Traumatology and orthopedics is a branch of medical science and practice that remains extremely important throughout the history of mankind. Archaeological finds and preserved written sources of antiquity are the evidence of the treatment of injuries. In the modern world, unfortunately, there is a tendency towards the increase of frequency of traumatism, which is due to a number of factors (natural disasters, wars, transport and industrial accidents, etc.). Furthermore, the increase of the average age of the population caused an increase in the frequency of specific "senile" injuries and diseases.
Nowadays, traumatology and orthopedics are developing at a rapid pace. Only in the second half of the 20th century, the technologies, which radically changed the approaches to the diagnosis and management of patients with injuries and diseases of the musculoskeletal system, emerged and were introduced into practice.
Highly informative non-invasive methods of visualization (ultrasound diagnostics, computed and magnetic resonance imaging) gained widespread use. The capabilities of these diagnostic techniques have largely changed the understanding of a number of pathological processes in bones, joints, soft tissues; contributed to the identification of previously latent pathologies in the early stages. For many diagnostic protocols, these studies are now mandatory.
A new "osteosynthesis ideology" has emerged and gained widespread recognition, based on the principles of preserving the blood supply to the bone, stable fixation and early functional loading. To implement such approaches, a whole generation of fixation devices has been created and methods of their installation have been developed. New opportunities have led to a significant expansion of indications for the surgical method of treatment as the most effective for the majority of injuries.
The use of endoscopic surgery created a huge field of opportunities, creating a whole direction in traumatology and orthopedics as a result. Arthroscopy, a surgical technology that allows performing a wide range of minimally invasive interventions on joints and periarticular structures, has become the "gold standard" of modern orthopedics in the treatment of a number of diseases and consequences of trauma.
Joint arthroplasty gained widespread use; such operations are now routine in orthopedic departments. The surgical technique continues to improve, the accessibility and safety of surgeries increases and improved versions of the designs of endoprostheses are being developed. The latest promising achievement in this direction became the use of an active robotic system, which permits installing an endoprosthesis with absolute, pre-programmed accuracy.
Greatest hopes are pinned on actively developing regenerative medicine in recent years, which aims to restore damaged or diseased tissues (articular cartilage, tendons, and bones). The first steps in that direction have been quite successful, but there is a long way ahead with hopeful prospects.
But this manual is not at all about these recent achievements, although they are somehow reflected in its pages.
What is the manual about? What should a general physician know, who is not going to redirect their professional activity to traumatology and orthopedics? It is unlikely that a physician of another specialty will need to master the technique of arthroscopy or endoprosthetics or to be an expert in the magnetic resonance imaging of the dorsal spine and joints and perform bone grafting.
The main task of the manual consists of teaching the reader the basics of diagnosing injuries and diseases of the musculoskeletal system, timely recognition of orthopedic deformities, standard protocols for examining orthopedic and trauma patients, principles of providing emergency and urgent medical care to surgical patients, and prevention of complications.
In the period of total enthusiasm for surgical methods, even traumatologists sometimes consider the knowledge of conservative methods for treating injuries to be something optional, and the methods themselves - outdated and mostly lost their relevance. But that isn't true. Without the knowledge of conservative methods of treatment, a physician, in case when the surgical treatment is impossible for a number of objective reasons, becomes absolutely helpless even in those situations, in which his predecessors who worked in the middle of the 20th century achieved good results with the help of skeletal traction, closed repositions, and plaster casts. Moreover, such knowledge is necessary for a general practitioner who in certain conditions does not always has the opportunity to refer a patient to a specialist in a timely manner.
The authors, relying on the modern achievements of world and domestic traumatology and orthopedics, as well as their own experience of practical work and teaching, tried to make this textbook not only informative and useful, but also interesting for the future physician.
Reviews and suggestions will be accepted by the authors with gratitude.