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“Hasty publications in prominent medical journals appear to provide the data used by doctors to recommend treatment.” These words were voiced by the cab driver transporting me to The Journal offices. The cab driver remarked that he had driven me in the past and remembered that I was a doctor. He informed me that he was wary of doctors because the treatment that they prescribed was usually based on inadequate and incomplete data. The driver proceeded to cite specific examples of publications that, one year, would tout a particular association as a causal relationship and then, in a subsequent year, would publish another study, often by the same authors, that completely refuted the original conclusions. The driver went on to observe that, in the haste to get information into print and the compulsion to provide the sound bite of the day, authors and journals often disregard scientific methodology and long-term follow-up. This conversation points to the sophistication of the public and our patients in relation to the medical sciences. This interest is probably the reason that articles in leading newspapers, magazines, and journals caution us to avoid drawing hasty conclusions based on inadequate data. Devotees of technology, manufacturers, consumers, those with political and personal agendas, medical societies, advocates of alternative medicine, physicians, non-physician caregivers, the media, even peer-reviewed medical journals, and “our not so gently graying baby boomers”11 are sending mixed signals in their efforts to hold onto a piece of the health-care pie. The baby boomers, reared to believe that they can retain their youthful bodies, are ably supported in this endeavor by clinicians, often belonging to the same peer group, who believe that they can reconstruct any part of the body. This generation expects to maintain the status quo—that is, to maintain the same level of physical …

This thought-provoking book is the product of a meeting on lumbar segmental instability, a subject of great controversy, that was held in Brussels, Belgium. The organizers of the meeting assembled an international group of specialists that included neurosurgeons and orthopaedic surgeons as well as radiologists, anatomists, biostatisticians, engineers, and others who study the basic science of the spine. One of the authors, Eisenstein, explains the reason for the controversy: “The problem with spinal instability is not the concept but the fact that the concept means so many different things to different people.” He discusses the problems of jargon and misinterpretation and points out that the definitions of key words are not always universally understood or accepted. The section on basic science includes chapters on the biomechanics of the spine, the clinical relevance of the biomechanics of lumbar spinal instability, biomechanical measurements, and the semantics of lumbar instability. The text is fairly well written and provides basic information on the current state of knowledge. In the section on clinical presentation and …

This beautifully illustrated atlas is a masterpiece: it clearly shows that black-and-white photographs can be equally if not more effective than those in color for providing a visual representation of the vascular anatomy. Crock clearly demonstrates that bone is a living organism; the photographs and the text both show that it is critical that surgeons who perform procedures on the skeletal system understand the blood supply of the bone that they are treating. As Professor Sir Roy Calne says in the foreword: “In the past there has been too much attention focused on the mechanics of surgical exposures of …

The fifth volume in the series Orthopaedic Knowledge Update. Home Study Syllabus maintains the high standards and comprehensive nature of the previous volumes. It should be read with the older volumes available, as it contains additional information. Initially, each new volume was supposed to replace an earlier one, but it appears that the two latest volumes are …

Occupational Musculoskeletal Disorders. Ed. 2. Nortin M. Hadler. Philadelphia, Lippincott Williams and Wilkins, 1999. $75.00, 433 pp. Hadler reminds us that clinical science, like the law, is "subject to the political pressures of the day in the formulation of the hypotheses to be tested and in the frame of reference for interpreting the results." Well known in legal and medical circles, Hadler has served on several national commissions on musculoskeletal disorders in relation to the workplace. In this book, he does not attack but instead thoughtfully and critically analyzes popular concepts and beliefs in medicine and a Workers' Compensation system that has gone awry because it is based on …

This atlas was written by a group of orthopaedic surgeons from various parts of the world who have a particular interest and expertise in problems of the foot and ankle. The editors have done an excellent job of standardizing the material from a diverse group of authors from completely different cultural and training backgrounds. …

This text is a compilation of information that was presented, in slides and handouts, during a board-review course on sports medicine. The information has been edited and organized for the primary-care physician. The major portion of the book deals with musculoskeletal problems. The format is similar for each joint or part of the body: each section contains a brief description of the relevant anatomy and biomechanics, the history and physical examination, and information on the most common injuries. For example, the section on the shoulder includes a brief discussion of impingement syndrome and rotator cuff injuries, shoulder instability, brachial plexus injuries, and rehabilitation. The process of transforming a talk or presentation into a chapter …

