- Email: [email protected]
Electrical safety in hospitals
Book
533
Reviews
a chapter on non-union of fractures, investigating all the factors involved and referring to the work of Hicks and other important contributors in this field. There is a short but interesting chapter about the healing of amputations and more about the intracapsular fracture of the femoral neck with beautiful microradiographs and injection studies. His wide experience of the end results of hip fractures has enabled him to examine femoral heads many years after the fractures have been fixed either by nails or other methods, so that the whole natural history of this common condition has been explored. He deals with fractures complicating bums and especially in bums of the scalp with the effects on the skull. There is a chapter about the healing of fractures which have been fixed with medullary nails, examining carefully the part played by the periosteal blood supply. He clearly shows that the revascularization of dead fragment ends in a long bone occurs from the endostium, cortex and periosteum and pays tribute to the work of Rhinelander on the centrifugal blood supply to the cortex from the medulla. He maintains, however, that most of these fractures unite firstly by collars of periosteal callus, developing first as fibrous bridging with extension of the fibrosis between the fracture and cortices. There follow chapters on the healing of tracks left by implants used for fixation, the histology of the tissues surrounding corroding implants and tissue metallosis. He finishes with a chapter about the remodelling and reconstruction of bone aher fractures and there is finally an appendix describing the technique of micro-angiography which he used so successfully in preparing this masterpiece. This book is the distillation ofhalfa life-time’s work and the author’s experience must be unrivalled in the study of the human response to bony injury. The bibliography is extremely comprehensive and every library should have a copy of this volume and every research worker in this field should possess one himself. R. L. BATTEN Electrical Safety in Hospitals. By C. S. Ward. 214 x I38 mm. Pp. 208. 1981. London, Henry Kimpton. f 10.25. This book purports to be concerned with electrical safety in hospitals. but less than one-third of its contents are concerned with such matters, thus to fill a book format, some rather pretentious padding has had to be introduced. To understand the dangers of electrical apparatus in hospitals, an understanding of fundamental principles is required, but do we need to start with atomic theory? A more accurate and readable account of basic electricity can be found in most ‘0’ level physics text books. If one could ignore the occasional quaint text and diagram in the early sections ofthe book, then the later sections make interesting and informative reading. I do not believe it can be considered to be a text book
J. S. ROHNSON
The Care and Management of Spinal Cord Injuries. By George M. Bedbrook. Pp. 35 I, with 147 illustrations. 198 I. Berlin, Springer-Verlag. DM 75. It has been said that a certain academician once reviewed a monumental historical survey simply by saying, ‘this is another book’. The reviewer would appreciate quite a few pages to welcome this longawaited text book on spinal cord injuries. The author, a well-known orthopaedic surgeon, returned to Perth in 1954 hoping to take up nerve injuries as a subspecialty. In the event he soon found himself in charge of the developing Spinal Injury Unit, which is now an Australian ‘institution’ and an internationally recognized centre of excellence. Most of the credit for this must go to Sir George Bedbrook, described in the Foreword by Robert Jackson as a man who truly cares about people. The book is directed to all medical and allied health professionals involved in the treatment and rehabilitation of spinal paralysis. Early chapters include sections on prevention of these devastating injuries and their early management. There is special emphasis on respiratory care, acid-base physiology, management of the paralysed bladder and the prevention of joint contractures and pressure sores. Inevitably there is some overlap between the various sections, but the 40 pages or so devoted to nursing management can be read with profit by traumatic and orthopaedic surgeons. Some may take the view that the I5 pages on the techniques of catheterization and urological management is too detailed. However, this fails to recognize that the patient’s subsequent health and destiny is determined by a scrupulous urological technique in the first few days after injury. Incidentally, similar principles are equally applicable in general orthopaedic practice. Readers of this Journal will be especially interested in the early management of the major injury, and it is well to be reminded of the altered physiology consequent on the cord injury, as well as the late effects of the bony and ligamentous damage. Decisions made by merely looking at the radiographs must surely lead to disaster. A conservative approach is advocated and the author’s reasons for this are cogently expressed. Early manipulative reduction is favoured for dislocations of the cervical spine, and when this is inappropriate skull traction is advised. Thoracic and lumbar injuries are treated by postural reduction. The indications for open reduction are briefly considered. I would like to see more discussion on the use of Harrington and Knodt (mis-spelt Knott) rods. and the place for open reduction in irreducible dislocations of the cervical spine when the cord damage is incomplete. Experience has shown the frailty of wires and conventional plates in the management of these injuries and that internal fixation should only be undertaken by surgeons thoroughly familiar with the technique. The care of the hand in tetraplegia, occupational therapy, orthoses and the all-important follow-up service are considered in later chapters. A number of distinguished contributors have written specialized
