Littleton, MA, John Wright/PSG, Inc. 1983. $120.00. IN THE MIDST OF A VERITABLE information explosion in the field of orthopaedics, Mr. Nigel Harris has ...
Book Reviews Atlas of Hand Surgery, Volume 2. Robert A. Chase. 496 pp. Philadelphia, WB Saunders. 1983. $85.00.
Advances in Surgery, Volume 17. G. Thomas Shires. 323 pp. Chicago, Year Book Medical Publishers. 1984. $39.95.
As NEW TEXTS ON HAND SURGERY have appeared with regularity in the past 5 years, potential purchasers must ask, "why another?" Previous authors of hand surgery texts, still actively engaged in practice, must obviously update past volumes in this rapidly advancing and changing surgical field. Dr. Chase, with the assistance of his Stanford colleague, V. R. Hentz, has done so in a more elaborate and expansive successor to his Volume 1 of Atlas of Hand Surgery. The subject is tackled on an anatomic basis with chapters on individual tissues, plus tumors, microsurgery, and congenital disorders in a "how-to-do-it" manual with clear diagrams and personal case representations. Each section begins with a theoretic discussion of the topic followed by essential details of appropriate operative techniques. The text has a crisp and succinct style resulting in an efficient explanation of each subject with sufficient detail to remind the surgeon of most critical points in the described operative procedure. Some minor points are overlooked, for example, freeing fascial attachments of the V-Y flap to periosteum to further mobilize the flap when employed for fingertip reconstructions. There are a few minor details with which this reviewer would take disagreement, an example being a recommendation of withdrawing the proximal cut end of the flexor pollicis longus (FPL) to the wrist level. This robs the tendon of blood supply, and many times its synovial fluid environment, often resulting in less function. The text has an uncommonly high degree of clinical perspective with clear-cut indications for each procedure and warnings against inappropriate use of more demanding techniques. When one of the latter is offered as the procedure of choice the operative details are presented clearly and concisely with excellent accompanying diagrams and photographs, so much so that the operation may appear deceptively easy to the inexperienced reader. The bibliography that concludes each chapter is limited to the more important original references, a commendable editorial dictate when the overall scope of the book is considered. As with most books covering a rapidly advancing specialty the reader must realize it is out of date when it finally appears in print. Absent are many of the newer and better techniques and procedures in microsurgical reconstruction of the upper extremity that have appeared in the last 3 years. In scope and content the text represents an illustrated, annotated index of techniques and procedures, both erudite and common, currently employed in overcoming a wide range of hand surgery problems. As such, it is a convenient encapsulation of most of the current knowledge. It rapidly lends itself to quick consultation and should take its place as a wellthumbed volume in a hand surgery library.
ADVANCES IN SURGERY IS A YEARLY review of major surgical topics written by leading authorities in their fields. The distinguished editorial board has consistently chosen subjects over the past 16 years that are timely in nature and of broad interest to surgeons. The 17th volume is no exception. Each of the nine topics represents major areas of surgical advances written by authorities who have been intimately involved in their development. Each topic area is comprehensive in nature, easy to read, well illustrated, and fully referenced. The nine issues include total parenteral nutrition, splenic trauma, reimplantation and free flaps with microsurgery, cyclosporin A in transplantation, hepatic resection for trauma, computerized tomography of the abdomen, arthroscopic knee surgery, stapling devices for gastrointestinal (GI) surgery, and pheochromocytomas. The article about total parenteral nutrition (TPN) represents a series of prospective studies conducted by Dr. Murray Brennan and others at the Memorial Sloan-Kettering Cancer Institute and contains 92 references. It discusses types of catheters for venous access, assessment of nutritional requirements, the proper composition of TPN fluid, and special modifications of TPN in disease states such as liver failure, adrenal insufficiency, and after cardiac surgery. Management of trauma to the spleen was written by Dr. Roger Sherman and has 95 references. He discusses the physiologic roles of the spleen, its structure, and immunologic function. A nice discussion about postsplenectomy infection that summarizes the pros and cons of splenic salvage is included. The microsurgery article written by Drs. Nahai and Jurkiewicz describes digital and extremity reimplantation, including the indications and evaluation of results. It also includes the use of composite grafts and the use of free tissue transfer for reconstruction in the head and neck, esophagus, scalp, and extremities and has 77 references. A superb review on the impact of cyclosporin A in transplantation was written by Dr. Peter Morris and includes 133 references. Both the experimental and clinical results that have been obtained so far with this new agent are impressive. There is a nice discussion about the mechanisms of action, toxicity, and monitoring of blood levels. Dr. Balasegaram describes his personal experience with 94 patients undergoing hepatic resection for trauma. He describes the surgical anatomy of the liver and techniques for obtaining hemostasis during the operative procedure. Next is a review about the use of computerized tomography (CT) involving various abdominal organs. Dr. Rubenstein and colleagues compare the results of CT scanning with other diagnostic modalities, such as radionuclide liver scans and ultrasonography; there are 26 references. Dr. Metcalf has written a nice article about arthroscopic knee surgery (53 references). It is well illustrated and describes the indications for arthroscopy, the requisite equipment, and the various techniques for managing specific knee lesions. The use of staples and staplers is reviewed by one of the originators of this technique, Dr. Mark
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Ravitch. There is an eloquent historic summary about the development of stapling devices for GI surgery and the current technique for employing them for large and small bowel surgery. This is a well illustrated review about this important technique. Finally, Drs. Levine and McDonald have reviewed the evaluation and management of pheochromocytomas with 58 references. They discuss the physiologic impact of adrenal catacholamines, as well as the pathology, clinical features, and management of pheochromocytomas. In summary, the Editorial Panel of Advances in Surgery has selected another thoughtful and timely series of surgical reviews that cover a broad range of interests for surgeons. It is certainly a worthwhile and valuable reference source for surgeons interested in any of these topics. CHARLES M. BALCH, M.D. Birmingham, Alabama Postgraduate Textbook of Clinical Orthopaedics. Nigel H. Harris. 1044 pp. Littleton, MA, John Wright/PSG, Inc. 1983.
