Copyright 1997 by The Journal of Bone and Joint Surgery, Incorporated

Book Reviews
A TEXTBOOK OF PAEDI ATRIC ORTHOPAEDICS. FROM THE ROYAL CHILDREN'S HOSPITAL, MELBOURNE. Edited by Nigel S. Broughton.

Philadelphia, W. B. Saunders, 1997. $95.00, 336 pp.

Tachdjian published his landmark two-volume text on pediatric
orthopaedics in 1972. Since then, a wide array of books have been
produced on this subject. However, despite their merits, most of them
have not taken into account the changing patterns in the education
of residents over the past quarter of a century. In particular, residents
have been spending progressively less time working in pediatric orthopaedics, with most pediatric rotations now a mere four months.
This comprehensive yet concise text fills the void that these
changed circumstances have produced. It can be finished during a
three to four-month rotation. Consistently well written and profusely
illustrated, it covers all of the pertinent topics. The eleven contributors,
all from the Royal Children's Hospital, tend to preach what is practiced in that institution. Chapter 2, on the "General Approach to
Paediatric Orthopaedics," by Menelaus, is itself a classic, while chapter
3, on "Normal and Pathological Gait," takes the pain out of learning
some of the basics of gait analysis. One of the book's few drawbacks
is that the references, although current, could have been expanded.
This excellent, compact text is recommended to residents in training and to general orthopaedic surgeons who have an interest in
pediatric orthopaedics.
S. Jay Kumar, M.D.
Department of Orthopaedics
Alfred I. duPont Institute
Wilmington, Delaware

FIREARMS AND BALLISTICS. FOR PHYSICIAN AND ATTORNEY. Jules C.

Ladenheim and Eric D. Ladenheim. Chapel Hill, North Carolina,

Professional Press, 1996. $40.00, 321 pp.
This book on firearms and ballistics was written by a neurosurgeon and a general surgeon. The text describes the different types
of available firearms in great detail and provides a description of
ballistics, the science of characterizing the flight of the projectile from
the moment of firing until it comes to rest. This process comprises
three parts: internal ballistics the movement of the projectile within
the firearm, external ballistics the movement from the muzzle to
the target, and terminal ballistics the passage within the bodily
tissue.
There is no doubt that the section on internal ballistics is useful,
as is the information about the types of available firearms. It is unlikely
that a surgeon or physician taking care of a patient who has a gunshot
wound will remember all of these details, nor do I believe that it is
essential for him or her to do so. It is critical, however, for the treating
physician to have some understanding of terminal ballistics the
path of the projectile through the tissues of the body. This section,
which is sixty-six pages long, has an extensive bibliography and is

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well written. It provides detailed information for the surgeon and is

of value for planning the management of the patient. This is certainly
a book to be kept in libraries and as a reference for the trauma
surgeon.
Leela Rangaswamy, M.D.
Deputy Editor
The Journal of Bone and Joint Surgery
Needham, Massachusetts

CLINICAL PEDIATRIC ORTHOPEDICS.

T H E A R T OF DIAGNOSIS AND

PRINCIPLES OF MANAGEMENT. Mihran O. Tachdjian. Stamford,

Connecticut, Appleton and Lange, 1997. $120.00, 500 pp.
Sadly, the publication of this book comes shortly after Dr.
Tachdjian's death. His texts have always been richly illustrated and
complete in their descriptions of pathophysiology and physical examination, and so it is with this one, which covers the gamut of pediatric orthopaedics. Emphasis is placed on the physical examination,
differential diagnosis, pathophysiology, and principles of management.
The operative choices are described briefly, but no attempt is made
to guide the practitioner through all of the phases of operative or
non-operative treatment of a particular condition.
Dr. Tachdjian intended his audience to be "general orthopedic
surgeons who treat children, orthopedic residents, pediatricians, primary care physicians, and allied health care personnel such as physical
therapists, occupational therapists, and orthopedic nurses." The tips
and subtleties of physical examination will be of use to the pediatric
orthopaedist, and the differential diagnosis and careful description
of conditions will help the general orthopaedic surgeon who manages
children. Orthopaedic residents will find this to be an excellent overview. Pediatricians and primary care physicians not completely familiar with musculoskeletal terminology and radiographs may find
the text too detailed and some of the terms too specialized. Interested
physical and occupational therapists and orthopaedic nurses will appreciate the radiographs and diagrams. All will appreciate the thorough illustration of measurements and indices that are so frequently
used but are so carefully illustrated only in this text. The attitudes
with regard to treatment and diagnostic studies are all up-to-date,
and the references include both classics and current citations. The
author's completeness in covering the topics sometimes leads to a
telegraphic style. In addition, the illustrations are occasionally disproportionate in their representation of the anatomy, but their richness and abundance more than make up for this minor annoyance.
This will be a welcome addition to a departmental library and
a helpful reminder to the general or pediatric orthopaedist.
John B. Emans, M.D.
Department of Orthopaedic Surgery
Children's Hospital
Boston, Massachusetts

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