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Creative Fractures
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Book Synopsis Creative Fractures by : M.D. Litonjua
Download or read book Creative Fractures written by M.D. Litonjua and published by AuthorHouse. This book was released on 2011-02-01 with total page 353 pages. Available in PDF, EPUB and Kindle. Book excerpt: The world is one of increasing diversity and pluralism. Our world is one of the different and of the many. Even the individual personality and the social self are increasingly diverse and plural. This is especially evident in racial and ethnic identities. The Ohioan, the New Yorker, the Texan, all became, after the cauldron of the Civil War, the American. Now the American is continually being hyphenated: Native-American, African-American, Latino-American, Asian-American, and a host of other hyphens. In the academy, the dichotomy between the fox who knows many things, and the hedgehog who knows one big thing (Archilocus), is giving way to different combinations and variations of learning, teaching, and expertise, as demanded by and reflecting the diversity and complexity of society and world. While these differences and pluralisms can lead to fragmentation, these fractures can also be creative. The ethnically hyphenated person who straddles two cultures need not be marginal to both, but can use the riches of his/her diverse experiences to cross-fertilize the cultures of which they are now part and parcel. The other, the different, especially the poor, must not be marginalized, pushed to the margins of society as outcasts; they need to be empowered for their betterment and for the common good of society. The academic, well-versed in several disciplines, should not be considered master of none, but can bring the insights of one discipline to tame the fundamentalism of another discipline and to expand the horizons of all. In one form or another, to a greater or lesser extent, this is what I have tried to do in the essays gathered in this second collection, the first being Critical Intersections (2006).
Book Synopsis Fragility Fracture Nursing by : Karen Hertz
Download or read book Fragility Fracture Nursing written by Karen Hertz and published by Springer. This book was released on 2018-06-15 with total page 169 pages. Available in PDF, EPUB and Kindle. Book excerpt: This open access book aims to provide a comprehensive but practical overview of the knowledge required for the assessment and management of the older adult with or at risk of fragility fracture. It considers this from the perspectives of all of the settings in which this group of patients receive nursing care. Globally, a fragility fracture is estimated to occur every 3 seconds. This amounts to 25 000 fractures per day or 9 million per year. The financial costs are reported to be: 32 billion EUR per year in Europe and 20 billon USD in the United States. As the population of China ages, the cost of hip fracture care there is likely to reach 1.25 billion USD by 2020 and 265 billion by 2050 (International Osteoporosis Foundation 2016). Consequently, the need for nursing for patients with fragility fracture across the world is immense. Fragility fracture is one of the foremost challenges for health care providers, and the impact of each one of those expected 9 million hip fractures is significant pain, disability, reduced quality of life, loss of independence and decreased life expectancy. There is a need for coordinated, multi-disciplinary models of care for secondary fracture prevention based on the increasing evidence that such models make a difference. There is also a need to promote and facilitate high quality, evidence-based effective care to those who suffer a fragility fracture with a focus on the best outcomes for recovery, rehabilitation and secondary prevention of further fracture. The care community has to understand better the experience of fragility fracture from the perspective of the patient so that direct improvements in care can be based on the perspectives of the users. This book supports these needs by providing a comprehensive approach to nursing practice in fragility fracture care.
Download or read book Orthogeriatrics written by Paolo Falaschi and published by Springer Nature. This book was released on 2021 with total page 355 pages. Available in PDF, EPUB and Kindle. Book excerpt: This new open access edition supported by the Fragility Fracture Network aims at giving the widest possible dissemination on fragility fracture (especially hip fracture) management and notably in countries where this expertise is sorely needed. It has been extensively revised and updated by the experts of this network to provide a unique and reliable content in one single volume. Throughout the book, attention is given to the difficult question of how to provide best practice in countries where the discipline of geriatric medicine is not well established and resources for secondary prevention are scarce. The revised and updated chapters on the epidemiology of hip fractures, osteoporosis, sarcopenia, surgery, anaesthesia, medical management of frailty, peri-operative complications, rehabilitation and nursing are supplemented by six new chapters. These include an overview of the multidisciplinary approach to fragility fractures and new contributions on pre-hospital care, treatment in the emergency room, falls prevention, nutrition and systems for audit. The reader will have an exhaustive overview and will gain essential, practical knowledge on how best to manage fractures in elderly patients and how to develop clinical systems that do so reliably.
