Current concepts in hand surgery

BOOK

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REVIEWS

preceding chapters. They provide brief but interesting accounts of a variety of problems associated with aesthetic surgery of the breast and their solutions. the

DAVID

L. HARRIS

Burns of the Head and Neck. By Thomas L. Wachtel and David H. Frank. Pp. 216 with 110 illustrations. Philadelphia, New York: W. B. Saunders Company, 1984.) Price f37.50. This little book is a monograph

in the series Major Clinical Problems in Clinical Surgery. It is obvious that the authors, nearly all from San Diego, are drawing on their personal experience and describe what they do and how they do it. No attempt is made to review the historical basis or discuss alternative methods, yet the book is full of interest and sound advice and there is a wealth of very up-to-date references at the end of each chapter. There are major sections on inhalations1 and upper respiratory thermal injuries, comprehensively and succinctly covered and good practical chapters on management of the burned eye, scalp, mouth and ears. Really outstanding is a 20 page long, beautifully written, humorous contribution by an obviously very experienced anaesthetist, which is full of wisdom and words of warning. Of similar value is a clear exposition on what to reconstruct first, when to do it and how, linked with a chapter on splints, pressure garments and face masks. It is emphasised that reconstruction should be considered at the time of resuscitation and first priorities given to the prevention and correction of functional deformity. The editors have succeeded in producing a very good practical book on how to manage patients with burns of the head and neck, written for doctors rather than “the multi-disciplinary burns team”. The illustrations complement points made in the text and clarity, brevity and the excellent references can be added to its strengths. Magill’s forceps have become Miguels in San Diego, but it is encouraging to read a strong condemnation of the futility and harm in tarsorrhaphy yet a pity to see a diagram of how to do one. I enjoyed this book. Every burns unit should have one as should every real plastic surgeon. JOHN

A. CLARKE

In addition to chapters on the general management of the patient and the diagnosis, treatment and coniplications of fractures of the mandible and maxilla there are sections devoted to injuries of the cervical spine, ljlrynx and a detailed conside&tion of the orbital blow-out fracture. The surgical correction of post-traumatic deformities is dealt with comprehensively, with special attention to the long term problems arising from temporo-mandibular joint injuries in childhood. This is an invaluable multidisciplinary work on maxillo-facial trauma. The book is clearly set out with copious line drawings and photographs. There are a few printer’s errors which will no doubt be corrected in the next edition. The author acknowledges at the outset the limitations of his broad horizon within a practical size of book, but he has nevertheless succeeded in giving us an excellent overall view of maxillo-facial trauma within these parameters and at a price which is not excessive by present day standards. It is a book to be recommended to all grades of staff from the youngest trainee to consultant and should certainly be part of the library of every Department where maxillo-facial trauma is seen and treated. JOHN

R. GIBSON

Current Concepts in Hand Surgery. Edited by John A. Boswick Jr. Pp. xi + 287, with 284 illustrations. (Philadelphia: Lea and Febiger, 1983.) Price $41.25. The fundamental defect of this book is revealed in the preface, which states that it is a compilation of material prepared for a seminar in Keystone, Colorado, in July 1981. As a conference it was no doubt outstanding, but much of its edge has been lost through the delay in publication and through its adaptation to book form. There are 28 chapter by 23 authors, 14 American, 6 Japanese, one from Hong Kong, one French and one Australian. There are two types of chapter, short didactic contributions covering broad topics, and longer chapters covering rarer topics in some detail. Some of the short chapters are good, and bring together the strands of a given topic in a useful way. Others are so brief as to be of little value, and were clearly originally conceived as short papers to stimulate discussion; they may have fitted that requirement well, but in isolation they leave the reader in the air. The chaoter on tumours is little more than a list of the

Maxillo-Facial Trauma. By Robert H. Mathog. Pp. xv t41.5 with 516 illustrations. First Edition. (Baltimore: Williams & Wilkins, 1984.) Price E62.00.

commoner lesions and a few rare ones. Two methods of treatment are at variance with common surgical practicecurettage of DIP joint ganglia (mucous cysts), defended on the grounds that three cases have failed to recur. and nerve resection

In the preface to this book the author stresses the importance of team work in the management and treatment of maxillo-facial trauma and to this end has assembled a team of 35 distinguished contributors in a multi-disciplinary approach to such injuries. Professor Mathog has marshalled his material logically and has approached his task with a deep understanding of all the problems involved. One might question the necessity for chapters on embryology and facial growth within the covers of a work on trauma, but the study of facial developmental anomalies following injuries in children, and their treatment wholly justifies their inclusion. This, together with excellent sections on relevant bone physiology and pathology, forms a sound foundation on which to build the surgical content of the book.

and grafting for neurolemmoma, which can be excised with minimal nerve sacrifice or none at all. Brief unqualified statements of controversial policies such as this serve little purpose. Chapters by Brand on mechanics of splinting and tendon transfer, and by Pillet on prostheses are particularly well written and useful, and P. C. Leung’s chapter on acupuncture in the painful hand syndrome is of great interest. Of the longer chapters, four by Saito and his colleagues are excellent, covering topics which are often not given detailed attention, namely nailbed injuries, brachymetacarpia, a detailed classification of fractures of the distal radius, and salvage operations for severely crushed hands. Regrettably. however, much of the material is already available in print, and although the book is beautifully produced and

