WHATʼS NEW IN ORTHOPAEDIC TRAUMA

The evaluation and treatment of musculoskeletal injuries, including fractures and dislocations, is the foundation of the specialty of orthopaedic surgery. Virtually every subspecialty deals with fractures and their sequelae. There are many areas of consensus and areas of controversy among the various subspecialties with regard to the appropriate management of fractures. Although most surgeons recognize the key role that soft tissues play in fracture-healing, classic teaching has emphasized the need to achieve maximal stability of bone during fracture fixation, often at the expense of the soft tissues. As our understanding of the biology and mechanics of fracture repair and stabilization improves, the interest in less invasive surgical approaches for fracture fixation is accelerating. Indirect reduction techniques have been developed in an attempt to preserve the blood supply to the injured bone, to improve the rate of fracture-healing, to decrease the need for bone-grafting, and to lower the incidence of infection. This article reviews recent advances in fracture care, emphasizing, when possible, the functional outcomes of treatment as determined with the use of limb-specific outcome measures and the physical function components of general health-status instruments. The article is designed to serve as a primary source for update and review for practicing orthopaedic surgeons who wish to stay current in the rapidly evolving field of orthopaedic traumatology. Information presented at the 2000 Annual Meeting of the Orthopaedic Trauma Association and the 2001 Annual Meeting of the American Academy of Orthopaedic Surgeons is reviewed. In addition, issues of The Journal of Bone and Joint Surgery and the Journal of Orthopaedic Trauma from March 2000 through March 2001 have been reviewed, and their contributions to orthopaedic traumatology will be summarized. Selected contributions from Clinical Orthopaedics and Related Research, the Journal of Trauma, and the Journal of the American Academy of Orthopaedic Surgeons are also …