underwent extensive mandibular re sections without bone grafting, using sequential dye injections and postoperative weight gain to chart the progress of osseous regener ation. Seven other animals were not operated and served as controls."

Sonography is a noninvasive diagnostic method that has gained an established place in many branches of medicine. Although the inability of ultrasound to penetrate bone delayed its application in the orthopedic field, the successful work of R. Graf in the early detection of pediatric hip disorders with ultra sound has served as an impetus for the increasing use of sonogra phy to detect and evaluate abnormalities of the musculoskeletal system. It is certain that further advances in this modality will be forth coming, and that sonography will be applied to new lines of inves tigation in orthopedic diagnosis. In Arthrosonography the authors use concise text and copious illustrations to demonstrate the potential applications of articular ultrasound, its diagnostic capabilities, and technical aspects of the ultrasound examination. Potential pitfalls are also explained. This book is the logical outcome of the application of diagnos tic ultrasound in orthopedics and rheumatology. It covers all basic practical aspects of arthrosonography and will be a valued re source for those concerned with the evaluation of the musculo skeletal system. HANS RETTIG Contents Introduction . . . . . . . . . . . . . 1 The Piezoelectric Effect - The Basis of Modem Sonography . . . . . . 1 Ultrasound Techniques. . . . . . . . . . . 1 General Principles of Diagnostic Ultrasound 2 Landmarks for Arthrosonography 6 Artifacts ........ . 6 Reverberations . . . . . 7 Hyperbolic Artifacts . . 7 Acoustic Mirror Image . 8 Special Phenomena in Arthrosonography 8 "Wandering Echo" Phenomenon . ."

The acute abdomen is one of the most frequent, most dangerous and most difficult problems that the diagnostic radiologist has to deal with. This comprehensive manual presents a clinico-radiologic approach to the use of diagnostic imaging techniques for acute abdominal conditions. Imaging techniques, radiologic symptoms and clinical conditions are treated separately. This lucid format, together with a detailed subject index, offer the reader a quick and reliable reference aid in daily practice. The text is clearly structured and concise in style, and provides helpful practical hints, including discussion of diagnostic pitfalls. It is supported by a wealth of illustrations covering native diagnosis, ultrasonography, computer tomography and angiography.

The reconstructive surgery of posttraumatic deformities has made significant advances in recent years. Reports on technical progress and clinical results are encouraging, even though they have often raised patient expectations to an unrealistic level. The operative methods available to us today enable corrective osteotomies to be performed with a high degree of accuracy and success. Precisely because the sequelae of trauma are so difficult to schematize, every case must be evaluated individually based on a critical assessment of subjective complaints, diagnosis and prognosis before a decision can be made. The planning and execution of corrective procedures are carried out with the same meticulous care as for idiopathic limb deformities. However, the occurrence of a traumatizing event with its immediate and long-term complications calls for special insight in the setting of therapeutic goals. It is essential that the patient be appraised of the results that can reasonably be expected and of the risks that are involved. Success in therapeutic procedures requires detailed theoretical knowledge, thorough operative training, and a strong commitment on the part of the surgeon. It is these aspects of the corrective surgery of posttraumatic deformities with which the editors are principally concerned.

Very thorough knowledge of breast pathology is a sine qua non for interpretation of breast films ... progress in X-ray diagnosis could only be made by careful comparison of the film with the actual specimen. H.INGLEBY Multiplication of the same e"oneous diagnosis does not make that diagnosis co"ect. J.G.AzZOPARDI Paradoxically enough, our specialty considers the radiologist who mis takes a skin fibroma or the calcifications in a sponge kidney for a kid ney stone to lack basic knowledge, while the radiologist who imme diately calls for the surgeon because of a few white spots on a mammogram is thought to be acting according to the rules of medical practice. Misunderstandings and confusion with regard to breast pathology as well as the comfortable philosophy that superfluous biopsies are the price we have to pay for the early detection of carcinomas have in many places led to a loss of confidence in mammography. Yet this is a meth od with which carcinomas can be detected earlier than with any other imaging technique.

This volume contains the proceedings of the Symposion on Shoulder Joint Replace ment held at the Kieler Yacht Club in conjunction with the 35th Annual Meeting of the Northwest German Orthopaedic Surgeons at Kiel in 1985. Since the advent of suitable implant materials hemiarthroplasty of the shoulder was explored in the 1950s; total shoulder joint replacement was first reported in 1971. As interest in solutions to problems of the shoulder is growing, it appeared timely to present to interested clinicians the possibilities and limitations of a proce dure as seen after nearly two decades of trials and experience. This volume is meant to give a comprehensive overview of the bases, the development, the alternatives, the state ofthe art and, an outlook on some future trends. The number of patients with problems warranting shoulder arthroplasty is rela tively small. We consider this a blessing. This may be the reason why the number of surgeons who ventured in this field has remained small, even after implants became available - testimony of an awareness, that shoulder surgery is difficult. The editors consider themselves fortunate to have been able to call on a number of those individuals, who were involved in first trials and in their evaluation. The editors are especially indebted to those from overseas who took it upon themselves to come, share their experience and join in the discussion."