Book Synopsis Anatomy and Physiology by : J. Gordon Betts
Download or read book Anatomy and Physiology written by J. Gordon Betts and published by . This book was released on 2013-04-25 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Oral and Maxillofacial Surgery for the Clinician by : Krishnamurthy Bonanthaya
Download or read book Oral and Maxillofacial Surgery for the Clinician written by Krishnamurthy Bonanthaya and published by Springer Nature. This book was released on 2021 with total page 1965 pages. Available in PDF, EPUB and Kindle. Book excerpt: This is an open access book with CC BY 4.0 license. This comprehensive open access textbook provides a comprehensive coverage of principles and practice of oral and maxillofacial surgery. With a range of topics starting from routine dentoalveolar surgery to advanced and complex surgical procedures, this volume is a meaningful combination of text and illustrations including clinical photos, radiographs, and videos. It provides guidance on evidence-based practices in context to existing protocols, guidelines and recommendations to help readers deal with most clinical scenarios in their daily surgical work. This multidisciplinary textbook is meant for postgraduate trainees, young practicing oral surgeons and experienced clinicians, as well as those preparing for university and board certification exams. It also aids in decision-making, the implementation of treatment plans and the management of complications that may arise. This book is an initiative of Association of Oral and Maxillofacial Surgeons of India (AOMSI) to its commitment to academic medicine. As part of this commitment, this textbook is in open access to help ensure widest possible dissemination to readers across the world. ; Open access Unique presentation with contents divided into color-coded core competency gradations Covers all aspects of oral and maxillofacial surgery Supplemented with videos of all commonly carried out procedures as operative video Every chapter or topic concludes with "future perspective" and addresses cutting edge advances in each area Every topic has a pull out box that provides the most relevant systematic reviews/ key articles to every topic.
Book Synopsis Distal Radius Fractures by : Geert Alexander Buijze
Download or read book Distal Radius Fractures written by Geert Alexander Buijze and published by Elsevier Health Sciences. This book was released on 2021-02-23 with total page 458 pages. Available in PDF, EPUB and Kindle. Book excerpt: Edited and authored by leading international experts, Distal Radius Fractures: Evidence-Based Management provides a state-of-the-art overview of diagnosis and management based on today’s best practices. Each chapter focuses on one key issue, offering a challenging case and then questioning the reader in an engaging fashion to provide the best available evidence on each topic. Practical and easy to read, this innovative text is a useful resource for all residents, physicians and surgeons who manage fractures. Combines current best practices with the knowledge and experience of a global team of expert contributing authors, with a focus on practical use in applying the evidence. Covers need-to-know topics such as anatomy and biomechanics, diagnostic management, acute fracture management, management of pediatric and elderly fractures, and more. Includes valuable case scenarios, technical tips and tricks, and pearls and pitfalls. Features high-quality illustrations including CT scans, x-rays, and clinical photographs. Consolidates the latest evidence on distal radius fractures into one convenient resource.
