Current concepts of internal fixation of fractures

Book Reviews All surgeons in training should read this book from cover to cover, final year students should make themselves familiar with its general message and all general and orthopaedic surgeons who have not had experience of such injuries should read it. Roughly the :Grst third of the book describes the effects of blast and of missiles of different types and speeds on the different tissues of the body. The second part deals with the principles of treatment and the third part with the management of injuries of the different parts of the body. Throughout the advice is practical; it is aimed at the competent surgeon, and omits the details that he would already know; it emphasizes the differences between conventional surgical practice and the management ofthe wounds of war and it also takes into account the allowances that may have to be made when the full range of special skills and equipment is not available. Each section is complete in itself which means that there is a certain amount of repeti tion, which is not a bad thing. A remarkable amount of information is conveyed by the author’s clear and simple style but, on points of detail, one may wonder just how stent should be used in the injured larynx and ask whether the significance of the closing missile track in the brain deserved mention. There are a few spelling mistakes. For years this reviewer has tried to persuade his junior staff of the value of reading the British Journal ofSurgery’s supplements on war surgery, which were doubtless regarded as old hat. He will do his best, short of lending them his own copy, to make sure that they all read Colonel Owen-Smith’s up-to-date and shorter version ofthose supplements. P. s. LONDON Current Concepts of Internal Fixation of Fractures. Edited by H. K. Uhthoff. Pp. 452 + ix. 287 illustrations. 1980. Berlin, Springer-Verlag. DM. 98. Springer-Verlag have a habit of bringing out timely well produced books on current orthopaedic topics at a reasonable price by medical standards and this is no exception. Following the success of rigid internal fixation as a method of treating fractures there has been some doubt expressed as to the complete desirability of almost total rigidity. This collection of papers puts forward the evidence for most points of view. Over 60 papers on internal fixation of fractures presented in Ottawa in May 1979 have been collected and represent the work of ‘200 researchers, surgeons, biochemical engineers and metallurgists from 6 European countries, the USA and Canada’. Herein lies thehisadvantage of such a book. It is, as the ladysaid after reading a dictionary ‘very interesting but a wee bit disjointed’. Undoubtedly most of the facts, concepts and theories are there but they are sometimes difficult to find. It is made slightly easier by the papers having been grouped into sections dealing with specific topics,

179 e.g. biomechanics, physical properties, biocompatibility, rigid fixation and less rigid fixation. A further disadvantage is that some of the papers are in abstract form and were only published in full in the Canudiun Journal of Surgery. However, this is not always the disadvantage it may seem; in some of the full papers I found myself lost in a wealth of scientific detail, whereas in a few of the abstracts the message was quite clearly stated. An excellent example of this is the abstract by Schatzker on the principles of internal fixation. The principles are didactically stated with a clarity which is not evident throughout the book; elsewhere for instance it may be difficult to understand what is meant by ‘the non-linear behaviour and ultimate fracture process ofdiaphyseal bone’. The analogy ofa dictionary may be apt. Perhaps this should not be read as a book; it should be referred to much as one would refer to a dictionary. Many of the papers refer to experimental work only and have no obvious practical purpose yet, but there may come a time when one needs to refer to such work. On the other hand there is much which is practical. There is a useful paper by Weisman on corrosion and it is interesting to note from McKibbin that epithelium will grow over carbon plates in open wounds. Corcoran’s paper on the concept of an absorbable plate is stimulating. There is a great deal of value in this book and the editor has done us a service by collecting these papers together. It should be read by all of us who practise intenal fixation but I suspect it is not a book for our personal libraries. N. TUBBS Illustrated Handbook in Local Anaesthesia, 2nd ed. By E. Eriksson. 248 x 174 mm. Pp. 160. 1979. London, Lloyd-Luke. fl5. At the same time as this book appeared on my desk another manual on a different subject arrived but that manual cost over E60, this manual on local anaesthesia is only f 15 and must be the best value for money on the book market. The illustrations in this manual are superb and successful conduction anaesthesia can often result when the operator has studied the manual but has had no other tuition. This is a method of practise your reviewer would not recommend but it is sometimes forced upon us. The standard of the book makes it as safe and as simple as such severe limitations allow. This is the second edition of this hugely successful book and the changes are not great, being mainly extensions of the sections on anaesthesia for endoscopies. This book is recommended for all who practise in accident and emergency departments or have need for local analgesic techniques in other spheres of medicine. J. ROBINSON