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Operation on fractures of shafts and joints is chiefly indicated in the upper arm, forearm, femur and tibia. Injuries in these areas can almost always be successfully treated by the techniques described in the 'AS IF Manual of Internal Fixation,' followed by early exercises. The fixation of small fragments which are of such biomechanical importance, has hitherto given indifferent results, especially when the distal parts of the hand and foot are involved. The implants and instruments developed by Dr. Heim and tried out by AS IF members during recent years have now been assembled into a 'small fragment set,' which is now available. These implants have significantly expanded the scope of AS IF instrumentation for internal fixation. Pannike first compared the application of the small fragment set with the conventional methods used in hand surgery. Heim and Pfeiffer in cooperation with Meuli, illustrate in this Volume the small fragment set, elucidating in a didactic manner the composition of the set, the indications for its use, and its method of application to all suitable fractures. Enough good results have been secured to establish the usefulness of this development. The following volume may therefore be regarded as an important supplement to the ASIF Manual. It makes it clear again that every internal fixation requires a high level of technical skill, a sense of responsibility, and very gentle handling of the soft tissues.
