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The injured adolescent knee
Injury, 11,34 l-342 Printed in Great Britain
341
Book Reviews Immediate Care of the Sick and Injured Child. Edited by Shiv K. Dube and Sophie H. Pierog. 255 x 175 mm. Pp. xv + 286, with 6 illustrations and index. St Louis. Mosby. E12.00. This volume of contributions from 20 American authors, edited by two paediatricians from New York, is too bulky to be carried around and is really a reference book for the accident and emergency department. It is divided into two main sections. The first, in forty pages, takes the reader through the seventeen most common signs and symptoms with which a child may present (for instance, fever, cough, noisy breathing, convulsions, limp etc.) and indicates clearly the most likely causes that should be looked for. The second section, in seventeen chapters spread over 186 pages, deals with the common emergencies as they affect the various body systems - cardiopulmonary, gastrointestinal, genito-urinary etc. -and adds sections on bums, child battering and poisoning, to mention only a few of the topics. There are five appendices, a list of abbreviations that would have been more welcome at the beginning of the book and an index. It would be quite correct to call this book a ‘mine of information’, but not all mines have very rich seams, the quality of the ore may vary greatly and the prospector (like the book reviewer) can only make a reliable assay from samples of material of which he has expert knowledge. A great deal of the information in this book deals with paediatric medical emergencies and such subjects as the management of coma, convulsion, dehydration and poisoning. The surgical guidance that is given is usually expressed in fairly general terms and is normally reliable. It is, however, a little disturbing to see bums still classified into four degrees and to read that in the treatment of minor bums one should ‘change the dressing daily’. This cruel practice, both physical and psychological, is unforgivable, especially in a paediatric unit. To reproduce accurately the mass of figures quoted in the text, tables and appendices, must have been sheer agony for the compositors and even worse for the proof readers, particularly when a misplaced decimal point can literally be death. The index is highly unsatisfactory, incomplete and does not make for easy reference. For instance ‘Nomogram, Done. 203’ is utterly meaningless until you look at page 203 and fmd there a nomogram on salicylate intoxication adapted
from an article by A. K. Done in a paediatric journal published in 1960. The print and lay out of the main body of the book is designed for the American reader and the American market. Its style is dull but clear and a welcome relief from the appalling jargon and execrable English of the opening two chapters, which made your reviewer wince so often that one could have been forgiven for mistaking the symptoms of early tetanus. Unfortunately, this book does not tell you how to treat tetanus and you will not find it even mentioned in the index! MICHAELN. TEMPEST
The Injured Adolescent Knee. Edited by J. C. Kennedy. 235 x 155 mm. Pp. 256. Illustrated, with index. 1979. Baltimore, Williams&Wilkins. $29.75. For those interested in the knee this is undeniably an enjoyable little book to read. Each section is written by world authorities on their subject and both the subject matter and the bibliography are extensive for such a small volume. However, the question remains as to whether there is either the justification or need for such a book. In the preface the editor states that ‘the adolescent knee is unhke the adult knee. The reader will immediately grasp the significance of this observation as the chapters unfold’. Unfortunately, this reader failed to grasp this significance and indeed became persuaded that the injured adolescent knee was similar to most injured adult knees. The justification would seem to rely on the two subjects of epiphyseal plate injuries and chondromalacia patellae and it must be said that these are described well as one would expect from Professors Salter and James who have contributed so much to our understanding of these conditions. The chapter on chondromalacia patellae is particularly rewarding in its commonsense, instructive and surprisingly conservative approach to this baming condition or conditions, but the fmal answer to chondromalacia patellae is neither reached nor given. It is a common condition in adolescent girls and it was slightly disappointing to read a description of open lateral retinacular release with its resultant large scar without a mention of the so-called closed lateral retinacular release with its small scar.
