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Trauma of the chest
256
Injury: the British Journal of Accident Surgery Vol. lo/No. 3
and sizes. The principles of local anaesthesia are also illustrated. Gentleness and asepsis in handling the tissues are recognized prerequisites. The subject matter is mainly concerned with wound closure without tension by using appropriate flaps. Detailed practice is based on sound surgical principles which make the book particularly useful for students and young doctors. The author has used photographs and diagrams so well that the American editors of the English edition (from the Johns Hopkins School of Medicine) confess they have made every effort ‘to avoid encumbering these superb illustrations with unneeded text, carefully heeding the adage that a picture is worth a thousand words’. There may not be much here that is new to the experienced plastic surgeon, but few surgeons will read the whole book (which one can do in an hour or two) without being made to think again about their own technique, or without real pleasure at such an artistic presentation of fundamental surgical procedures. D.
JACKSON
Femoral Neck Fractures and Hip Joint Injuries. Edited by D. S. Muckle. 240 x 160 mm. Pp. xvi+263, illustrated, with index. 1977. Hampshire, Chapman & Hall. E12.00. This is an excellent book and I do recommend it to all young accident/orthopaedic surgeons, for it contains a wealth of information starting with a brief review of the evolution of the treatment of fracture of the femoral neck. This is followed by a chapter on basic sciences of the hip, which deals among other things with the metabolism, nutrition and repair of articular cartilage; one of those grey areas so many young surgeons would do well to read about. Fractures of the femoral neck are covered in two chapters which deal with every aspect of classification, treatment and complications. The complications of prosthetic replacement which are quoted should certainly make us much more selective in deciding on this operation. The chapter on metabolic disorders, which deals mainly with osteoporosis and osteomalacia, is excellent. It stresses not only the diagnosis and the differential diagnosis, but how these conditions can be treated, especially osteomalacia-‘the most important treatable cause of fractured femoral neck’. Fractures of the femoral neck in children and slipped upper femoral epiphysis are fully covered. The degree of slipped femoral epiphysis and the treatment is well dealt with, especially in late cases by osteotomy. Avascular necrosis is considered in general under pathological fractures, but it is also dealt with in practically every chapter in the book in a particular
relationship to the subject under discussion. There is much discussion about the role of weight bearing after hip injury in causing avascular necrosis. This problem has obviously not been solved, for under fractures of the femoral neck early mobilization is advocated, whereas under dislocation of the hip, even a simple posterior dislocation after stable reduction, 9 weeks’ non-weight bearing is advocated. The author does not say how a young child is kept non-weight bearing for 9 weeks with a painless hip. Classification of dislocation of the hip is always complicated by the acetabular fractures. Here a further classification is made. Fig. 7.6~1, b is subtitled a three-quarter external oblique view of the hip and a three-quarter oblique view with the patient rotated 45” from and 45” to the injured side respectively. The text, however, refers to these as three-quarter oblique and one-quarter oblique views. This clearly wants restating. Also, how to perform the very painful exercise of rotating a patient 45” on to his fracture-dislocated hip needs more explanation. Actually, the Fisk 60” oblique view gives as much information but is not mentioned. The final chapter on medical factors, pre- and postoperative assessment, is excellent as it deals not only with the more common conditions such as bronchopneumonia, pulmonary embolus and fat embolus, but also with thyroid disease, ataxia and Parkinsonism, including the variety due to drugs used for depression; conditions from which old people suffer. The book is well written in clear print with a hard back and is well worth reading; but it is expensive at 512, especially as there are some printing errors. H.
PROCTOR
Trauma of the Chest. Edited by W. G. Williams and R. E. Smith. 216 x 138 mm. Pp. xi+257, illustrated, index. 1977. Bristol, Wright 59.50. This book is a record of the Coventry Conference held in July 1977, and all concerned should be congratulated on its prompt appearance. It has the great merit of presenting the current practice of the various speakers and the other participants in all the important branches of chest injury. Although the reproduction of some of the illustrations is poor, generally speaking they are adequate. The various papers provide an excellent combination of academic and practical considerations, which is enhanced by the inclusion of the discussion between the participants, many of whom have considerable experience in the field. This is a book which should be read by everyone interested in the subject. L.D.
