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Major fractures of the pilon, the talus and the calcaneus
Book reviews
ABC of Spinal Cord Injury. 2nd Edition. D. Grundy and A. Swain. BMJ Publishing Group. 072790760 3. f8.95, 1993,56pp.
This is the 2nd edition of a valuable publication
which was first published in 1986 and reprinted in 1989, 1990 and 1991, denoting the importance of the subject and the popularity of the 1st edition. The chapters are written in the same logical sequence and contain very useful sketches that will help the first-time reader in many ways. The myotomal and dermatomal distribution of the spinal cord as well as the various types of cord syndromes are likely to be particularly useful to the casualty officer who, for the first time, has a patient to manage. As with the 1st edition, this new edition presents the information in the same concise, precise and to-the-point manner, highlighting the ‘do’s and dont’s’ before the transfer of the patient to a spinal injuries centre. The authors discuss the management of the multi-system impairment and in a practical way demonstrate the management procedures of this impairment by the various members of a multidisciplinary team. The importance of early psychosocial rehabilitation and the mechanics of this process are well described, reinforcing the importance of the management of patients with spinal injuries from a very early stage in spinal injuries centres. The involvement in the community and the importance of long-term follow up and management procedures by the spinal injury team are also well described. The authors provide a further reading list for the interested clinician and the absence of specific references does not disadvantage this publication. At f8.95 the book is affordable by most casualty officers and is valuable to every casualty department. W. S. El Masry
Violence -a Compendium from the American Medical Association. American Medical Association. 089970493 X. Price US$29.95, 1992, 424 pp. One in three high school students have fired their gun at someone. Can this be true? On re-reading we find that 6.4 per cent own a handgun so it is presumably only 2 per cent who have apparently tried to kill someone. Even so, it is not a reassuring statistic. This and many other items can be found in a collection of papers originally published in JAMA and its associated journals in the first half of 1992. The intention was to increase public and professional awareness of violence in American society as part of a campaign to have it recognized as a public health emergency. Inevitably one tends to retreat from many of the papers on the ownership and use of guns as being a reflection of an American phenomenon that is unlikely to occur in Europe. Nevertheless British newspapers suggest that violence in Britain is increasing and many of the other papers do have immediate relevance. Child abuse is dealt with extensively, as are other forms of 0 1994 Butterworth-Heinemann 0020-1383/94/060411-02
Ltd
domestic violence. The financial problems of their trauma centres are worth examining as we may find that this type of medical and surgical excellence does not fit happily into the market-place of the new British Health Service. For those who study the history of medicine there is a definitive account of J.F.K.‘s autopsy. The suspicious detail concerning the paperwork is cleared up by J. J. Humes MD, one of the pathologists. At the end of the postmortem he found that his notes had become stained with J.F.K.‘s blood, making them potentially a grisly collectors’ item. So he simply copied them out verbatim and burned the originals. Nothing suspicious at all, though it might have been wiser to have kept the originals in a secure place. Oh, and by the way, it was two high-velocity rounds fired from above and behind. You can forget the grassy knoll. Richard Cherry
Major Fractures of the Pilon, the Talus and the Calcaneus. H. Tscheme and J. Schatzker. Springer-Verlag GmbH & Co. KG. 354055837 3, DM198.00, 1993. This book which is edited by two gurus of the fracture world, represents the proceedings of a joint meeting of the Trauma Associations of Austria, Germany, Switzerland and North America held in May 1991. The meeting was asked to explore and compare current concepts in management of fractures of the talus, OS calcis, and distal tibia. The book is thus in three sections; each consists of several papers discussing different aspects of the management of these complex injuries covering the European and North American viewpoints. Inevitably there is some overlap in content between the chapters and, interestingly, some differences in interpretation of existing concepts and facts. The topics discussed include: biomechanics, assessment of fractures and soft tissues, operative techniques, short- and long-term results of treatment, complications and salvage surgery. The operative techniques are not always spelt out as clearly as one would like but, nevertheless, there are many useful tips to be learnt. In most of the chapters, the diagrams are all placed at the end of the text which leads to a lot of page-turning but on the whole the figures complement the discussions well. The book emphasizes the difficulties inherent in treating these fractures and the need for them to be dealt with by committed and interested injury surgeons. As this book gives the viewpoints and experience of most of the leading international names in these fields and includes an informative reference list it will be of value to any enthusiastic injury surgeon. As a sideline, this book does illustrate how contused some issues remain and may provide food for thought for those researchers who would like to fill in some of the gaps in our knowledge. This book should be in the library of any orthopaedic department interested in the care of injury patients. D. Eastwood
ABC of Spinal Cord Injury. 2nd Edition. D. Grundy and A. Swain. BMJ Publishing Group. 072790760 3. f8.95, 1993,56pp.
