In the last decade, there has been explosion of thinking and interests in the management of fractures. The standard large textbooks dealing with trauma have gradually become reference books, in which a consultant may or may not find his solutions, but the students at large get lost in it. Today the young surgeons, who are trained where operative fixation of fractures was the norm, are inclined to look down upon these whose first choice of treatment is non-operative, and the later in turn feel that the “always operate” merchants do so because fixation is profitable and fun. Indeed, who can deny the joy of using skilled hands effectively. However, a well-trained trauma surgeon must have a balanced view. Freehand techniques of surgeons have been mostly replaced by mechanical jigs and cutting blocks. Operative exposures are being confined to the peep holes of endoscopy. Intraoperative imaging has become ‘a must’ guide in the fracture surgery. No doubt with extended rehearsed learning curve each has helped in refinement of the surgical techniques. In quest of further improving the technique, the expensive sophisticated computer-assisted orthopaedic surgery (CAOS) has been introduced, where a digital image of a particular surgical procedure is produced to guide the surgeon as a map. Surgical instruments can be incorporated into the map, so that their position, placement and progress can be monitored and controlled to an accuracy of fractions of a millimetre or degree—almost like instrumented landing of an aircraft or driving a car using a ground-positioned satellite system. However, the introduction of the highly expensive computer navigated systems and the ‘robotics’ have not yet emerged out by controversies with a big question mark on their general utility. Knowledge—an amalgam of theory and practice—comes from healthy balance of reading, listening, seeing and proper practice. In preparing the second edition, the author have tried to acquaint the readers with the global advancements in trauma care with their possible utility in the tropical countries. Care has been taken to caution the surgeons to keep in mind the traditional and social customs and values in managing the particular patients, especially those of rural background and elderly ones. Advancements are of value, only when they satisfy our patients A to Z as far as possible. Remember—in the fracture treatment surgeons fail much more than the ‘osteoblasts’.

• Publisher: Jaypee Brothers Medical Publishers (January 1, 2011)
• Language: English
• ISBN: 9788184489910