.th ec li ni cs .c om You may have noticed the unusually large size of this issue of the Orthopedic Clinics of North America, and the trauma section has eight articles on an assortment of contemporary issues facing surgeons who care for injured patients. Whereas most surgeons in developed countries have the luxury of fluoroscopic-assisted intramedullary nailing, this technology is simply not available in much of the developing world. The SIGN program has allowed surgeons in developing nations, where trauma is a growing health care burden, to provide interlocked medullary nailing. Dr Zirkle and coauthors share their extensive experience with their techniques in this issue of the Orthopedic Clinics of North America. Nonunions are challenging problems to treat even without infection and bone loss. Drs Brinker and O’Connor share their insights and management tips in their review article entitled “Management of Aseptic Tibial and Femoral Diaphyseal Nonunions Without Bony Defects.” Fractures about the knee and elbow, such as patellar, distal femur, and elbow fractures, require a thorough appreciation of the local biomechanics and fixation options. Patellar fractures, often considered relatively straightforward problems, do not do as well as we seem to think. Drs Kakazu and Archdeacon give their tips and techniques to try and help you achieve good results. Similarly, Drs Gangavalli and Nwachuku review the surgical management options to optimize results when treating distal femur fractures. Dr Jennings and coauthors review the complexities of adult elbow fracture dislocations and their management strategies.