“AO Principles of Fracture Management” has lived up to the expectations of trauma surgeons and the third edition was an eagerly anticipated publication. It has two volumes, the first of which deals with the general principles of fracture care and the second with specific fractures.
The first volume describes brief description of the AO philosophy, starting from the origin of AO to its evolution over time. The biology and biomechanics of fracture healing are discussed in a simple but fairly comprehensive manner. The chapters on implant technology, and recent modifications to the comprehensive fracture and soft tissue injury classifications are very informative. The illustrations are excellent and there are also online links to very helpful short videos wherever needed.
The next section is contributed to decision making and planning of fracture management. It deals with the various factors to be taken into account in the decision making, and the different principles in the management of articular and diaphyseal fractures. The fracture reductions, the techniques and approaches used for fracture reduction and fixation are described as separate section. The principles of minimally invasive fracture fixation, techniques for obtaining relative stability and absolute stability and the indications for the same are discussed. There is also a chapter dealing with locked plates and the use of locking head screws and how this has changed fracture management in recent times.
The section on “General topics” deals with pathophysiology and management principles of polytrauma, principles of management of open fractures and soft tissue injuries. The various possible soft tissue reconstructions and their indications are discussed in greater detail. The chapter on Paediatric fractures includes the different nature of fracture in children, the recent developments as well as the techniques and implants used in treating these fractures. There are also chapters on the rationale of the use of prophylactic antibiotics, venous thrombo-embolism prophylaxis, and postoperative care and rehabilitation. The chapter on the management of fragility fractures and Orthogeriatrics, which are growing field and on imaging in orthopedic trauma and radiation hazards are essential for trauma surgeons. The last section of this volume deals with complications such as infections, nonunions and malunions.
The second volume deals with specific fractures. It starts with the upper limb and includes all the regions starting with the scapula and shoulder girdle to the hand and deals with practical aspects of management of these fractures. The lower limb sections starts with the pelvis and acetabulum and goes down to the foot and ankle.
Each fracture/clinical condition is described in a format which includes epidemiology, anatomy and classification, radiology, indications of surgery, implant selection, operating room set up, surgical approaches, reduction techniques and internal fixation, complex fracture patterns, assessment of reduction and fixation, postoperative management and rehabilitation, early and late complications, prognosis and outcome. This pattern is maintained consistently throughout the book. Each part of the chapter is inclusive of line diagrams depicting fracture classification, vascular anatomy, surgical set up for particular fracture in the operating room, incision and exposure. The sequential X-rays also show the outcome of treatment. This all made the understanding of each fracture very easy.
The illustrations in this book are outstanding with excellent links to the online videos. The chapters are written by trauma surgeons from all regions of the world that are well recognized in their fields. Although there are multiple authors involved from all round the world, the editors have done an excellent job in threading all the sections together in a coherent fashion. It should have a place in every medical library and it is a must have for all trauma surgeons.