Evolution of trauma care in Italy: What should we expect in the future?

In this volume a selection of papers has been included reflecting the current situation of our world of orthopedic science, with a focus on trauma treatment modalities, which in Italy, like in the majority of other countries, are advanced and increasingly modernized. The articles that were received and eventually selected cover a number of interesting topics with work carried out in the different parts of our country. The final selection ought to be stimulating, research wise and culturally diverse, but most importantly of all to be ethical and to the highest scientific and clinical standard. In recent years Orthopaedics and traumatology have provided material for Major Investments in research and, over the past three decades, they have shown a great development in the science of biomaterials and functional results through the use of ever increasingly complex and interesting surgical applications [1], [2], [3] and [4]. In addition, fracture healing processes are now better understood [5], [6] and [7]; the Diamond concept and the Pentagon of Regeneration for instance have highlighted clearly what elements are necessary to achieve bone repair. Through the analysis of risk factors and the application of new classification systems, it is possible to identify patients at risk of failure in acute fractures but also in pathological fractures and bone infections helping the clinician to make the right decision for the right patient [8]. These innovative approaches, supported by the improvement of new diagnostic tools in imaging and laboratory, resulted in new concepts of care, able to establish algorithms of treatment. Such a strategy offers the possibility to provide better care treatment, especially today where demands have been increasing, e.g. the 24-h treatment of femoral fractures, currently requested in Italy. Application of these principles, by Italian surgeons, using new fixation devices and complimenting these when necessary with Biotechnologies (growth factors, mesenchymal stromal cells and scaffolds), the so called polytherapy, has opened new avenues in the treatment of complex cases. Our hope and aim is to give tangible proof that Italian Orthopaedics are culturally rich and alive and reach far beyond the structural and political limits in which they are often “forced” to operate. Being authors and publishing in a major magazine like “Injury” means having both responsibilities and abilities as well as independence. We believe that the publication of the results of the clinical research proposed in this special issue is the ultimate basis for most therapeutic decisions to be considered in orthopedic practices and trauma today. We strongly believe that the way to effectively address the deterioration of clinical performance is to promote professional development, achieved by monitoring biomedical literature and through research of scientific evidence, analyzing patients’ problems. The selection implemented by SIOT and the subsequent publication in the prestigious scientific journal “Injury” proves how much the scientific society cares about training and “education” especially of younger colleagues. The future of orthopedics will be very challenging and exciting indeed [9], [10], [11], [12], [13], [14] and [15]. One can not ignore the fact that more and more patients require orthopedic surgery and they have high expectations in terms of their health state, being eager to maintain an active lifestyle and improve their quality of lives. Orthopedic surgeons, of all nationalities (this is crucial because they supply individual and local experiences, as we do in this special edition) are, therefore expected to collaborate developing strategies for education, research and development of products that take into account the increasing trend towards hyper-specialization and globalization of treatments. It is our duty that all of us, jointly, can continue to provide the highest quality of care of the muscular-skeletal system. Advances in biomechanics, biomaterials, molecular biology, implantology, nanotechnology and genetics are underway on a global level and therefore we are compelled to broaden our educational horizons and to ensure that knowledge is spread on a constant basis among developed countries. This special edition is the result of the work of the Italian Society of Orthopaedics and Traumatology and many of its associates, who, with dedication and passion, wanted to offer the reader the “Italian perspective” on Orthopaedics and the most modern Traumatology. The content of this volume highlights the collaborative work of the members of SIOT. It is envisaged that it will be of educational value to the readership of the journal