Book Synopsis Bone Stress Injuries by : Adam S. Tenforde, MD
Download or read book Bone Stress Injuries written by Adam S. Tenforde, MD and published by Springer Publishing Company. This book was released on 2021-07-17 with total page 219 pages. Available in PDF, EPUB and Kindle. Book excerpt: “This book gives a nice summary of the current state of diagnosis, treatment, and prevention of bone stress injuries. It is particularly useful for sports medicine fellows and residents with an interest in athletes and active patients." ---Doody's Review Service, 3 stars Bone stress injuries are commonly seen in athletes and active individuals across a full spectrum of physical activity, age, and gender. While most overuse injuries can be addressed through non-operative care, injuries may progress to full fractures that require surgery if misdiagnosed or not correctly managed. Written by leaders in sports medicine including physical medicine and rehabilitation, orthopaedics, endocrinology and allied health professionals of biomechanics, physical therapy and dietetics, Bone Stress Injuries offers state-of-the-art guidelines and up-to-date science and terminology to practitioners. Using a holistic approach to understand the management of bone stress injuries, this book highlights specific considerations by injury, gender, and risk factor to ensure that a comprehensive treatment plan can be developed to optimize bone health, neuromuscular re-education, gait mechanics, and injury prevention. Organized into four parts, opening chapters cover the general need-to-know topics, including clinical history, imaging, and risk factors including biological and biomechanical factors. The book proceeds anatomically through the body from upper extremity to foot and ankle injuries, with each chapter underscoring diagnostic and treatment strategies specific to that region. Chapters dedicated to special populations discuss the differences in injury evaluation and management according to age, gender, and military background. Final chapters review the prevention of injuries and examine both common and novel treatment strategies, such as medications, nutrition, gait retraining, orthobiologics, and other interventions. Invaluable in its scope and approach, Bone Stress Injuries is the go-to resource for sports medicine physicians, physiatrists, and primary care providers who manage the care of athletes and individuals leading active lifestyles. Key Features: Promotes evidence-based practice for diagnosis, treatment, and prevention of bone stress injuries Covers specific anatomy that is prone to bone stress injuries with dedicated chapters on upper and lower extremities, pelvis and hip, spine, and foot and ankle Considers evaluation and management differences according to specific populations of pediatric, male, female, and military personnel Discusses emerging strategies to treat bone stress injuries, such as gait retraining, orthobiologics, and other non-pharmacological treatments
Book Synopsis Fractured Scenes by : Damien Charrieras
Download or read book Fractured Scenes written by Damien Charrieras and published by Springer Nature. This book was released on 2021-03-29 with total page 274 pages. Available in PDF, EPUB and Kindle. Book excerpt: Fractured Scenes is the first extensive academic account of music and sound art practices that fall outside of the scope of ‘mainstream music’ in Hong Kong. It combines academic essays with original interviews conducted with prominent Hong Kong underground/independent musicians and sound artists as well as first hand-accounts by key local scene actors in order to survey genres such as experimental/noise music, deconstructed electronic music, indie-pop, punk, garage rock, sound art and DIY ‘computer’ music (among others). It examines these Hong Kong underground music practices in relief with specific case studies in Mainland China and Japan to begin re-defining the notion of a ‘musical underground’ in the context of contemporary Hong Kong.
Book Synopsis Traumatic Dental Injuries by : Jens O. Andreasen
Download or read book Traumatic Dental Injuries written by Jens O. Andreasen and published by John Wiley & Sons. This book was released on 2011-10-07 with total page 100 pages. Available in PDF, EPUB and Kindle. Book excerpt: TRAUMATIC DENTAL INJURIES: A MANUAL The third edition of Traumatic Dental Injuries: A Manual builds on the widespread success of the previous two editions. The ultimate guide to dental trauma, the manual preserves its uniquely usable and reader-friendly format, demonstrating step-by-step treatment protocols for commonly occurring traumatic injuries. Several new sections have been added to expand the number of clinical scenarios, describing soft tissue injuries associated with dental trauma, showing how decoronation of ankylosed anterior teeth in adolescents can preserve the alveolar process for later implant placement, and identifying predictors for pulpal and periodontal ligament healing complications as well as for tooth loss. A unique feature of the new edition is the accompanying DVD which presents computer animations of all trauma scenarios, as well as links to the internet-based interactive Dental Trauma Guide to predict healing complications for individual trauma scenarios. KEY FEATURES Written by international authorities on dental trauma Demonstrates treatment protocols in a clear step-by-step format Illustrated throughout with high-quality color images and diagrams Includes more sections to expand number of clinical scenarios Accompanied by a new DVD of trauma scenario animations REVIEWS OF PREVIOUS EDITIONS The text is clear and well written and well referenced ... The chapters on diagnosis of periodontal and pulpal complications are particularly helpful as this is a difficult area for many clinicians. The manual will serve as an excellent reference for practitioners and dental students who have a good working knowledge of dental traumatology. Journal of Orthodontics Overall, this book is excellent and I believe would be an essential member of a dentist’s library. It is the sort of book that can be quickly read, and information and guidance can be located easily when the need arises. The price makes the book very affordable and I wholeheartedly recommend it as an essential reference source for the general dentist and dental student. Australian Endodontic Journal BY THE SAME AUTHORS Textbook and Color Atlas of Traumatic Injuries to the Teeth Fourth Edition Edited by J.O. Andreasen, F.M. Andreasen and L. Andersson ISBN 9781405129541 Oral and Maxillofacial Surgery Edited by L. Andersson, K.E. Kahnberg and M.A. Pogrel ISBN 9781405171199 DVD animations can be found by entering the ISBN at Booksupport.wiley.com
Book Synopsis Nutritional Aspects of Bone Health by : Susan A. New
Download or read book Nutritional Aspects of Bone Health written by Susan A. New and published by Royal Society of Chemistry. This book was released on 2003 with total page 774 pages. Available in PDF, EPUB and Kindle. Book excerpt: A review of the role of diet in the development and maintenance of bone health throughout the lifecycle and prevention of osteoporosis in later life, this reference includes key areas such as epidemiology, genetics and the impact of non-nutritional exogenous factors influencing the skeleton.
