Preface - 21/08/11
The first edition of Skeletal Trauma: Fractures, Dislocations, Ligamentous Injuries was written between 1988 and 1991. This represented a unique window for the creation of this text, coinciding with the increased recognition of the special needs of trauma victims. By the mid-1980s, more than 500 regional trauma centers had been established throughout the United States and Canada. The volume and acuity of blunt trauma and associated musculoskeletal injuries reached a high-water mark. The editors and contributing authors for Skeletal Trauma had been on the front lines working in the major trauma centers throughout this period. They helped to develop a new operative approach to the treatment of these injuries that stressed early skeletal fixation and rapid mobilization. The incomparable firsthand experience that they gained helped shape their contributions to the text.
In the early 1990s, many states adopted the child restraint device and seat belt legislation. Successful initiatives to control driving under the influence of alcohol significantly lowered incidence of motor vehicle crashes. Improvements in automotive design, such as airbags and strengthened bodies, continued to reduce the incidence and severity of blunt trauma and complex musculoskeletal injuries. Although there was an alarming increase in injuries and deaths from gunshots in our major cities, penetrating trauma does not usually result in the multiplicity and complexity of skeletal injuries that are caused by vehicular crashes. In addition, managed care contracting practices resulted in the dispersion of trauma patients to community hospitals, often reducing the number of injuries seen in trauma centers. In retrospect, the 1980s provided a unique opportunity for the creation of this text.
The excellent manuscripts provided by our contributing authors and the beautiful illustrations created by the artists were assembled into an outstanding text by the W.B. Saunders production department. In the year of its publication, 1992, it won first prize in medical sciences from the Association of American Publishers as the best new medical book. The text was widely embraced by orthopaedic and trauma surgeons throughout the world for its clarity and its utility. They consistently expressed their appreciation of our approach, which stressed the discussion of problem-focused clinical judgment and proven surgical techniques. The textbook was regarded by surgeons in training and practicing physicians to be a practical resource that helped guide them through the management of the musculoskeletal injuries with which they are confronted.
SECOND EDITIONWe retained and strengthened the basic philosophy and organization of the original text in the second edition that was published in 1998. We added new chapters to cover important subjects that were not addressed adequately in the first edition.
In the years since the publication of the second edition of Skeletal Trauma, major new global epidemiologic trends have been noted that influence the character of musculoskeletal injuries throughout the world. In the developed market economies, decreased birth rates and increasing longevity have resulted in the aging of the population. Osteoporosis and associated fragility fractures have grown in number and significance. Road safety improvements in these countries, such as pediatric restraint devices, seat belts, drunken driving control, airbags, vehicle design improvements, and enhanced law enforcement, have decreased the number and severity of road traffic injuries. In the developing world, however, there is a growing epidemic of road traffic injuries. Vulnerable travelers such as pedestrians, bicyclists, motorcycle riders, and passengers on overcrowded buses and trucks are the main victims. Annually, 1.2 million people die on the world’s roads and an estimated 24 to 33 million are severely injured or disabled.
To raise awareness of the burden of these and other musculoskeletal disorders, empower patients, expand research and improvements for prevention and treatment of these problems, and engender multidisciplinary cooperation, the years 2000-2010 have been declared the “Bone and Joint Decade” by U.N. Secretary General Kofi Annan. The movement has also been endorsed by the World Health Organization, the World Bank, and the governments of forty nations.
THIRD EDITIONThe third edition of Skeletal Trauma, published in 2003, was written in recognition of the challenges of the era and was dedicated to the improvement of musculoskeletal trauma care throughout the world in keeping with the spirit of the “Bone and Joint Decade.” Although there have been dramatic advances in biology, pharmaceuticals, technology, and fixation to improve the care of patients with musculoskeletal disorders in wealthy countries, a large portion of the world’s population lacks basic health care and has very limited orthopaedic services available. Road traffic injuries and deaths have risen to epidemic proportions in the developing countries. With the leadership of the country of Oman and its UN Mission, the UN implemented an international road safety program in 2004. The WHO serves as a coordinating agency is working with UN regional commissions and member countries to address this major global health problem. Prevention is the primary focus of this initiative, but serious injuries will continue to occur, so capacity building for treatment in developing countries is essential.
