The fourth volume of Progress in Orthopaedic Surgery is somewhat different from pre vious publications of the series. The editors have again tried to present two topics but the publications presented from the European literature are of very recent origin. In the age of total joint replacement it was felt to be imperative to counteract the pre sent tendency to treat every joint which does not seem to be healthy with an artificial re placement. Orthopaedic surgery seems to be influenced by trends. In 1963, E. A. Nichol discussing intracapsular hip fractures, quoted from Alice In Wonderland in an editorial written for volume 45B of the Journal of Bone and Joint Surgery "The Queen had only one way of settling all difficulties, great or small, "Off with his head" ." Today one could paraphrase his implied critizism by saying "Out with the joint." No one doubts that joint replacements have been of great value in treating degenerative joint changes, but it is already apparent that replacement operations are not the ultimate answer for treating every joint deformity. This volume represents the European experience of different types of surgery in treat ing arthrosis of the joints of the lower limb. A reader of the Anglo-American literature will find suggestions in it which reaffirm his uneasiness in considering only one solution for problems concerning lower limb joints. I feel strongly that there are other ways which allow a patient to function well with less extensive operations."

In the past 10-15 years marked progress has been made in the surgical treatment of congenital anomalies of the hand. More and more, the reluctance to operate on these deformities has been abandoned. One reason for this - at least in the German-speaking countries - was the thalidomide catastrophe (1959-1962), which involved the birth of many children with deformed upper limbs. These previously rare severe abnormalities resulted in many problems and required new ways of thinking in terms of their treatment by all persons concerned with their care. At the same time hand surgery was beginning to come of age and the combination of these two events increased the interest in the field of hand anomalies, particularly by orthopaedic surgeons who had always been involved in it. The idea and preparation for this book go back to 1964. Since that time nearly all operations on anomalous hands were systematically charted by us. They were photographically recorded from skin incision to wound closure. Regular follow-up examinations were performed. This atlas represents our experience gained in over a thousand operations. The book has been written by practitioners. We hope that a hand surgeon looking for additional advice will find answers in regard to therapy and surgical suggestions. This intent influenced the book's compilation and structure: - Only those operations that have given us good long-term results will be discussed.

Recent experience of the treatment of segmental idiopathic necrosis of the femoral head are discussed in this book by several experts. The discussed methods oftreatment are practically unknown in the US orthopaedic literature. It describes alternate methods of treatment with regard to total joint replacement In Chapter 1 Dr. Wagenhauser expresses his thoughts on posture and its affects on the human body. The following 7 chapters focus on diagnosis and treatment of idio pathic necrosis of the femoral head - an especially timely subject since the incidence of this disease, which primarily affects males during the most active period of their lives, seems to be increasing. New Haven, Connecticut, August 1981 Ulrich H. Well The Question of Posture F. J. Wagenhliuser Every expert would agree with Taillard (1964) that. posture is the most unsettled of all orthopaedic problems. Its onus of ambiguity no longer concerns orthopaedists alone, nor is it limited only to the fields of medical practice and research. It is, rather, a fundamental question spanning a wide range of sciences and occupations that deal with human exist ence and actions. Therefore fascination with this problem has steadily increased. Ques tions on human posture, its concepts and terminology, its normal forms and variations, the diagnosis of pathologic disorders, and their response to treatment concern many of today's anatomists, pathologists, physiologists, orthopaedists, rheumatologists, pediatri cians, gerontologists, psychiatrists, psychosomatic therapists, physiologists, behavioral therapists, and epidemiologists."