BookRewews
342
If it is truly a book about the adolescent there are a few unnecessary inclusions, such as a description of patella’ tendon realignment in the skeletally mature and an example of an avulsed tibia1 intercondylar eminence in a 23-year-old. The purist will be sad to see pes anserinus and pes anserine in the same paragraph and to read of tibia varum. However, these are minor criticisms of a wellwritten, clear and concise book. I just wonder whether such a title is justified and whether it will dissuade most accident surgeons from reading it. It only takes two evenings to read and provides a useful approach to knee injuries in general.
well as the usefulness of any length of stump provided that it has good sensibility. The psychological effects of injury of the hand receive consideration, which could usefully have included a reference to the fact that a patient buoyed up by the enthusiasm and encouragement of medical and other therapeutic staff in the hospital may lapse into despondency when he goes home and is exposed directly to the well-intentioned but over-anxious sympathy of his kin and kith- but perhaps such things do not happen in France! P.S. LONDON
NIGELTUBBS
Mutilating Injuries of the Hand. Edited by D. A. Campbell Reid and the late J. Gosset. 280 x 225 mm. Pp. 144. Illustrated, with index. 1979. Edinburgh, Churchill Livingstone. f18. This is the third volume in the series of monographs reduced by Groupe d’Etude de la Main, the interTiatlonal membership of which is more than merely hinted at by the fact that among the twenty-eight collaborators one editor is English, one of the contributors is Indian, another Swiss and three others Australian. The quality and practical value of the book will quickly become evident to the enquiring reader with an interest in the surgical care of injured hands. The twenty-five chapters vary in length from a half to fourteen pages and it is to the credit of the editors that they have achieved an agreeable unity of style. It will be noted sadly that in his introduction Campbell Reid draws attention to the death of Professor Gosset shortly before the book went to press. One of the refreshing features of this book is the succinctness of the text and, with few exceptions, the helpful clarity ofthe illustrations. All sorts and degrees of damage from the loss of a finger tip up to destruction of the hand are included. Newcomers to so-called minor surgery will derive much benefit from studying carefully the properly detailed advice on techniques for amputation in the hand. Perhaps an outstanding example of the contributors’ restraint is the chapter by O’Brien and his colleagues, who have stressed the need for careful thought before attempting tore-attach a severed part, and in two other chapters on microsurgical techniques, including the transplantation of a toe to the hand, the authors discuss indications rather than technicalities. The use of surgical diathermy as a means of preventing painful neuromas deserves widespread publication. The different methods of reconstructing a missing or mutilated thumb could perhaps have received slightly more consideration of their respective indications as
Advanced Training for Ambulance Attendants. Edited by B. G. B. Lucas. I50 x I22 mm. Pp. 63. Illustrated. 1979. Medical Commission on Accident Prevention. f2. The title suggests that the ambulanceman seeking advanced training will fmd all that he needs to know, short of practical details, in its pages and the fact that three of its contributors are doctors and two are senior ambulance officers might seem to support this suggestion. However, the preface clearly states that the book is intended as only a ‘basis for training... in advanced resuscitative techniques’ and ‘as a reference book by students and as a guide for those arranging training. Even by these qualified standards the book is disappointing and it would be more appropriately entitled to show that it is merely an introduction. In many respects the information available is a good deal less than is to be found in other works aimed at the higher levels of practice within the ambulance service. There is, for example, no reference to the paradoxical movements of the chest that occur after it has been stove-in or as a result of tetraplegia, and in the chapter on head injuries there is no reference to the movements and posture that indicate decerebration. This makes the statement that spontaneous movements are reassuring dangerously misleading. In matters of detail, the carina and dyspnoea are wrongly defined; diffusion is stated to be the same as osmosis and the word electrocardiograph is used instead of electrocardiogram. To state that Hartmann’s solution is better that saline for maintaining the circulating volume is misleading. The act of intubation is described in some detail whereas venepuncture is accorded less and the account of cardiac irregularities, which govern the management of some cases, is very brief. Admittedly these are matters that should be learned on the job but their omission disqualifies this as a reference book. The idea is a good one but it could be-and one may be sure that it will be-better realized. P.S. LONDON
