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Prevention and Management of Common Fracture Complications

M. T. Archdeacon, J. O. Anglen, R. F. Ostrum, D. Herscovici Jr (eds) pp. 362 Thorofare: SLACK Incorporated 2012, ISBN: 978-1-55642-975-0

This hardbound volume of 35 chapters divided into six anatomical sections is the work of 48 contributing authors, many of whom will be well known to the readership.

With the exception of the first section which deals with Complications in General, the subsequent sections are anatomically themed. Each section has a separate editor reflecting the subspecialisation within Orthopaedics and Trauma. I was pleased to see the very first chapter which is entitled ‘Preventing Complications in Orthopaedic Communication’. This chapter highlights and focuses the less experienced readers’ attention upon the absolute importance of informed consent and communication between the treating physician and the patient with regard to the potential for unfavourable outcome which accompanies even exemplary treatment.

Section 1, ‘General’, also deals with infection, deep venous thrombosis and non-union. Of note in the chapter devoted to non-union, the author reflects a North American enthusiasm for the use of external bone stimulators which may not be the experience of the wider readership.

In the remaining anatomically-themed chapters almost all follow the pattern of presenting a detailed review section on the prevention of complications before considering in some depth individual and particular complications related to that anatomical region. The chapter on elbow injuries properly highlights the risks associated of ‘overstuffing’ the radio-capitellar joint when replacing the radial head for comminuted fractures, and the importance of the collateral ligaments in determining management options in such cases.

Seven chapters are devoted to the pelvis and acetabulum which is perhaps more detailed than the ‘average’ trauma surgeon requires and there is some inevitable overlap between chapters. A useful review of the management of heterotopic ossification may be more relevant to the readership who may be required to manage such patients upon their return to community hospitals.

In contrast the chapters devoted to proximal femoral fractures both intra- and extra-articular are detailed and contain valuable references for trauma surgeons both in training and in practice. Detailed discussions regarding implant placements and reduction techniques are found within this section which will be useful reminders to surgeons in training in particular.

I was interested to note that in the management recommendations for tibial plateau fractures, no discussion regarding the utility of a single midline incision is to be found. The final section of the book deals with foot and ankle injuries and whilst the detailed discussion of ankle and syndesmotic fractures will be of value to general a readership, I suspect that the more detailed management of complex foot injuries now falls within the area of responsibility of the subspecialist. Nevertheless, the primary management of these significant dislocations may determine the further treatment options available and as such a detailed understanding of the therapeutic options, strategies to avoid the complications and the methods of dealing with these complications are valuable to a general readership.

The preface to this volume states that its intention is to provide a ‘convenient and invaluable asset for the practicing orthopaedic surgeon’; in this regard I think the book succeeds. Its format is convenient and easy to follow; one caveat however with regard to the literature cited relates to the timescale of publishing. Many of the studies referred to as ‘recent’ in the text were actually five to ten years old. The individual sections are of sufficient detail to be useful to the practicing orthopaedic trauma surgeon and the extensive references and clear figures make it a valuable addition to an orthopaedic library.

D. L. Shaw

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