This is the 2nd edition of a valuable publication
which was first published in 1986 and reprinted in 1989, 1990 and 1991, denoting the importance of the subject and the popularity of the 1st edition. The chapters are written in the same logical sequence and contain very useful sketches that will help the first-time reader in many ways. The myotomal and dermatomal distribution of the spinal cord as well as the various types of cord syndromes are likely to be particularly useful to the casualty officer who, for the first time, has a patient to manage. As with the 1st edition, this new edition presents the information in the same concise, precise and to-the-point manner, highlighting the ‘do’s and dont’s’ before the transfer of the patient to a spinal injuries centre. The authors discuss the management of the multi-system impairment and in a practical way demonstrate the management procedures of this impairment by the various members of a multidisciplinary team. The importance of early psychosocial rehabilitation and the mechanics of this process are well described, reinforcing the importance of the management of patients with spinal injuries from a very early stage in spinal injuries centres. The involvement in the community and the importance of long-term follow up and management procedures by the spinal injury team are also well described. The authors provide a further reading list for the interested clinician and the absence of specific references does not disadvantage this publication. At f8.95 the book is affordable by most casualty officers and is valuable to every casualty department. W. S. El Masry
Violence -a Compendium from the American Medical Association. American Medical Association. 089970493 X. Price US$29.95, 1992, 424 pp. One in three high school students have fired their gun at someone. Can this be true? On re-reading we find that 6.4 per cent own a handgun so it is presumably only 2 per cent who have apparently tried to kill someone. Even so, it is not a reassuring statistic. This and many other items can be found in a collection of papers originally published in JAMA and its associated journals in the first half of 1992. The intention was to increase public and professional awareness of violence in American society as part of a campaign to have it recognized as a public health emergency. Inevitably one tends to retreat from many of the papers on the ownership and use of guns as being a reflection of an American phenomenon that is unlikely to occur in Europe. Nevertheless British newspapers suggest that violence in Britain is increasing and many of the other papers do have immediate relevance. Child abuse is dealt with extensively, as are other forms of 0 1994 Butterworth-Heinemann 0020-1383/94/060411-02
Ltd
domestic violence. The financial problems of their trauma centres are worth examining as we may find that this type of medical and surgical excellence does not fit happily into the market-place of the new British Health Service. For those who study the history of medicine there is a definitive account of J.F.K.‘s autopsy. The suspicious detail concerning the paperwork is cleared up by J. J. Humes MD, one of the pathologists. At the end of the postmortem he found that his notes had become stained with J.F.K.‘s blood, making them potentially a grisly collectors’ item. So he simply copied them out verbatim and burned the originals. Nothing suspicious at all, though it might have been wiser to have kept the originals in a secure place. Oh, and by the way, it was two high-velocity rounds fired from above and behind. You can forget the grassy knoll. Richard Cherry
Major Fractures of the Pilon, the Talus and the Calcaneus. H. Tscheme and J. Schatzker. Springer-Verlag GmbH & Co. KG. 354055837 3, DM198.00, 1993. This book which is edited by two gurus of the fracture world, represents the proceedings of a joint meeting of the Trauma Associations of Austria, Germany, Switzerland and North America held in May 1991. The meeting was asked to explore and compare current concepts in management of fractures of the talus, OS calcis, and distal tibia. The book is thus in three sections; each consists of several papers discussing different aspects of the management of these complex injuries covering the European and North American viewpoints. Inevitably there is some overlap in content between the chapters and, interestingly, some differences in interpretation of existing concepts and facts. The topics discussed include: biomechanics, assessment of fractures and soft tissues, operative techniques, short- and long-term results of treatment, complications and salvage surgery. The operative techniques are not always spelt out as clearly as one would like but, nevertheless, there are many useful tips to be learnt. In most of the chapters, the diagrams are all placed at the end of the text which leads to a lot of page-turning but on the whole the figures complement the discussions well. The book emphasizes the difficulties inherent in treating these fractures and the need for them to be dealt with by committed and interested injury surgeons. As this book gives the viewpoints and experience of most of the leading international names in these fields and includes an informative reference list it will be of value to any enthusiastic injury surgeon. As a sideline, this book does illustrate how contused some issues remain and may provide food for thought for those researchers who would like to fill in some of the gaps in our knowledge. This book should be in the library of any orthopaedic department interested in the care of injury patients. D. Eastwood