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BRITISH JOURNAL OF PLASTIC SURGERY

thoroughly edited, as a whole it does not haye the impact and educational value that the seminar from which it ardse undoubtedly had. DAVID M. EVANS

Atlas of Breast Reconstruction Following Mastectomy. Edited by Bernard M. &Gibbon MD. Pp. xvi+ 181 with 202 illustrations. First Edition. (Baltimore: University Pqrk Press and London: Edward Arnold, 1984.) Price E59.00. This Atlas has 12 contributors, including a psychiatrist and two general surgeons with ap interest in Breast Clinics, under the Editorial supervision of Dr Bernard McGibbon who is himself the author of several sections &f this book. It outlines the more usual forms of breast reconstruction following mastectomy that are now cqrrently in use and devotes a lot of space to the various permutatlons of the latissimus dorsi flap and the use of the rectus abdominus (sic) musculocutaneous flaps that have become so much the vogue in recent months. There is also a short chapter on reconstruction of the nipple&eola complex. It is an incomplete, unimpressive and unimaginative book. The photographs are of very uneven quality, badly lit and with little attempt to standardise the positions in which the photographs are taken. The drawings are adequate but otherwise unremarkable. It is an exwnsive boo% with far too many “white” spaces and I cannot think that many librarians (or surgeons) will be over-anxious to find a place for this volume on their shelves. MICHAEL N. TEMPEST

Chirurgie Du Sein: Plasties et Reconstructions (Plastic and Reconstructive Surgery of the Breast). By G. F. Maillard, MD, Denys Montandon MD, and Jean-Louis Goin, MD. Pp. xviii + 317 with 650 illustrations and drawings. First Edition. (Paris: Masson, 1983.) Price 490F. This book is written by three plastic surgeons, Dr G. F. Maillard working in Lausanne, Dr Denys Montandon in Geneva and Dr J-L Goin in Bordeaux. In support of this surgical triumvirate we have a preface written by three other surgeons, Paul Tessier (Paris), Madeleine Lejour (Bruxelles) and Professor CharlesMarie Gros, President of the International Society of Senology. This is a bilingual book: the text on the left hand pages is in English, that on the right hand side in French. Captions in both languages are used for all the illustrations and drawings. The translation into English reads easily and if there are occasionally sentences or words that seem a little quaint or strange, the original French can be consulted at once on the opposite page. Every aspect of breast reconstruction is covered and if French surgical procedures are given greater emphasis or prominence, this is oerfectlv understandable. Theauthors have taken very great care with the standardisation of the clinical photographs of their patients, both in position, lighting and timing (the post-operative photographs are taken at 6 to 18 month intervals). Most of the drawings, we are told, were done “live” in the operating theatre. This is

certainly a highly commendable procedure, but many of the finished illustrations as fhey appear in the book would be en’ormously improved by spme tidying up and attention to detail in the interests of clarity. Many of them still look like sketches and suffer from a surfeit of lines which distract rather than attract attention. The book ends with a few rag-bag items, such as the correction of chest-wall defects, the use of the chest as a donor site for flaps and finally a somewhat incomplete account on the management of lymphoedema of the upper limb. The book is nicely produced and is a credit to the authors and the publishing team. I personally would prefer to have the book in either French or English rather than as a composite affair. The bibliograpliy at the end’ of the vohime is accurate and useful. Most of the spelling mistakes are in the names of various surgeons and in the nomenclature of certain operations, but these are unimportant when reviewed against the book as a whole. MICHAEL N. TEMPEST

Proportions of the Aesthetic Face. By Nelson Powell, DDS, MD, and Brian Humphreys, MD. First Edition. Pp. x+66 with numerous illustrations. (New York: Thieme-Stratton Inc., 1984.) Price DM 80. This slim volume is the first in a series of some seven monographs on various aspects of plastic and maxilla-facial surgery. This is illustrated almost entirely with line drawings and, not surprisingly, concentrates mainly on the female face. There is, at first, an analysis and comparison of various systems of cephalometric bony measurement and also photographic soft tissue measurement. This provides a useful amalgamation of standard orthodontic practice with an analysis of the contours of the upper third of the face as well but loses some of its impact as, with few exceptions, the face used throughout the book is the same. It will be interesting to see how this volume complements the future volumes on “Rhinoplasty” and “Surgery of the Mandible” which are planned and whether the aesthetic concepts described here are actually used in practice. On its own it will provide a useful addition to a library as a quick reference to various forms of analysis and also some descriptive terms. It will also be useful to anybody engaged in aesthetic surgery who wishes to make a meaningful analysis of their results and may also be useful to students of art. PETER K. B. DAVIS

The Planning of Local Plastic Operations on the Body Surface: Theory and Practice. By A. A. Limberg MD. (Translated by Dr S. Anthony Wolfe, MD.) Pp. x+635 with numerous illustrations and diagrams. (Lexington, Mass., USA: The Collamore Press, DC Heath and Company: Tunbridge Wells: Castle House Publications Ltd, 1984.) Price f46.00. This book was originally published in Russian in 1963 by the Government Publishing House for Medical Literature in Leningrad (USSR). Dr Aleksandr Aleksandrovich Limberg died in December 1974 at the age of 80 and had been for many years