Preface

“A multitude of texts and publications currently exist directed at the “ER doc.” The “ER doc” has rapidly been replaced by a new physician who practices only emergency medicine. No current orthopedics text is directed at this physician. As emergency medicine has developed, there must evolve a cooperative relationship between the orthopedic surgeon and the “emergentologist” based on acknowledging the experience and expertise of one another to make prudent decisions and to recognize areas beyond the limitations of each practitioner. It is this spirit that permeates this text.

Currently available publications can be divided into two groups: those that are directed to the orthopedic surgeon and those that, although supposedly directed toward a more advanced audience, are in reality directed to the junior medical student. When one considers that disorders and injuries to the extremities compose more than 50% of what the emergency physician will see and that, initially, he or she will see more acute injuries than will the orthopedic surgeon, can it be acceptable to give only bits of information rather than the full range of mechanism of injury, treatment, associated injuries, and complications of a particular fracture or injury?”

Orthopedics in Emergency Medicine, 1st Edition, 1982

More than 30 years later, this quote makes me marvel at the accomplishments of our specialty, and at the same time, believe that there is work left to be done. This seventh edition represents the first time that individual authors have contributed to every chapter. Their insights have added significantly to the quality of the material within these pages. Other additions include new clinical photos, radiographs, and videos. As in previous edition, a fracture index is presented at the front of the book and continues to be a unique feature. The emergentologist can look at figures of a fractured bone, select which one the patient has, and refer directly to the page where everything pertinent about that particular fracture is described.

The body of the text is divided into four parts: Part I. Orthopedic Principles and Management, Part II. Spine, Part III. Upper Extremities, and Part IV. Lower Extremities. Part I includes chapters on general principles, including emergency splinting, the selection of definitive treatment, and indications for operative treatment. In addition, analgesia, rheumatology, complications, special imaging techniques, and pediatrics are discussed. Chapter 5, Special Imaging Techniques has been significantly revised to include much more musculoskeletal ultrasound, a growing area of practice. Part II includes four chapters on the spine. Part III, on the upper extremities, includes six chapters: hand, wrist, forearm, elbow, arm, and shoulder. Part III on the lower extremities includes chapters on the pelvis, hip, thigh, knee, leg, ankle, and foot. Each chapter is organized so that fractures are covered first, followed by a discussion of soft-tissue injuries. We present a detailed discussion of each type of fracture, including, where appropriate, essential anatomy, mechanism of injury, examination, imaging, associated injuries, and treatment.

The Appendix describes and illustrates the steps involved in placing a particular type of splint or cast. Videos have been added to this addition to help illustrate the proper splinting techniques. References to the Appendix are made throughout the text.