Author :Frances S. Waters, DCSW, LMSW, LMFT Publisher :Springer Publishing Company ISBN 13 :082619964X Total Pages :472 pages Book Rating :4.8/5 (261 download)
Book Synopsis Healing the Fractured Child by : Frances S. Waters, DCSW, LMSW, LMFT
Download or read book Healing the Fractured Child written by Frances S. Waters, DCSW, LMSW, LMFT and published by Springer Publishing Company. This book was released on 2016-03-28 with total page 472 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Anyone who works with troubled children and their families should not miss this book. Healing the Fractured Child weaves together comprehensive theory and neurobiology that substantiate practical treatment guidelines for children and their families. The complexity of symptoms, diagnoses, assessment, use of medication, and a variety of innovative treatment approaches for stabilization, trauma processing and integration are explored and come to life through the clear, practical and touching clinical illustrations peppered throughout the book. Fran Waters has drawn on her vast clinical experience and thorough knowledge of current perspectives on dissociation and child therapy to write an integrative, readable, and immensely useful masterpiece, a gift to the field of child psychology and psychotherapy and to the many therapists, children and parents who will benefit from her wisdom." --Pat Ogden PhD, Founder, Sensorimotor Psychotherapy Institute; Author, Sensorimotor Psychotherapy Interventions for Trauma and Attachment "A skillfully written, comprehensive and remarkable volume. Well-grounded in theory and full of rich, practical applications and detailed case examples. Water's outstanding work will expand clinicians' capacity to understand and assess dissociation as well as to effectively accompany children in their healing journeys. An essential resource for therapists of all orientations working with trauma and dissociation." Ana M. GÛmez, MC, LPC, Author of EMDR Therapy and Adjunct Approaches with Children: Complex Trauma, Attachment and Dissociation "Healing the Fractured Child" provides an invaluable source of information for all professionals and non-professionals interested in childhood dissociation. Based on her many years of experience in this field, Waters takes us from an explanation of dissociation and related theories to the behaviors which may be noticed by a parent, teacher or doctor, through the assessment quagmire and the challenges of parenting, to the important work of emotional regulation and the identification of self-states, bringing in consideration of where medication can or cannot assist and describing the hard work of trauma processing, to integration, possible relapse, and back again to even stronger internal integration. The intricately described clinical examples provide a plethora of ideas for working with these children and offer readers the encouragement and hope so important for working with children who experienced trauma. Sandra Wieland, Ph.D., R.Psych. Illuminates the most promising treatments available for dissociative children Written by one of the nation's leading practitioners in the field of childhood trauma, abuse, and dissociation, this comprehensive resource fills a void in the literature to provide in-depth knowledge of current interventions for treating dissociation in youth. It describes a detailed, careful assessment process and creative, evidence-supported techniques for helping children and their families to heal from chaotic, traumatizing experiences. With both a theoretical and practical focus, the book offers proven strategies for successfully treating children and adolescents with varying degrees of dissociation and co-morbid symptoms. It also integrates adjunct therapies in environments beyond those of traditional psychotherapy, such as school, and describes how their strategies can be used effectively to augment therapy and understand dissociative children. Based on a model integrating five prominent therapeutic modalities, and underscoring the importance of attachment style, the book focuses on the neurobiology of trauma, a high co-morbidity of symptoms, specialized clinical interventions, psychopharmacology, and family intervention techniques. Also addressed are adjunct therapies in art, and EMDR. In addition, the book provides a window into the effects of traumatic events such as medical illness that may be overlooked, and safe techniques with dissociative youth who are exhibiting dangerous behaviors. Rich clinical examples demonstrate the various phases of treatment and offer a window into the internal world of dissociative children. This resource provides mental health clinicians, and other health professionals with a wealth of tools to effectively treat this troubled client population. Key Features: Describes theoretical conceptualization and specialized integrative techniques to treat dissociative children effectively Integrates psychotherapy with EMDR, art therapy, neurobiology and psychopharmacology Distills current research on neurobiology of trauma and how to intervene with specially designed treatment strategies Provides in-depth knowledge of the latest creative interventions for treatment across degrees and ages of dissociation, and co-morbid symptoms Sensitizes the therapist to often overlooked traumatic events, e.g. medical illness, that can exacerbate symptoms
Book Synopsis Designing to Avoid Disaster by : Thomas Fisher
Download or read book Designing to Avoid Disaster written by Thomas Fisher and published by Routledge. This book was released on 2013 with total page 274 pages. Available in PDF, EPUB and Kindle. Book excerpt: Author Thomas Fisher introduces the idea of fracture-critical design and provides many solutions for how we can design to avoid major disasters.