For many years, the Skeletal Trauma editorial group had discussed the possibility of creating a separate volume for skeletal trauma reconstruction. Our contributing authors and others had gained wide experience in post-trauma reconstruction, but there were no comprehensive texts written on this subject. In conjunction with our publisher, we made a decision to incorporate this material into the third edition. As we were limited by the established size of the two volumes, some basic science chapters were deleted and other information was condensed to make room for the new reconstructive material. New chapters were added on perioperative pain management, osteoporotic fragility fractures, chronic osteomyelitis, gunshot wounds of the spine, fractures in the stiff and osteoporotic spine, medical management of patients with hip fractures, total hip arthroplasty after failed primary treatment of fractures involving the hip joint, acute foot injuries, foot injury reconstruction, lower extremity alignment, periprosthetic fractures, and amputations for trauma. Some of the authors from previous editions continued but made major revisions to revitalize their work. In other cases, new authors were recruited to add international perspective and broaden the base of expertise. Minimally invasive plating, an important new technique, was covered by one of its major developers in the chapter on the distal femur. New biologic agents are addressed in an expanded chapter on enhancement of fracture healing.
In addition to discussing the treatment of acute injuries, the authors of the anatomic chapters were asked to expand their scholarly writing to include the management of nonunions, malunions, bone loss, osteomyelitis, and fixation in osteoporotic bone. The use of fusion and arthroplasty in post-traumatic arthritis was described in detail.
FOURTH EDITIONThe publication of the fourth edition in 2008 brings a number of new features and an important addition to the editorial team. Many surgical texts have begun to include videos of surgical techniques and lectures that are provided in a companion DVD or via a website. To add this dimension to Skeletal Trauma, we turned to Professor Christian Krettek, Chairman of the Department of Traumatology at Hannover Medical University in Hannover Germany. An outstanding trauma surgeon, educator, investigator and innovator, he has been a leader in the use of videos in orthopaedic and trauma education. He has utilized an annual educational meeting involving guest lecturers and his faculty as a platform to develop a phenomenal library of surgical videos and lectures. Selected videos from this collection that are relevant to the subject of the text have been included in a special companion DVD and made accessible through the website developed for Skeletal Trauma Ed 4. To recognize this contribution and the leadership that Professor Krettek has provided for the assembly, production and translation of these videos, we have made him a member of our editorial team. As members of his department have served as contributing authors for previous editions and his predecessor, Professor Harald Tscherne wrote the forward to the third edition, this represents an even closer affiliation. Surgeons from Europe have contributed greatly to the development of musculoskeletal trauma management. The growing connection with this important European center and inclusion of other authors from the continent reflects our move to internationalize the text.
In recognition of the contemporary movement by younger physicians to acquire increasing amounts of information electronically via the internet, the 4th editon will be offered as an ‘Expert Consult’ title with online and print components. The Publisher of this text, Elsevier, has published more than 70 text/web product packages across the medical and surgical specialties since release of the first such product in March 2003. This combination of text and web product has been very well received in the market and is now a mature and well organized offering. The publisher’s objective in marketing and branding the concept is to provide currency and portability of information, and counter the charges that print texts are ‘out of date’ upon publication. Many studies acknowledge that this generation of residents and fellows have fully embraced online access to information. Premium features of the web components include full text search; link through to full text articles in Pub Med and Cross Ref; all images and figures downloadable to Power Point, video components; and, the most popular feature, content updates.
The editors have been gratified by comments from surgeons around the world indicating that Skeletal Trauma has been adopted by many trauma centers and orthopaedic training programs as the principal fracture text. We have welcomed their constructive criticism as well as their accolades. Many of the changes in the current edition were made in response to comments from these surgeons and our own residents.
We are grateful to our contributing authors, whose high level of scholarship and dedication to their chapter writing and video production makes this such a readable and useful reference. The pressures of modern medical practice have made these surgeons busier than they were during the writing of the second and third editions, so they should be afforded special recognition for the devotion they have shown communicating to other surgeons about their subject. Together we have refashioned our text to better address readers’ needs for information concerning basic science, acute injury management, and post-traumatic reconstruction.
© 2009 Elsevier Inc. Tous droits réservés.
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