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The Shoulder (in 2 vols)
Mayo Clin Proc, J u l y 1990, Vol 65
discusses useful rehabilitation sequences. The other five chapters could probably be considered individual monographs, i n a s m u c h as each ad dresses an extremely important subject in de tail. A special note should be made of the illustrations by R. J. Demarest. The excellent quality of t h e s e clear and accurate drawings truly classifies them a s medical art. The five major chapters of the book address the following topics: fractures; dislocations; rotator cuff tears, biceps lesions, and impinge ment; prosthetic glenohumeral arthroplasty; and a variety of problems discussed under the heading, "Less Frequent Procedures." The au thor developed the currently used classification s y s t e m for upper humeral fractures. The s y s t e m is updated in this text; in addition, the author describes his methods for evaluating and treat ing other fractures of the shoulder. This mate rial is not readily available elsewhere. In the second major chapter (on instability of the shoulder), the author, well known for his development of a solution to the problem of multidirectional instability, describes the modes of evaluation and m a n a g e m e n t of other, often more common, types of shoulder instability. The reader will be impressed by the soundness and simplicity of the approach. N o n e t h e l e s s , t h e s e problems are not minor, nor are the solutions easily accomplished; however, with u s e of Neer's guidelines, a successful outcome can usually be expected. The subacromial impingement syndrome w a s elevated to clinical usefulness by the author, and in this text, the understanding of this problem is further developed. The various possible causes of the problem, the importance of recognizing and treating it, and the spectrum of clinical manifestations are described in a breadth and depth that have not previously been available (and perhaps will not be offered again). Essentially, Dr. N e e r developed the currently used technique of prosthetic glenohumeral arthroplasty, and the fourth major chapter is devoted to this subject. The chapter reviews the evolution of prosthetic arthroplasty, describes the associated pathologic conditions for which this treatment might be needed, and includes
BOOK REVIEWS 1043
details of m a n a g e m e n t t h a t have heretofore not been fully described or adequately illustrated. The fifth major chapter, encompassing sub jects designated as "Less Frequent Procedures," is indeed a delight. Many of the problems consid ered are common, and the treatment is almost always nonoperative. Subjects discussed in clude the frozen shoulder, calcific tendon depos its, acromioclavicular and sternoclavicular ar thritis, and scapular pain syndromes, all of which are presented with refreshing clarity. Confusion and uncertainties have no place in this enlightening text. The approximately 300 references encompass all the major articles in the field, including Neer's earlier writings and, most importantly perhaps, his early abstracts. These sources are sometimes difficult to find but address m a n y important issues. A "must" for orthopedic surgeons (both practitioners and trainees), this well-focused, amply illustrated text should also be useful to other specialists who treat patients with shoulder conditions. Physical therapists, for example, will appreciate not only the chapter on rehabilitation techniques but also the succinct presentations of major disease categories and their overall treatment. This text will undoubtedly endure and undergo numerous reprintings. Robert H. Cofield, M.D. Department of Orthopedics
T h e S h o u l d e r (in 2 vols), edited by Charles A. Rockwood, Jr., and Frederick A. Matsen III, 1,108 pp, with illus, $175, Philadelphia, W. B. Saunders Company, 1990 This two-volume text represents an encyclope dic exposition of current medical knowledge pertaining to the shoulder joint—in health and disease, in children and adults. The 29 chapters were written by the editors and 44 contributing authors, all of whom are recognized authorities in their fields of interest. This definitive text covers "everything you ever wanted to know" about the shoulder. It
Mayo Clin Proc, J u l y 1990, Vol 65
1044 BOOK REVIEWS
begins with chapters on developmental and gross anatomy of the shoulder, biomechanics, clinical and roentgenographic evaluation, and arthroscopy. All possible afflictions o f t h e struc tures of the shoulder joint, such as t r a u m a and fractures, degenerative diseases, neurologic prob lems, tumors, amputation and prosthetic re placement, sepsis, sports-related conditions, and occupational disorders, are considered. The text is mechanically well done, with copi ous, clear illustrations and complete, appropri ate referencing. The chapters are uniformly organized to include historical review, anatomy, classification, clinical and roentgenographic findings, differential diagnosis, surgical and nonsurgical methods of treatment, and the au thors' preferred therapeutic methods. The uninformed m i g h t be astonished t h a t so much could be written about the shoulder joint. The shoulder, however, is an extremely com plex structure, comprising all the bony and soft tissues that form the shoulder girdle. It is an intrinsically unstable diarthrodial joint, the function of which h a s reached an advanced state of phylogenic precision in Homo sapiens. The m o v e m e n t and stability of the joint are in a fine balance that depends on both static and dynamic soft t i s s u e constraints. Thus, t r a u m a or degenerative diseases affecting any of the multitude of structural components of the shoulder girdle complex are likely to have pro found effects on the ability of a person to work or otherwise function effectively. Clinical eval uation of this complex structure is difficult and d e m a n d s a high level of knowledge and diagnos tic acumen. This book is a cornucopia of helpful hints and suggestions that should be useful to any physi cian who encounters patients with shoulder problems. It should be studied from cover to cover by those with a special interest in shoulder problems, although a complete reading is a daunting task. These two volumes constitute a valuable reference source that belongs in the library of every orthopedic surgeon. Richard N. Stauffer, M.D. D e p a r t m e n t of Orthopedics
