Trauma Section

We have four interesting orthopedic trauma topics for the current issue of the Orthopedic Clinics of North America . Damage control orthopedics has gained popularity, although is a term that is often misused. Furthermore, identifying who needs to be treated with initial external fixation of the femur can be confusing, and most centers cannot check biomarkers such as IL-6 levels readily. Drs D’Alleyrand and O’Toole review the current evidence and practical applications of damage control theory. I am particularly in favor of the term they have named this, “Early Appropriate Care.”

Many surgeons tend to be conservative with allowing weight-bearing after treatment of periarticular fractures, but with very little evidence to support their practice. Dr Kubiak and colleagues have reviewed this topic and present the available evidence on when we can allow our patients to weight-bear safely.

Talus fractures continue to be challenging injuries from a technical standpoint. Unfamiliar surgical approaches are often utilized and surgical strategies for achieving satisfactory outcomes are also not widely understood. Drs Shakked and Tejwani give an in-depth review of the surgical treatment of talus fractures in this volume.

Fractures from gun-related violence continue to be a regular phenomenon in our urban trauma centers. Many orthopedic surgeons often ask me what the basic principles are of management of these injuries, and what the evidence is behind our practice. Dr Tosti has done a fine job reviewing this topic, which rounds out this volume.

I hope you enjoy this particular issue!

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