533
Reviews
a chapter on non-union of fractures, investigating all the factors involved and referring to the work of Hicks and other important contributors in this field. There is a short but interesting chapter about the healing of amputations and more about the intracapsular fracture of the femoral neck with beautiful microradiographs and injection studies. His wide experience of the end results of hip fractures has enabled him to examine femoral heads many years after the fractures have been fixed either by nails or other methods, so that the whole natural history of this common condition has been explored. He deals with fractures complicating bums and especially in bums of the scalp with the effects on the skull. There is a chapter about the healing of fractures which have been fixed with medullary nails, examining carefully the part played by the periosteal blood supply. He clearly shows that the revascularization of dead fragment ends in a long bone occurs from the endostium, cortex and periosteum and pays tribute to the work of Rhinelander on the centrifugal blood supply to the cortex from the medulla. He maintains, however, that most of these fractures unite firstly by collars of periosteal callus, developing first as fibrous bridging with extension of the fibrosis between the fracture and cortices. There follow chapters on the healing of tracks left by implants used for fixation, the histology of the tissues surrounding corroding implants and tissue metallosis. He finishes with a chapter about the remodelling and reconstruction of bone aher fractures and there is finally an appendix describing the technique of micro-angiography which he used so successfully in preparing this masterpiece. This book is the distillation ofhalfa life-time’s work and the author’s experience must be unrivalled in the study of the human response to bony injury. The bibliography is extremely comprehensive and every library should have a copy of this volume and every research worker in this field should possess one himself. R. L. BATTEN Electrical Safety in Hospitals. By C. S. Ward. 214 x I38 mm. Pp. 208. 1981. London, Henry Kimpton. f 10.25. This book purports to be concerned with electrical safety in hospitals. but less than one-third of its contents are concerned with such matters, thus to fill a book format, some rather pretentious padding has had to be introduced. To understand the dangers of electrical apparatus in hospitals, an understanding of fundamental principles is required, but do we need to start with atomic theory? A more accurate and readable account of basic electricity can be found in most ‘0’ level physics text books. If one could ignore the occasional quaint text and diagram in the early sections ofthe book, then the later sections make interesting and informative reading. I do not believe it can be considered to be a text book
J. S. ROHNSON
The Care and Management of Spinal Cord Injuries. By George M. Bedbrook. Pp. 35 I, with 147 illustrations. 198 I. Berlin, Springer-Verlag. DM 75. It has been said that a certain academician once reviewed a monumental historical survey simply by saying, ‘this is another book’. The reviewer would appreciate quite a few pages to welcome this longawaited text book on spinal cord injuries. The author, a well-known orthopaedic surgeon, returned to Perth in 1954 hoping to take up nerve injuries as a subspecialty. In the event he soon found himself in charge of the developing Spinal Injury Unit, which is now an Australian ‘institution’ and an internationally recognized centre of excellence. Most of the credit for this must go to Sir George Bedbrook, described in the Foreword by Robert Jackson as a man who truly cares about people. The book is directed to all medical and allied health professionals involved in the treatment and rehabilitation of spinal paralysis. Early chapters include sections on prevention of these devastating injuries and their early management. There is special emphasis on respiratory care, acid-base physiology, management of the paralysed bladder and the prevention of joint contractures and pressure sores. Inevitably there is some overlap between the various sections, but the 40 pages or so devoted to nursing management can be read with profit by traumatic and orthopaedic surgeons. Some may take the view that the I5 pages on the techniques of catheterization and urological management is too detailed. However, this fails to recognize that the patient’s subsequent health and destiny is determined by a scrupulous urological technique in the first few days after injury. Incidentally, similar principles are equally applicable in general orthopaedic practice. Readers of this Journal will be especially interested in the early management of the major injury, and it is well to be reminded of the altered physiology consequent on the cord injury, as well as the late effects of the bony and ligamentous damage. Decisions made by merely looking at the radiographs must surely lead to disaster. A conservative approach is advocated and the author’s reasons for this are cogently expressed. Early manipulative reduction is favoured for dislocations of the cervical spine, and when this is inappropriate skull traction is advised. Thoracic and lumbar injuries are treated by postural reduction. The indications for open reduction are briefly considered. I would like to see more discussion on the use of Harrington and Knodt (mis-spelt Knott) rods. and the place for open reduction in irreducible dislocations of the cervical spine when the cord damage is incomplete. Experience has shown the frailty of wires and conventional plates in the management of these injuries and that internal fixation should only be undertaken by surgeons thoroughly familiar with the technique. The care of the hand in tetraplegia, occupational therapy, orthoses and the all-important follow-up service are considered in later chapters. A number of distinguished contributors have written specialized