Preface

This Current Diagnosis and Treatment in Orthopedics is the sixth edition of the Orthopedic Surgery contribution to the Lange Current series of books. Much has changed in orthopedics since the first edition came out, but 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 clinicians. The format in this edition is unchanged from the previous edition: there is emphasis on the major diagnostic features of disease states, the natural history of the disease where appropriate, the workup required for definitive diagnosis, and finally, definitive treatment. The book focuses on orthopedic conditions, deemphasizing 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 disease 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 Current Diagnosis and Treatment in Orthopedics is truly current. The entire book has been updated, including the references, which are recent except when classic articles are necessary to refer back to major advances in understanding or treatment. These selected older references represent landmarks in understanding orthopedic diseases and conditions.

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 subinterns 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 subspecialty basis, review of individual chapters will provide house officers rotating on subspecialty 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 practitioners, pediatricians, general practitioners, internists, physical therapists, and athletic trainers 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 subspecialties of orthopedics, will find the book a helpful resource in reassuring them that their treatment in areas outside their subspecialty interest is current and up-to-date.

The book is structured similarly to the structure of orthopedic surgery. Natural subspecialization 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 subspecialization 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 introduces aspects of interest in the perioperative care of the orthopedic patient, including social aspects of the patient-physician relationship, and is an outgrowth of the importance of outcomes in orthopedics. Management of orthopedic problems arising from trauma is covered in Chapter 2. New to this edition, because the field of sports medicine has grown so large, we have split this topic into two chapters: Chapters 3 focuses on the upper extremity and Chapter 4 on the lower extremity. Chapter 5 covers all aspects of spine surgery, including infection of the spine, degenerative spinal problems, spinal deformity, and spinal trauma.

Chapter 6 provides comprehensive coverage of tumors in orthopedic surgery, including benign and malignant soft-tissue and hard-tissue tumors. Also new to this edition, because there is so much more information, Chapter 7 on arthritis and joint preservation surgery has been split off from Chapter 8 on adult joint reconstruction. In Chapter 9, infections, with their special implications for orthopedic surgery, are covered. Chapter 10 discusses foot and ankle surgery, and Chapter 11, hand surgery. Chapter 12 covers diseases in orthopedics unique to children. The final chapter, Chapter 13, deals with amputation and all aspects of rehabilitation fundamental to orthopedic surgeons in returning patients to full function.

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.

Disorders and conditions are explained by diagnoses, and the essentials of diagnosis are listed when helpful. Nonoperative and operative treatments are discussed, as well as the indications for surgery.

Concise, current, and comprehensive treatment of the basic sciences underlying the understanding of orthopedic surgery is provided in individual chapters, where pertinent.

• Sports medicine has been expanded so that there are now separate chapters on the upper and lower extremity.

• Advances in treatment of back pain, including disk replacement, are included, along with the latest information on reverse shoulder replacement.

• The musculoskeletal tumor chapter includes the latest on molecular biology of neoplasms.

• New materials in orthopedics that are making changes in the way replacement arthroplasty is performed are included.

• The chapter on adult joint reconstruction has been reformatted, and the information on arthritis and joint preservation surgery has been given its own chapter including much on hip conditions amenable to arthroscopic treatments.

• The latest information on important growth factors in orthopedics is elucidated with their current usage.

We are pleased to be able to say, with the concurrence of our coauthors, that these new features added to the information in the previous edition make this edition a significant improvement over the last.