Book Synopsis Pelvic Ring Fractures by : Axel Gänsslen
Download or read book Pelvic Ring Fractures written by Axel Gänsslen and published by Springer Nature. This book was released on 2020-11-25 with total page 622 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book provides in-depth coverage of all aspects of pelvic ring fractures and their management. The opening chapters supply essential information on surgical anatomy, biomechanics, classification, clinical evaluation, radiological diagnostics, and emergency and acute management. The various operative techniques, including navigation techniques, that have been established and standardized over the past two decades are then presented in a step-by-step approach. Readers will find guidance on surgical indications, choice of approaches, reduction and fixation strategies, complication management, and optimization of long-term results. Specific treatment concepts are described for age-specific fractures, including pediatric and geriatric injuries, and secondary reconstructions. Pelvic ring fractures represent challenging injuries, especially when they present with concomitant hemodynamic instability. This book will help trauma and orthopaedic surgeons at all levels of experience to achieve the primary treatment aim of anatomic restoration of the bony pelvis to preserve biomechanical stability and avoid malunion with resulting clinical impairments.
Download or read book The Creative Wound written by Mark Pierce and published by . This book was released on 2019-01-30 with total page 232 pages. Available in PDF, EPUB and Kindle. Book excerpt: An empathetic guide to recovering your creative soul. Combining heartfelt personal stories with inspirational and practical insights, Mark Pierce demonstrates how we can overcome artistic anxiety, find renewed creative courage, and produce meaningful work that matters. "Simple, powerful, and works like pure magic. I haven't read a book that shook me up this much since The War of Art by Steven Pressfield. The Creative Wound: Heal Your Broken Art is a must-read--and an essential tool--for creative people across the globe."- Lauren Sapala, author of Firefly Magic and The INFJ Writer As an artist, you put your heart into what you do. It's the seat of all your work. But if your creative heart breaks, you lose all expressive power. Deep down, you know if this damage would only heal then freedom of movement would return and you'd discover all that you are truly capable of. But how? This book explains: * Why your gift is desperately needed, especially as technology advances.* What understanding your story will reveal to your future creative self. * How to find inspiration when you're just not feeling it.* When daydreaming is your best productivity option.* How to own your own creativity and stop waiting for a big break.* The power of curiosity in living a truly creative life.* Effective ways to change course and find your true creative path. And that's just for starters... Praise for THE CREATIVE WOUND "A soothing balm for your creative battle scars, this is a book for anyone who feels they have more to bring to the world but suffer doubt, feel ashamed, or wildly over-think their creativity. It gently equips you to direct your life's art with purpose and perspective, rather than allowing the pain to write for you. Happy healing!" - Andy Mort, musician, writer, and creator of The Gentle Rebel Podcast The Creative Wound is a book that will help you take that vital look inside, and offers great wisdom and practical tips toward rebuilding your creative foundations in a stronger, more positive way." - Rick Jesse, Dogtooth brand & experience design TABLE OF CONTENTS PART ONE: WHY YOUR CREATIVE LIFE MATTERS * Why Make Art? * Where Does The Art Go? PART TWO: DEFINE & LOCATE YOUR CREATIVE WOUNDS * When Creativity Freezes * Creative Wound Stories * The Clues Hidden In Your Story PART THREE: HEAL YOUR CREATIVE WOUNDS * Interpreting Our Stories * Passion & Choice * Find Out Who You Are * Good Ground * Inspiration * Community * Forgiveness * Thankful Thursday * 168 Hours * Cognitive Junk Food * Date Nights & Deadlines * Don't Patronise Me, I'm Starving * Perfectionism & Play * Meet You In Melbourne * Finish Something * Conclusion An addition to the conversation on creativity and vulnerability, The Creative Wound offers perspectives on themes sure to be familiar to readers of Elizabeth Gilbert's Big Magic, Steven Pressfield's The War Of Art, and Rob Bell's How To Be Here. It's time to heal your broken art.
