The early chapters are full of wisdom and illustrate the basic established in seven hospitals throughout the
out the country for this
philosophy equipment and techniques of orthopaedic surgery
including basic surgical approaches to the limbs. Anyone
buying this book is strongly advised to read these introductory
sections.
The author from the onset states that the concept of the book
is to cater for the “junior man” and many operations which
may be left to him at the end of the list are covered in detail not
found in larger standard textbooks.
Each chapter deals with a specific area of the body and is
prefaced with introductory remarks. The descriptions are well
written and clearly illustrated with good black and white line
drawings. Postoperative management is described and there is
a comment section at the end of each procedure which may
emphasise special difficulties, complications, or ways of
making the procedure easier and is a valuable contribution.
No single person can obviously be experienced in every branch
of this wide subject and the more specialised readers,
especially those who subscribe to this journal, will frequently
find themselves disagreeing with the author’s point of view.
The section covering Forearm, Wrist and Hand is stated as not
designed to cover the “higher flights of hand surgery”, but
odd examples such as primary tendon repair in the digital
sheath and two stage tendon grafting are described lengthily,
yet in insufficient depth to allow the tyro really to appreciate
what is involved. Other minor hand operations are, in general,
adequately outlined.
The bibliography which is sparse is not generally referred to in
the text and is collected together in a single section at the back.
I would have preferred the appropriate bibliography to be
included at the end of each section with “in text” references.
This book, nonetheless, is an excellent and portable volume
which will be of immense help to the Registrar or Senior House
Officer, and at the price would be well within reach of his
pocket. Certainly no post-graduate library should be without
it.
David Nairn
ATLAS OF SKELETAL DYSPLASIAS.
By Ruth Wynne-Davies, Ph.D., F.R.C.S. Formerly Reader in
Orthopaedic Genetics Research, University of Edinburgh,
Christine M. Hall, F.R.C.R. Consultant Radiologist, Hospital
far, Sick ‘Children, London, U.K., and A. Graham Apley,
F.R.C.S., Honorary Consulting Surgeon, St. Thomas’
Hospital, London. UK. 28cm x 23cm x 3.8cm. 646 pages,
mostly photographs, x-rays and charts. Some text, apart from
extensive captions. References with each condition. Index.
Edinburgh, London, Melbourne and New York. Churchill
Livingstone 1985. ISBN 0 443 03047 2. Price &90.
Some of the disorders described in this book are well
recognised by clinicians and radiologists, but many
practitioners are not aware of the manifestations of others.
Although each condition may be rare the authors estimate that
there are upwards of 10,000 people in England, Scotland, and
Wales who are affected by one of the skeletal dysplasias
mentioned in this atlas. The development of cyto-genetics and
the vast improvement of the treatment of these patients has led
the authors to feel that there is a need for more accurate
clinical delineation of these disorders. The compilation of this
work has clearly been a labour of love. As a result of ten years
study of patients in special skeletal dysplasia clinics which were
VOL. 11-B No. 2 JUNE 1986
purpose, this comprehensive and exhaustive guide has been
produced.
The first chapter contains, normal growth charts, and a
number of radiographs of normal children. Eighty-five
conditions are then systematically described, giving genetic,
clinical, and radiological descriptions, clinical photographs,
growth charts, and radiographs. These are very clearly set out.
There can be no doubt that this atlas represents a major
contribution to the study and recognition of these conditions.
It is therefore a great pity that many of the radiographs are not
of higher quality. Some do not clearly illustrate the point
which the authors wish to make. This may be due to the fact
that the radiographic field is too large and the illustration too
small, necessitated no doubt by the extensive nature of this
work and the large number of radiographs illustrated; but it is
to be hoped that this can be corrected in subsequent editions.
R. D. Harvey-Samuel
MASTERY OF SURGERY
Edited by M. Nyhus and R. J. Baker. 1650 pages, Figures,
Index. E182.00 (2 ~01s). Little, Brown & Company, Boston.
1984 ISBN O-316-61742-3.
This large multi-author work must primarily be aimed at the
general surgeon although a number of “specialist” areas are
covered with varying degrees of thoroughness. The first
section of Volume 1 is entitled “General Principles” and deals
with selected aspects of peri-operative care, including
metabolic response, myorcardial support, renal insufficiency
and respiratory care. Bacteriology in surgery is covered in
some detail, but aspects of wound healing are completely
omitted, perhaps suggesting the intended reader is at an
advanced stage in his surgical training and already has a good
grasp of general surgical principles.
Most of the main sections thereafter begin with an anatomical
outline followed by the descriptions of operative surgical
technique. Contributors are, in general, eminent in their fields
and in some cases were the originators of the operation they
describe. Illustrations are mostly of a high standard, but vary
in style from one chapter to another. Some more common
procedures are covered twice by different authors to give a
more balanced view. The choice of subjects though is often
suprising with, for example, considerable space devoted to
such specilised gynaecological operations as construction of an
artificial vagina, but surgery of the male genetalia is omitted
except for management of genital trauma.
The final two chapters of the book are devoted to hand
surgery, the first dealing with infections and the second with
peripheral nerve injuries. Certainly these topics are
satisfactorily covered, but why they should be selected and no
other aspect of hand surgery is not immediately clear. If the
implication is that they might be dealt with by general
surgeons, I am sure there are many who would strongly
disagree.
This perhaps exemplifies the problems with this book. The
reader at which it is aimed does not seem to have been clearly
defined with the result that many excellent individual
contributions fail to combine together to meet a particular
need. Too much is attempted for the general surgical reader
and too little for any of the specialities, hand surgery included.
Christopher M. Backhouse
301