341
Book Reviews Immediate Care of the Sick and Injured Child. Edited by Shiv K. Dube and Sophie H. Pierog. 255 x 175 mm. Pp. xv + 286, with 6 illustrations and index. St Louis. Mosby. E12.00. This volume of contributions from 20 American authors, edited by two paediatricians from New York, is too bulky to be carried around and is really a reference book for the accident and emergency department. It is divided into two main sections. The first, in forty pages, takes the reader through the seventeen most common signs and symptoms with which a child may present (for instance, fever, cough, noisy breathing, convulsions, limp etc.) and indicates clearly the most likely causes that should be looked for. The second section, in seventeen chapters spread over 186 pages, deals with the common emergencies as they affect the various body systems - cardiopulmonary, gastrointestinal, genito-urinary etc. -and adds sections on bums, child battering and poisoning, to mention only a few of the topics. There are five appendices, a list of abbreviations that would have been more welcome at the beginning of the book and an index. It would be quite correct to call this book a ‘mine of information’, but not all mines have very rich seams, the quality of the ore may vary greatly and the prospector (like the book reviewer) can only make a reliable assay from samples of material of which he has expert knowledge. A great deal of the information in this book deals with paediatric medical emergencies and such subjects as the management of coma, convulsion, dehydration and poisoning. The surgical guidance that is given is usually expressed in fairly general terms and is normally reliable. It is, however, a little disturbing to see bums still classified into four degrees and to read that in the treatment of minor bums one should ‘change the dressing daily’. This cruel practice, both physical and psychological, is unforgivable, especially in a paediatric unit. To reproduce accurately the mass of figures quoted in the text, tables and appendices, must have been sheer agony for the compositors and even worse for the proof readers, particularly when a misplaced decimal point can literally be death. The index is highly unsatisfactory, incomplete and does not make for easy reference. For instance ‘Nomogram, Done. 203’ is utterly meaningless until you look at page 203 and fmd there a nomogram on salicylate intoxication adapted
from an article by A. K. Done in a paediatric journal published in 1960. The print and lay out of the main body of the book is designed for the American reader and the American market. Its style is dull but clear and a welcome relief from the appalling jargon and execrable English of the opening two chapters, which made your reviewer wince so often that one could have been forgiven for mistaking the symptoms of early tetanus. Unfortunately, this book does not tell you how to treat tetanus and you will not find it even mentioned in the index! MICHAELN. TEMPEST
The Injured Adolescent Knee. Edited by J. C. Kennedy. 235 x 155 mm. Pp. 256. Illustrated, with index. 1979. Baltimore, Williams&Wilkins. $29.75. For those interested in the knee this is undeniably an enjoyable little book to read. Each section is written by world authorities on their subject and both the subject matter and the bibliography are extensive for such a small volume. However, the question remains as to whether there is either the justification or need for such a book. In the preface the editor states that ‘the adolescent knee is unhke the adult knee. The reader will immediately grasp the significance of this observation as the chapters unfold’. Unfortunately, this reader failed to grasp this significance and indeed became persuaded that the injured adolescent knee was similar to most injured adult knees. The justification would seem to rely on the two subjects of epiphyseal plate injuries and chondromalacia patellae and it must be said that these are described well as one would expect from Professors Salter and James who have contributed so much to our understanding of these conditions. The chapter on chondromalacia patellae is particularly rewarding in its commonsense, instructive and surprisingly conservative approach to this baming condition or conditions, but the fmal answer to chondromalacia patellae is neither reached nor given. It is a common condition in adolescent girls and it was slightly disappointing to read a description of open lateral retinacular release with its resultant large scar without a mention of the so-called closed lateral retinacular release with its small scar.