Foot Orthoses: P r i n c i p l e s a n d Clinical Ap p l i c a t i o n s , by Kent K. Wu, 379 pp, with illus, $75, Baltimore, Williams & Wilkins, 1990 Surgical t r e a t m e n t is only one of the m a n y therapeutic options for foot disorders. Many patients can obtain relief from pain through the effective use of foot orthoses. This welcome addition to the literature on foot care presents the techniques u s e d by the author and his col leagues at Henry Ford Hospital in Detroit. Although the text is mainly concerned with foot orthoses, it addresses the spectrum of con servative (nonsurgical) techniques for care of the foot, beginning with the basics of examina tion and biomechanics. Two excellent chapters cover the principles, definitions, and general considerations of orthoses for the foot. The bulk of the text is directed toward techniques for fabrication of various orthoses and their applica tions. Some of t h e s e applications are specialized (for example, adapting partially amputated or deformed feet to accommodate regular footwear), w h e r e a s others address more commonly encoun tered problems such as metatarsalgia, toe de formities, corns, calluses, and arthritic joints. The author devotes a lengthy chapter to the diagnosis and treatment of foot ulcers. This section begins with a review of antibiotics, pro g r e s s e s to a discussion of d i s e a s e s in which foot ulcers m a y occur, and then outlines useful diag nostic methods. Appropriately, considerable e m p h a s i s is given to diabetes-related foot ulcers. Although unexpected in light of the book's title, the text also includes a several-page overview of the surgical treatment of diabetic and rheuma toid problems of the feet. The book concludes with a chapter devoted to foot orthoses in rela tionship to sports shoes and sports medicine. Dr. Wu's book goes well beyond the scope of its title, including material more commonly found in introductory texts on foot surgery. Although applied science plays a major role in the field of foot orthoses, the "art" remains an essential element. For this reason, the parts of the book that address materials and technique are espe cially valuable. The references and lists of sug gested readings are extensive; the reader would
discusses useful rehabilitation sequences. The other five chapters could probably be considered individual monographs, i n a s m u c h as each ad dresses an extremely important subject in de tail. A special note should be made of the illustrations by R. J. Demarest. The excellent quality of t h e s e clear and accurate drawings truly classifies them a s medical art. The five major chapters of the book address the following topics: fractures; dislocations; rotator cuff tears, biceps lesions, and impinge ment; prosthetic glenohumeral arthroplasty; and a variety of problems discussed under the heading, "Less Frequent Procedures." The au thor developed the currently used classification s y s t e m for upper humeral fractures. The s y s t e m is updated in this text; in addition, the author describes his methods for evaluating and treat ing other fractures of the shoulder. This mate rial is not readily available elsewhere. In the second major chapter (on instability of the shoulder), the author, well known for his development of a solution to the problem of multidirectional instability, describes the modes of evaluation and m a n a g e m e n t of other, often more common, types of shoulder instability. The reader will be impressed by the soundness and simplicity of the approach. N o n e t h e l e s s , t h e s e problems are not minor, nor are the solutions easily accomplished; however, with u s e of Neer's guidelines, a successful outcome can usually be expected. The subacromial impingement syndrome w a s elevated to clinical usefulness by the author, and in this text, the understanding of this problem is further developed. The various possible causes of the problem, the importance of recognizing and treating it, and the spectrum of clinical manifestations are described in a breadth and depth that have not previously been available (and perhaps will not be offered again). Essentially, Dr. N e e r developed the currently used technique of prosthetic glenohumeral arthroplasty, and the fourth major chapter is devoted to this subject. The chapter reviews the evolution of prosthetic arthroplasty, describes the associated pathologic conditions for which this treatment might be needed, and includes
BOOK REVIEWS 1043