Download or read book Fractured Souls written by Desley Polmear and published by Xlibris Corporation. This book was released on 2021-11-24 with total page 299 pages. Available in PDF, EPUB and Kindle. Book excerpt: Miriam O’Connor’s father was a hot head and it got him into trouble. She adored him and wondered for years why he abandoned her and her six year old twin siblings after their mother died on her 13th birthday. Where was he? Does he ever think of the family he left behind? Was he still alive? Despite the early set-backs, Miriam made a good, successful life for herself after her Aunt Daisy took in the trio and raised them as her own. From pre WW2, Wales, UK, to the turn of the century in Sydney, we are taken on Rhys Collins’s journey of adventures, strife and multiple identities. As he encounters people from all walks of life, and turns his hand to different jobs, he often wonders about his growing children he left behind in Wales, his place of birth. But his transgressions, and encounters with people on the wrong side of the law make him afraid to find out. Will Miriam and her siblings find their missing father before he becomes completely lost in the constant dramas of his own making?
Book Synopsis Interdisciplinary Nutritional Management and Care for Older Adults by : Ólöf G. Geirsdóttir
Download or read book Interdisciplinary Nutritional Management and Care for Older Adults written by Ólöf G. Geirsdóttir and published by Springer Nature. This book was released on 2021 with total page 274 pages. Available in PDF, EPUB and Kindle. Book excerpt: This open access book aims to primarily support nurses as leaders and champions of multimodal, Interdisciplinary nutrition care for older adults. A structured approach to fundamentals of nutrition care across Interdisciplinary settings is combined with additional short chapters about special topics in geriatric nutrition. The book is designed to provide highly accessible information on evidence-based management and care for older adults, with a focus on practical guidance and advice across acute, rehabilitation, and primary and secondary malnutrition prevention settings.The cost of malnutrition in England alone has been estimated to be £19.6 billion per year, or more than 15% of the total public expenditure on health and social care. ^65 years). The importance and benefit of specialised nutrition care, delivered by experts in field, is well established for those with complex nutrition care needs. However, despite the substantial adverse impact of malnutrition on patient and healthcare outcomes, specialised management of this condition is often under-resourced, overlooked and under-prioritised by both older adults and their treating teams. As an alternative, timely, efficient, and effective supportive nutrition care opportunities may be appropriately implemented by nurses and non-specialist Interdisciplinary healthcare team members, working together with nutrition specialists and the older adults they care for. Practical, low-risk opportunities should be considered across nutrition screening, assessment, intervention, and monitoring domains for many patients with, or at risk of malnutrition. Whilst a variety of team members may contribute to supportive nutrition care, the nursing profession provide a clear focal point. Nurses across diverse settings provide the backbone for Interdisciplinary teamwork and essential patient care. The nursing profession should consequently be considered best placed to administer Interdisciplinary, multimodal nutrition care, wherever specialist nutrition care referrals are unlikely to add value or are simply not available. As such, the book is a valuable resource for all healthcare providers dedicated to working with older patients to improve nutrition care. .
Book Synopsis Internal fixation of femoral neck fractures by : Jenó Manninger
Download or read book Internal fixation of femoral neck fractures written by Jenó Manninger and published by Springer Science & Business Media. This book was released on 2007-05-15 with total page 318 pages. Available in PDF, EPUB and Kindle. Book excerpt: This illustrated atlas provides a comprehensive monograph of femoral neck fractures. It has more than 800 representative figures, x-rays and drawings, and describes in detail non-invasive internal fixation.