BookRewews
342
If it is truly a book about the adolescent there are a few unnecessary inclusions, such as a description of patella’ tendon realignment in the skeletally mature and an example of an avulsed tibia1 intercondylar eminence in a 23-year-old. The purist will be sad to see pes anserinus and pes anserine in the same paragraph and to read of tibia varum. However, these are minor criticisms of a wellwritten, clear and concise book. I just wonder whether such a title is justified and whether it will dissuade most accident surgeons from reading it. It only takes two evenings to read and provides a useful approach to knee injuries in general.
well as the usefulness of any length of stump provided that it has good sensibility. The psychological effects of injury of the hand receive consideration, which could usefully have included a reference to the fact that a patient buoyed up by the enthusiasm and encouragement of medical and other therapeutic staff in the hospital may lapse into despondency when he goes home and is exposed directly to the well-intentioned but over-anxious sympathy of his kin and kith- but perhaps such things do not happen in France! P.S. LONDON
NIGELTUBBS
Mutilating Injuries of the Hand. Edited by D. A. Campbell Reid and the late J. Gosset. 280 x 225 mm. Pp. 144. Illustrated, with index. 1979. Edinburgh, Churchill Livingstone. f18. This is the third volume in the series of monographs reduced by Groupe d’Etude de la Main, the interTiatlonal membership of which is more than merely hinted at by the fact that among the twenty-eight collaborators one editor is English, one of the contributors is Indian, another Swiss and three others Australian. The quality and practical value of the book will quickly become evident to the enquiring reader with an interest in the surgical care of injured hands. The twenty-five chapters vary in length from a half to fourteen pages and it is to the credit of the editors that they have achieved an agreeable unity of style. It will be noted sadly that in his introduction Campbell Reid draws attention to the death of Professor Gosset shortly before the book went to press. One of the refreshing features of this book is the succinctness of the text and, with few exceptions, the helpful clarity ofthe illustrations. All sorts and degrees of damage from the loss of a finger tip up to destruction of the hand are included. Newcomers to so-called minor surgery will derive much benefit from studying carefully the properly detailed advice on techniques for amputation in the hand. Perhaps an outstanding example of the contributors’ restraint is the chapter by O’Brien and his colleagues, who have stressed the need for careful thought before attempting tore-attach a severed part, and in two other chapters on microsurgical techniques, including the transplantation of a toe to the hand, the authors discuss indications rather than technicalities. The use of surgical diathermy as a means of preventing painful neuromas deserves widespread publication. The different methods of reconstructing a missing or mutilated thumb could perhaps have received slightly more consideration of their respective indications as
Advanced Training for Ambulance Attendants. Edited by B. G. B. Lucas. I50 x I22 mm. Pp. 63. Illustrated. 1979. Medical Commission on Accident Prevention. f2. The title suggests that the ambulanceman seeking advanced training will fmd all that he needs to know, short of practical details, in its pages and the fact that three of its contributors are doctors and two are senior ambulance officers might seem to support this suggestion. However, the preface clearly states that the book is intended as only a ‘basis for training... in advanced resuscitative techniques’ and ‘as a reference book by students and as a guide for those arranging training. Even by these qualified standards the book is disappointing and it would be more appropriately entitled to show that it is merely an introduction. In many respects the information available is a good deal less than is to be found in other works aimed at the higher levels of practice within the ambulance service. There is, for example, no reference to the paradoxical movements of the chest that occur after it has been stove-in or as a result of tetraplegia, and in the chapter on head injuries there is no reference to the movements and posture that indicate decerebration. This makes the statement that spontaneous movements are reassuring dangerously misleading. In matters of detail, the carina and dyspnoea are wrongly defined; diffusion is stated to be the same as osmosis and the word electrocardiograph is used instead of electrocardiogram. To state that Hartmann’s solution is better that saline for maintaining the circulating volume is misleading. The act of intubation is described in some detail whereas venepuncture is accorded less and the account of cardiac irregularities, which govern the management of some cases, is very brief. Admittedly these are matters that should be learned on the job but their omission disqualifies this as a reference book. The idea is a good one but it could be-and one may be sure that it will be-better realized. P.S. LONDON