details of m a n a g e m e n t t h a t have heretofore not been fully described or adequately illustrated. The fifth major chapter, encompassing sub jects designated as "Less Frequent Procedures," is indeed a delight. Many of the problems consid ered are common, and the treatment is almost always nonoperative. Subjects discussed in clude the frozen shoulder, calcific tendon depos its, acromioclavicular and sternoclavicular ar thritis, and scapular pain syndromes, all of which are presented with refreshing clarity. Confusion and uncertainties have no place in this enlightening text. The approximately 300 references encompass all the major articles in the field, including Neer's earlier writings and, most importantly perhaps, his early abstracts. These sources are sometimes difficult to find but address m a n y important issues. A "must" for orthopedic surgeons (both practitioners and trainees), this well-focused, amply illustrated text should also be useful to other specialists who treat patients with shoulder conditions. Physical therapists, for example, will appreciate not only the chapter on rehabilitation techniques but also the succinct presentations of major disease categories and their overall treatment. This text will undoubtedly endure and undergo numerous reprintings. Robert H. Cofield, M.D. Department of Orthopedics
T h e S h o u l d e r (in 2 vols), edited by Charles A. Rockwood, Jr., and Frederick A. Matsen III, 1,108 pp, with illus, $175, Philadelphia, W. B. Saunders Company, 1990 This two-volume text represents an encyclope dic exposition of current medical knowledge pertaining to the shoulder joint—in health and disease, in children and adults. The 29 chapters were written by the editors and 44 contributing authors, all of whom are recognized authorities in their fields of interest. This definitive text covers "everything you ever wanted to know" about the shoulder. It
Mayo Clin Proc, J u l y 1990, Vol 65
1044 BOOK REVIEWS
begins with chapters on developmental and gross anatomy of the shoulder, biomechanics, clinical and roentgenographic evaluation, and arthroscopy. All possible afflictions o f t h e struc tures of the shoulder joint, such as t r a u m a and fractures, degenerative diseases, neurologic prob lems, tumors, amputation and prosthetic re placement, sepsis, sports-related conditions, and occupational disorders, are considered. The text is mechanically well done, with copi ous, clear illustrations and complete, appropri ate referencing. The chapters are uniformly organized to include historical review, anatomy, classification, clinical and roentgenographic findings, differential diagnosis, surgical and nonsurgical methods of treatment, and the au thors' preferred therapeutic methods. The uninformed m i g h t be astonished t h a t so much could be written about the shoulder joint. The shoulder, however, is an extremely com plex structure, comprising all the bony and soft tissues that form the shoulder girdle. It is an intrinsically unstable diarthrodial joint, the function of which h a s reached an advanced state of phylogenic precision in Homo sapiens. The m o v e m e n t and stability of the joint are in a fine balance that depends on both static and dynamic soft t i s s u e constraints. Thus, t r a u m a or degenerative diseases affecting any of the multitude of structural components of the shoulder girdle complex are likely to have pro found effects on the ability of a person to work or otherwise function effectively. Clinical eval uation of this complex structure is difficult and d e m a n d s a high level of knowledge and diagnos tic acumen. This book is a cornucopia of helpful hints and suggestions that should be useful to any physi cian who encounters patients with shoulder problems. It should be studied from cover to cover by those with a special interest in shoulder problems, although a complete reading is a daunting task. These two volumes constitute a valuable reference source that belongs in the library of every orthopedic surgeon. Richard N. Stauffer, M.D. D e p a r t m e n t of Orthopedics
Foot Orthoses: P r i n c i p l e s a n d Clinical Ap p l i c a t i o n s , by Kent K. Wu, 379 pp, with illus, $75, Baltimore, Williams & Wilkins, 1990 Surgical t r e a t m e n t is only one of the m a n y therapeutic options for foot disorders. Many patients can obtain relief from pain through the effective use of foot orthoses. This welcome addition to the literature on foot care presents the techniques u s e d by the author and his col leagues at Henry Ford Hospital in Detroit. Although the text is mainly concerned with foot orthoses, it addresses the spectrum of con servative (nonsurgical) techniques for care of the foot, beginning with the basics of examina tion and biomechanics. Two excellent chapters cover the principles, definitions, and general considerations of orthoses for the foot. The bulk of the text is directed toward techniques for fabrication of various orthoses and their applica tions. Some of t h e s e applications are specialized (for example, adapting partially amputated or deformed feet to accommodate regular footwear), w h e r e a s others address more commonly encoun tered problems such as metatarsalgia, toe de formities, corns, calluses, and arthritic joints. The author devotes a lengthy chapter to the diagnosis and treatment of foot ulcers. This section begins with a review of antibiotics, pro g r e s s e s to a discussion of d i s e a s e s in which foot ulcers m a y occur, and then outlines useful diag nostic methods. Appropriately, considerable e m p h a s i s is given to diabetes-related foot ulcers. Although unexpected in light of the book's title, the text also includes a several-page overview of the surgical treatment of diabetic and rheuma toid problems of the feet. The book concludes with a chapter devoted to foot orthoses in rela tionship to sports shoes and sports medicine. Dr. Wu's book goes well beyond the scope of its title, including material more commonly found in introductory texts on foot surgery. Although applied science plays a major role in the field of foot orthoses, the "art" remains an essential element. For this reason, the parts of the book that address materials and technique are espe cially valuable. The references and lists of sug gested readings are extensive; the reader would