Preface to the English Edition
C. Colton

The "Atlas of Internal Fixation" by Rafael Orozco and his colleagues will stand as monument to surgical discipline in several ways.

Firstly, it is dedicated to the professional life of Professor Maurice Müller, who has for many decades inspired surgeons, young and old, to submit themselves to the disciplines of accurate fracture classification, meticulous pre-operative planning and immaculate surgical technique. Those of us who have had the privilege of being taught by this master of the surgical art shall never forget his insistence upon precision and biological respect.

The authors, in their turn, show us in these writings much of the importance of discipline. They record in great detail a large number of cases of skeletal injury treated by osteosynthesis. The fact that they had access to such a volume of clinical data is the testament to the clinical documentation of the classification of the fractures, the surgical techniques used and their outcome. This required the discipline of structured audit.

The authors demonstrate over and over again their careful adherence to the surgical discipline of a sound biomechanical basis for their interventions, a precision of technique attainable only through deep personal commitment to deliver to the patient the best achievable standards of care and a personal involvement in promoting the highest possible aspirations. Without immense personal discipline, they would have stumbled along the way.

Finally, for the authors to take years to assemble, collate and present in such attractive format this moun-tain of data, would not have been possible if this thread of discipline had not been woven into the fabric of their professional dedication.

There will be those reading this text who will feel that the surgical principles employed may have been somewhat overtaken by more modern concepts of “biological osteosynthesis”. The success of the authors in achieving excellent outcomes indicates clearly that, whilst they followed carefully the early teachings of the A O group in terms of mechanical concepts of internal fixation, they have both instinctively and deliberately observed the biological status of the fracture locus. Although this tends to be emphasised in a more structured manner these days, it has always been of paramount concern for the skilled and disciplined fracture surgeon, long before its formalisation as a “modern” concept.

For these reasons, and many more beyond the scope of a brief preface, I commend this superb work to the trauma community as an example of surgical discipline. Surgery is not a science, it is a scientific art. Any artist, however, must work with the chosen material in manner dictated by the characterisitics of that material - and he or she must do so with discipline. The carpenter who does not discipline himself with the grain of the wood will never produce a single satisfactory piece. The sculptor who does not understand the nuances of the grain of his marble, will never achieve the form desired, and the gardener who fails to observe the discipline of understanding his soil and his plants, will produce little short of a desert!

Therefore, by the same token, the surgeon who does not submit to the disciplines of the surgical art and the needs of the biological material will founder. Let this work stand as a shining example to the young surgical world of those disciplines which will always remain the sine qua non of our chosen profession.

Former President of the AO/ASIF Foundation