Download Surgery Science and Industry PDF free

Download Surgery Science and Industry PDF free

nterdependent collaboration between clinical medicine, laboratory science and industry is an increasingly prominent feature of post-World War II health care. The AO, an abbreviation originally standing for the Swiss Arbeitsgemeinschaft für Osteosynthesefragen founded in 1958, that is, the Association for the Study of Internal Fixation of Fractures (ASIF) as this worldwide organisation is now termed, seems to fit this development. From around 1960, the AO promoted the systematically organised treatment of a great variety of fractures with its own industrially produced and marketed plates, screws and instruments. Today, the AO system represents a sort of international gold standard. Albeit not new in the 1950s, many variants of such treatments before the AO had more often than not been considered as being a haphazard ‘injury superaddit to an injury’. Thus, the obvious questions are: How, where and why did this true revolution in fracture care come about? Was it ubiquitous and simultaneous? How is it to be explained in personal biographical, sociocultural and even political perspectives? How were unavoidable errors and opposition dealt with? Deeply rooted in their cultural soil, the less than half a dozen founders certainly had far-reaching visions; they also had complementary capabilities which made them strong as an association, and they were altruistically generous in financial matters. Yet, is this sufficient to explain the AO as a mutual win–win merger for surgical practitioners, laboratory scientists and producers alike for the benefit of patients? Are there similarities with developments in other (medical) fields? What are, in brief, the general and specific reasons for the AO’s incontestable success? These historical questions and answers have a bearing for our current and future practices. Thus, reading the AO’s history, chapter after chapter, as written by a young historian, is an exciting privilege for one who has known, as I have, the AO’s first 25 years fairly well from personal experiences as a student, scientist – and patient. When the truly engaging author opens new vistas, describes and analyses entire pictures, and solves some of the riddles involving the past 15 years of AO history, he is constantly leading one to understand its benevolent founders, their successors, and indeed parts of one’s own life, in an often unexpected context. At last, the changes that have transpired in medical culture over the past 40 years become tangible. A core issue is the evidence deemed sufficient to warrant changes: What criteria were needed for an innovation to be considered ‘better’ than a timehonoured treatment – and by whom? The answers are at times surprising. What makes for fascinating reading immediately raises further questions as viii to whether or in what respect our contemporary criteria are different, and, if (not) so, why. Two examples: the highly lauded physiological and pathophysiological concepts of bone formation and repair emerge to have played the role of satisfying the academic need for scientifically explaining the empirical success of osteosynthesis ex post rather than as a basis for specific techniques. And with all the clinical, statistical and laboratory evidence at hand to show and explain the excellent chance-to-risk ratio of operative fracture treatment, its success in daily practice has depended on human factors: the personal contact with colleagues, motivating and to some extent even controlling them within ‘the AO family’, and, above all, the trustworthiness of its protagonists have been essential. Such personal qualities and seemingly old-fashioned virtues are, those with surgery, science and industry careers should bear in mind, indispensable complements to the quest for naked, quantified, objective standards; a pursuit that is rightly stressed in our times. Indeed, the book makes its case on how the AO used both facts and virtues to cope with its own success and the partly self-induced developments in this emerging trilateral field. It is certainly worth reflecting upon whether this model might work in the future and elsewhere. Well founded standards are to be strived for, certainly, in surgery as well as in history, but they are not enough to make patients – or readers – happy. Thanks to both his professional skills as a historian and his empathy when treating the apparently hitherto unique AO phenomenon, Thomas Schlich will succeed in making many readers and, perhaps, via the surgeons amongst them, many a patient happy

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