ABRAMS
Injury: the British Journal of Accident Surgery Vol. lo/No. 3
and sizes. The principles of local anaesthesia are also illustrated. Gentleness and asepsis in handling the tissues are recognized prerequisites. The subject matter is mainly concerned with wound closure without tension by using appropriate flaps. Detailed practice is based on sound surgical principles which make the book particularly useful for students and young doctors. The author has used photographs and diagrams so well that the American editors of the English edition (from the Johns Hopkins School of Medicine) confess they have made every effort ‘to avoid encumbering these superb illustrations with unneeded text, carefully heeding the adage that a picture is worth a thousand words’. There may not be much here that is new to the experienced plastic surgeon, but few surgeons will read the whole book (which one can do in an hour or two) without being made to think again about their own technique, or without real pleasure at such an artistic presentation of fundamental surgical procedures. D.
JACKSON
Femoral Neck Fractures and Hip Joint Injuries. Edited by D. S. Muckle. 240 x 160 mm. Pp. xvi+263, illustrated, with index. 1977. Hampshire, Chapman & Hall. E12.00. This is an excellent book and I do recommend it to all young accident/orthopaedic surgeons, for it contains a wealth of information starting with a brief review of the evolution of the treatment of fracture of the femoral neck. This is followed by a chapter on basic sciences of the hip, which deals among other things with the metabolism, nutrition and repair of articular cartilage; one of those grey areas so many young surgeons would do well to read about. Fractures of the femoral neck are covered in two chapters which deal with every aspect of classification, treatment and complications. The complications of prosthetic replacement which are quoted should certainly make us much more selective in deciding on this operation. The chapter on metabolic disorders, which deals mainly with osteoporosis and osteomalacia, is excellent. It stresses not only the diagnosis and the differential diagnosis, but how these conditions can be treated, especially osteomalacia-‘the most important treatable cause of fractured femoral neck’. Fractures of the femoral neck in children and slipped upper femoral epiphysis are fully covered. The degree of slipped femoral epiphysis and the treatment is well dealt with, especially in late cases by osteotomy. Avascular necrosis is considered in general under pathological fractures, but it is also dealt with in practically every chapter in the book in a particular
relationship to the subject under discussion. There is much discussion about the role of weight bearing after hip injury in causing avascular necrosis. This problem has obviously not been solved, for under fractures of the femoral neck early mobilization is advocated, whereas under dislocation of the hip, even a simple posterior dislocation after stable reduction, 9 weeks’ non-weight bearing is advocated. The author does not say how a young child is kept non-weight bearing for 9 weeks with a painless hip. Classification of dislocation of the hip is always complicated by the acetabular fractures. Here a further classification is made. Fig. 7.6~1, b is subtitled a three-quarter external oblique view of the hip and a three-quarter oblique view with the patient rotated 45” from and 45” to the injured side respectively. The text, however, refers to these as three-quarter oblique and one-quarter oblique views. This clearly wants restating. Also, how to perform the very painful exercise of rotating a patient 45” on to his fracture-dislocated hip needs more explanation. Actually, the Fisk 60” oblique view gives as much information but is not mentioned. The final chapter on medical factors, pre- and postoperative assessment, is excellent as it deals not only with the more common conditions such as bronchopneumonia, pulmonary embolus and fat embolus, but also with thyroid disease, ataxia and Parkinsonism, including the variety due to drugs used for depression; conditions from which old people suffer. The book is well written in clear print with a hard back and is well worth reading; but it is expensive at 512, especially as there are some printing errors. H.
PROCTOR
Trauma of the Chest. Edited by W. G. Williams and R. E. Smith. 216 x 138 mm. Pp. xi+257, illustrated, index. 1977. Bristol, Wright 59.50. This book is a record of the Coventry Conference held in July 1977, and all concerned should be congratulated on its prompt appearance. It has the great merit of presenting the current practice of the various speakers and the other participants in all the important branches of chest injury. Although the reproduction of some of the illustrations is poor, generally speaking they are adequate. The various papers provide an excellent combination of academic and practical considerations, which is enhanced by the inclusion of the discussion between the participants, many of whom have considerable experience in the field. This is a book which should be read by everyone interested in the subject. L.D.
ABRAMS