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This Current Diagnosis and Treatment in Orthopedics is the Fourth Edition of the orthopedic surgery contribution to the Lange Current Series of books. It is surprising to realize that it has been 10 years since the first edition of this book. The goal of this book has not changed. It is intended to fill a need for a ready source of up-to-date information on disorders and diseases treated by orthopedic surgeons and related physicians. The format in this edition is unchanged from previous: there is emphasis on the major diagnostic features of disease states, the natural history of the disease where appropriate, the work-up required for definitive diagnosis, and, finally, definitive treatment. The book focuses on orthopedic conditions, de-emphasizing the treatment of the patient from a general medical viewpoint, except when it pertains to the orthopedic problem under consideration. Importantly, pathophysiology, epidemiology, and pathology are included when they assist in arriving at a definitive diagnosis or an understanding of the treatment of the diseases or condition. In many conditions, such as infection or neoplasm, it is extremely important to understand the pathophysiology because the disease may be encountered at various time points in the progression of the disease.

This edition of the Current Diagnosis and Treatment in Orthopedics is truly current.

The entire book has been updated in its references to include only those references since 2000, except in cases where classic articles are necessary to refer back to major advances in understanding or treatment, or in situations where there has been little change in the sub-specialization in orthopedics, such as rehabilitation. These selected references to the older literature represent landmarks in the advancement of the understanding of orthopedic diseases and conditions, and serve as useful sources of the fundamental basis for understanding these diseases and conditions.

INTENDED AUDIENCE

The unique format of the Lange series textbooks allows readers of many levels of understanding to derive benefit from the information.

Students will find that the book encompasses virtually all aspects of orthopedics that they will encounter in classes and as sub-interns in major teaching institutions. Residents and house officers can use the book as a ready reference covering the majority of disorders and conditions in emergency and elective orthopedic surgery. Despite its small size, it is truly comprehensive. Because of the organization of the book on a sub-specialty basis, review of individual chapters will provide house officers rotating on sub-specialty orthopedic services with an excellent basis for further in-depth study.

For emergency room physicians, especially those with medical backgrounds, the text provides an excellent resource in managing orthopedic problems seen on an emergent basis. Similarly, family practice, pediatricians, general practitioners, and internists will find the book particularly helpful in the referral decision process, and as a resource to explain disorders to patients. Finally, practicing orthopedic surgeons, particularly those in sub-specialties of orthopedics, will find the book a helpful resource in reassuring them that their treatment in areas outside their sub-specialty interest is current and up-to-date.

ORGANIZATION

The book is structured similarly to the structure of orthopedic surgery. Natural sub-specialization has occurred in orthopedic surgery over the years, which has resulted in some overlap in anatomic areas. This has resulted in the book having some overlap and some artificial division of subjects. Because of the primarily sub-specialization structure, the reader is encouraged to read entire chapters, or for more discrete topics, go directly to the index for information. For example, the house officer rotating on the pediatric orthopedic service would find reading the pediatric chapter to be a prudent method of developing a baseline knowledge in pediatric orthopedic surgery. Knee problems however, might be best approached by looking in the sports medicine chapter, or in the adult reconstruction chapter, since these areas overlap, mostly in age of patient.

The first chapter serves as a basis for the rest of the book because it summarizes current basic information that is fundamental in the understanding of orthopedic surgery. Chapter Two introduces aspects of interest in the perioperative care of the orthopedic patient, including social aspects of the patient/physician relationship. Management of orthopedic problems arising from trauma is covered in Chapter Three, while Chapter Four deals with sports medicine with an emphasis on the knee and shoulder. Chapter Five covers all aspects of spine surgery, including degenerative spinal problems, spinal deformity, and spinal trauma.

Chapter Six provides comprehensive coverage of tumors in orthopedic surgery, including benign and malignant soft tissue and hard tissue tumors. Adult joint reconstruction, including the disorders that lead to joint reconstruction are covered in Chapter Seven. In Chapter Eight, infections, with their special implications for orthopedic surgery are covered. Chapter Nine discusses foot and ankle surgery, and Chapter Ten, hand surgery. Chapter Eleven covers diseases in orthopedics unique to children. The final two chapters deal with amputation and all aspects of rehabilitation fundamental to orthopedic surgeons in returning patients to full function.

OUTSTANDING FEATURES

  • Illustrations have been carefully selected to maximize their benefits in pointing out orthopedic principles and concepts. The effect of changes in imaging technology on optimal diagnostic studies is emphasized, including cost-effectiveness.
  • Bone and soft tissue tumor differential diagnoses are simplified by comprehensive tables that categorize tumors by age, location, and imaging characteristics. The molecular basis of the current understanding of tumor etiology is expanded.
  • Concise, current, and comprehensive treatment of the basic sciences underlying the understanding of orthopedic surgery is provided.

NEW TO THIS EDITION

  • Information on shoulder evaluation has been widely expanded, including tables to elucidate the diagnosis of shoulder problems.
  • Advances in treatment of back pain, including disk replacement, are included.
  • The latest on molecular biology of neoplasm has been expanded in the musculoskeletal tumor section.
  • Surgical management of osteoporosis, including techniques such as kyphoplasty and vertebroplasty, and information on shoulder replacement have been widely expanded.
  • Guidelines for predicting function, such as ambulatory capability after spinal cord injury, are updated.
  • New materials in orthopedics that are making changes in the way replacement arthroplasty is performed are included.
  • The latest information on important growth factors in orthopedics is elucidated with current usage.

I am pleased to be able to say, with the concurrence of my co-authors, that these new features added to the information in the previous edition, make this edition a significant improvement over the last.

Harry B. Skinner, MD, PhD

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