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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 The "ER doc" has rapidly been replaced by a new physician who practices only emergency medicine.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? Current fracture classifications are directed more toward the orthopedic surgeon and are not presented in a format that the nonspecialist can use quickly and easily. This text categorizes fractures according to degree of complexity, treatment modality, and prognosis—a system much more relevant to the emergency physician.

This sixth edition represents a major rewriting of the text, including a new section on the spine. In addition to new figures and radiographs, this edition features full color clinical photographs and colored figures. This edition also marks the first time that video is used to further demonstrate emergency orthopedic principles. Over 60 videos demonstrating examinations, injections, arthrocentesis, and reduction techniques are available on the accompanying DVD as well as the online version of the book.

A fracture index is presented at the front of the book and continues to be a unique feature of the book. 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.

Part II includes four new 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. Major revisions with many more detailed step-by-step illustrations have been added to the sixth edition. References to the Appendix are made throughout the text.

In addition, the reader will find axioms—major statements that serve as guidelines to prevent the misdiagnosis of a particular problem. The axioms should be regarded as rules by which the emergency physician should practice.

There are a number of areas in orthopedics where treatment programs differ and legitimate controversy over some therapeutic modalities exists. In most cases, the authors have tried to present the various types of treatment for a particular injury. The author's preferred method of treatment is presented, however, to facilitate a plan of action for the patient. In cases where significant controversy exists, the authors advise referral or consultation with the orthopedic surgeon.

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