This text by late Prof. Dr. Stephan M Perren (1932-2019) was first published in the book “Great Circle” 2007 and is published here as a reference to his immense contribution to the advancement of bone fracture research and clinical treatment.

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Osteoporosis

Our round-the-world flight was a modern day adventure. At the same time, it was undertaken in the service of medical research into fractures in osteoporotic bone. We were able to exchange knowledge of osteoporosis and the problems caused by fracture with our colleagues in Middle Eastern and Asio-Pacific countries with reference to clinical practice and research. We were able to present new technologies for the treatment of osteoporotic fractures.

The first part of this book welcomes you to the structure and function of bone. It is a microscopical world that is not only of interest to doctors. Bone is a tissue that has many important mechanical and chemical functions. Unfortunately bones break! How does fracture occur? Why are there different fracture patterns? If a fracture can heal spontaneously, i.e. without treatment, why is it treated? How were bones treated before? Which improvements were urgently required? Which ones were achieved by the AO (Association for the Study of Internal Fixation)? Which problems are still unsolved?

The second part is an introduction to the AO Group, a Swiss Group of thirteen general and orthopedic surgeons. This small society developed into an internationally active Foundation that has made essential contributions to fracture treatment based on experimental and clinical research. What were the goals and principles of the AO Group? How did we collaborate?

The third section poses the following question: What was accomplished by AO in 30 years of research from 1967-1996 under the directorship of Stephan Perren? What fundamental progress resulterd from research? Which improvements in patient treatment were realised? Which “generally accepted” schools of thought were challenged? How did this open up the way for new and creative approaches and what were they? How have researchers, clinicians and patients benefitted?

This is followed by a commentary on the question: what demands are made on research? Research methods and organization are examined in detail.

The separate section on osteoporosis (Perren and Blauth) discusses bone loss: What is osteoporosis? How likely are we to suffer from it? What are the consequences, especially in cases of fracture? Why do professionals call osteoporosis a ‘silent killer’?