Even the earliest applications of nuclear magnetic resonance (NMR) spectroscopy and tomography to medical inquiries, using experimental apparatus that was primitive by today's standards, demonstrated the extraordinary potential of the NMR method. The subsequent rapid advances in this area were due largely to the ef forts of commercial manufacturers, who, by improving magnet and computer designs, were able to produce and market instruments having a remarkable image quality. Experimental data from the ftrst systematic studies on the medical uses of NMR leave little doubt that NMR will gain a permanent place in clinical diagnosis. The clinician, then, is confronted with an entirely new diagnostic modality. Because NMR has been used extensively in chemistry and physics for years, a great many textbooks are already available on the subject. However, the majority of these have been written for the natural scientist who is well versed in mathematics and physics. Assumptions are made and terms are used that would not be appro priate for a medical or biochemical text. The goal of this introduc tion, therefore, is to discuss the principles of the NMR technique in terms that are meaningful to the medical student and medical pro fessional.

It is a great pleasure and honor to be asked to participate in the translation of this important and historical volume on thoracic surgery and to provide this foreword. Martin Kirschner of Mannheim/Heidelberg was an early pioneer in thoracic and esophageal surgery. His operation for bypass of the esophagus using the entire stomach remains a standard of the surgical armamentarium to this date. The original Kirschner Textbook of Surgery was a standard in its day. We are fortunate that Professors H. Pichlmaier and F.W. Schildberg and other colleagues have provided us with this important modern successor of a classic textbook. The reader is rewarded by an extensive treatise which includes not only the most up to date techniques in pulmonary, esophageal, mediastinal, and chest wall (including breast) surgery but also provides an excellent perspective on the techniques used by pioneers in the field. Although some of these early techniques are not commonly used today, knowledge of their use and application broadens the capability of the thoracic surgeon. Changing times bring renewed problems with infectious diseases. Knowledge of the management of the pleural space and pulmonary infectious problems is a critical part of the education of the thoracic surgeon.

This manual is conceived as an aid to AO course participants both in grasping theoretical principles and in performing practical exercises, as well as a practical guide for clinicians in the application of AO principles. These principles are discussed in Part I and related to notions of stability, biomechanics, and technique. In addition to interfragmentary fixation and load bearing, the technique of external fixation is explained. The use of rigid external fixators with the mandible is proposed as a replacement for pin fixation, which has been obsolete for over two decades. Part II is a practical guide to the theoretical principles set forth in the first section of the volume, with the focus on case studies classified according to fracture type. This section provides a solid empirical basis of particular value in establishing indications and selecting appropriate techniques. Equally important is the anatomy of surgical points of access. In Part III, the increasing variety of indications for rigid internal fixation is confirmed. Three areas take on particular relevance here: the surgical treatment of pseudarthrosis, the by-pass of primary defects as an integral part of mandibular tumor surgery, and sagittal splinting and condylar replacement for orthopedic interventions involving the locomotor system of the mandible. A foldout entitled "AO Classification of Mandibular Fractures" is inserted at the back of the book. Its purpose is to help the clinician confronted by an acute case to determine its classification.

In this second English-language edition, existing chapters have been completely revised and new chapters added. The number of illustrations has been expanded and new terminolo- gy included. The novel how-to approach emphasizes basic principles that will help experienced as well as beginning eye surgeons master the unexpected.

For more than 100 years, congenital dislocation of the hip has been an area of concern in orthopedics. This publications on the subject are al most too numerous to count. Yet our knowledge of the basic principles of congenital hip dislocation and its management is constantly being expanded by new research. In Germanspeaking countries, Kaiser pub lished the last comprehensive textbook on congenital hip dislocation in 1958, and Schlegel followed with a comprehensive handbook in 1961. In the Angloamerican world, Coleman's monograph was pub lished in 1978, Somerville's in 1982, and Wilkinson's in 1985. In 1982 Tachdjian compiled a volume on congenital hip dislocation that con tained contributions from 44 authorities. The purpose of the present book is to provide an overview of our pre sent state of knowledge of congenital hip dislocation, covering basic principles, diagnosis, methods of closed and open treatment, and indi cations. In the process, an attempt is made to trace progress in the field from its beginnings to the present time. Many authors describe the diagnosis and treatment of congenital hip dysplasia and dislocation in terms of specific age groups. We believe it is more prudent to take an individualized approach based on arthro graphic findings and the degree of severity of pathologic changes. Less emphasis is placed here on the management of patients by age group."