$120.00. IN THE MIDST OF A VERITABLE information explosion in the field of orthopaedics, Mr. Nigel Harris has edited, and written several of the chapters in, a most remarkable, comprehensive, and affordable textbook of clinical orthopaedics. It was written with a broad scope specifically for the surgeon in training. Mr. Harris realistically acknowledges that the entire field of orthopaedics cannot be condensed into 1044 pages. He has, therefore, omitted acute trauma and detailed operative techniques. He and an outstanding international group of authors have covered most aspects of orthopaedics in 32 chapters divided into three sections: Pediatrics, General Orthopaedics, and Special Topics. The Pediatric section is particularly good, as are the two chapters on rheumatoid arthritis in the General Orthopaedic section. The chapter on lower extremity joint replacement suffers from the state of the art. Recent advances have been so rapid that no general text can possibly keep pace. There is no mention of porous coated, noncemented arthroplasty, the newest and most exciting topic in orthopaedics today. Nevertheless, the basics of total joint replacement are superbly
covered. The knee is generally well covered, although operative arthroscopy receives little attention. The three sections on pathology are fairly complete, but suffer from fragmentation and redundancy by multiple authors. Condensation into one chapter would make this a more useful reference. The Special Topics section includes scanning techniques, arthrography, biomechanics, rehabilitation, and orthotics. This well-executed section adds significantly to the value of this book. This well-written and easy-to-read text stresses clinical concepts of disease and principles of management in a format unlike that found in the more surgically oriented texts. Indications for nonsurgical and surgical treatment are outlined. While several authors have gone into greater surgical detail, most have merely emphasized important technical aspects of certain procedures, pitfalls to be avoided, and complications of treatment. Overall, this text is a comprehensive but manageable handbook of orthopaedic surgery which, by design, does not stand
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alone. Though a definitive text in some areas, its real value is as a primer for junior orthopaedic residents and it is well worth owning, or at least reading, at that level. VINCENT S. MOSCA, M.D. Toronto, Ontario, Canada Vascular Surgery-A Comprehensive Review. Wesley S. Moore. 994 pp. New York, Grune & Stratton, Inc. 1983. $89.00. THIS MULTI-AUTHORED REVIEW TEXT was released just prior to the examination for the Certificate of Special Competence in General Vascular Surgery in November 1983. Each chapter is followed by a question set intended to represent a "fair and adequate survey of the material concerned"; and, although the editors quite appropriately point out that none of the authors participated in the preparation of the examination (avoiding charges of "conffict of interest"), the text and questions generally anticipated the examination well. Vascular Surgery begins with routine introductory chapters on the history of vascular surgery, surgical exposure of blood vessels and atherogenesis, followed by two excellent chapters, Porter's "Non-Atherosclerotic Vascular Disease" and Strandness "Hemodynamics for the Vascular Surgeon." The chapter "The Vascular Laboratory" deals with many outmoded modalities, especially in the field of carotid evaluation, but is useful in pointing out the limitations of these earlier techniques. The chapter on angiography is broad, covering all aspects of diagnostic and interventional angiography, but some of the arteriograms seem poorly chosen, especially one of the chronic mesenteric ischemia showing a patent superior mesenteric artery described as being "occluded." A chapter on vascular grafts completes the background section and is well done. Those chapters that discuss the commonly encountered clinical problems comprise the heart of the book and range from good to exceptional, covering aneurysms, occlusive disease, trauma, venous disease, and amputation in thorough and generally readable style. An excellent chapter in this section is "Drugs in Vascular Surgery," which is well written and current. Vascular Surgery is a review text of great value that was used quite successfully in the recent examination. It necessarily fulfills less well the second goal of the editors, which is being a comprehensive text of vascular surgery, however, and should be supplemented by the second edition of Rutherfords' text of the same title and with many of the same authors. BRUCE M. SMITH, M.D. Nashville, Tennessee
Management of Wilderness and Environmental Emergencies. Paul S. Auerbach, Edward C. Geehr. 656 pp. New York, Macmillan Publishing Co. 1983. $68.00 THIS TEXT HELPS TO FILL A VOID in the educational and reference material available to the practitioner involved in emergency care. The editors have attempted to compile a definitive text on the therapy of a wide variety of biologic and surgical insults. Increase in recreational and athletic activities as well as a wide variety of technologic advances have made environmental encounters of the general public more common and more complex. Since each of these encounters entails some risks, the diversity and frequency of patients sustaining environmental injuries are increasing.