This book provides algorithms that can be used when making decisions about the treatment of musculoskeletal problems. Bucholz states that “the detail of the algorithms is insufficient to act as complete treatment pathways for managed care applications”; however, it is not clear exactly what the phrase managed care applications encompasses in this context. The issue of payment for care is not the focus of the book, and one assumes that the authors are writing about the decision-making process in the treatment of particular problems. The main question that needs to be answered has to do with the intended readership. An informal poll of orthopaedic surgeons from different parts of the country and at different levels of training and practice failed to identify potential readers. It …

This manual, according to the foreword, is intended to serve as a portable text for the treatment of acute hand injuries. In the preface, the authors state that most books of this type are extremely detailed and heavy in terms of weight and are not easy to use for the evaluation of a complicated hand injury in the middle of the night. However, I am not sure that this book avoids this problem either. There is no …

This book was written for primary health-care providers who manage athletes on site, with the hope that these practitioners will “profit from reflecting on and then applying the material presented in the easy-to-read text.” It is intended to provide “a practical induction into properly caring for the special athlete who competes at any level.” The phrase special athlete is not defined, and it is not clear if it refers to the amateur or the professional athlete or whether the athlete is a child or an adult. Although the title suggests that the book will provide …

This excellent text provides, in the words of the author, “a coherent and easy to assimilate description of the common neurological disorders.” The book covers the essential features of a neurological evaluation and goes into great detail in terms of the history and the clinical examination. The text is presented in an extremely attractive format, which enhances the reader's appreciation of the data. The key points, …

The gradual (soon to be exponential) increase in the geriatric population has stimulated a great deal of interest in and a plethora of publications on the systemic disease that is known as osteoporosis. Chapter 1 begins with the statement that “osteoporosis is a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue with a consequent increase in bone fragility and susceptibility to fracture [Consensus Development Conference, 1993].” Osteoporosis is the result of the destruction of processes that normally maintain skeletal balance. Kanis discusses the manner in which skeletal mass is …

This book, which is well on its way to becoming a classic in orthopaedics, is, like the earlier editions, replete with excellent illustrations. Line drawings are used freely to indicate specific features of the photographs, many of which are in color. When …

The layout of this three-volume seminal text on the treatment of fractures has been entirely redone. The advantages of desktop publishing have made it possible to present the data in a much more visually appealing fashion. The tables all have been highlighted and set apart, the text is extremely readable, and the quality of the print and paper make the book both more aesthetically pleasing and easier to read. …

This book on sports medicine and the school-age athlete was edited by Reider, and there were fifty-five contributors to the text. It is divided into three sections: Part I, covering the different types of training and the different modalities of physical therapy that are available, as well as rehabilitation, nutrition, and the annual sports physical examination; Part II, addressing specific injuries according to the anatomy; and Part III, dealing with problems related to specific sports and activities, such as football, basketball, swimming, running, wrestling, and ballet. The text is easy and enjoyable to read. The chapters are fairly comprehensive, with appropriate references that are discussed in the text. The book provides practical information, a good method for clinical examination, and a reasonable rationale for the treatment of most problems. However, there is no word of caution about the potential hazards of being involved in several sports at one time—for example, football, karate, soccer, basketball, and running—all at highly competitive levels. It seems that we are being encouraged to worship at the Temple of Sports …

This edition has eight new contributors. The section on congenital anomalies has been expanded, with the extremities discussed according to anatomy. The text is much more readable, visually attractive, and comprehensible than that of the first edition. Issues …

In the words of Robert Nisbet, “living with the past is vital to industry and society alike.” This book invokes memories of those who have gone before us in the field of orthopaedic surgery. It is, …

This atlas was designed to give an overview of the appearance on ultrasound of pathological entities in the upper and lower extremities. The book begins with a section on the general ultrasound appearance of various structures in the body. The normal as well as the pathological appearance of muscles, bones, bursae, capsules, cartilage, neurovascular structures, and skin is discussed. The images are well presented. However, as stated in the …

This new edition of the atlas deals with the technical details of the most commonly performed orthopaedic procedures in …

This book by Baldry, who is the president of the Acupuncture Association of Chartered Physiotherapists, consists of three sections. The first section, which is extremely well done, provides a historical review of acupuncture and gives some background as to its basis, which is the concept that musculoskeletal pain is referred from a focus of neural hyperactivity known as a trigger …

This excellent atlas demonstrates the anatomical relationships that must be familiar to clinicians who provide regional anesthesia. The illustrations are outstanding, with emphasis on …

This is the second volume of a video textbook on commonly performed procedures on the foot and ankle. As in the first volume, the quality of the photographs is excellent. A number of new topics have been introduced; this is …

These lectures, presented at the Second Congress of the European Federation of National Associations of Orthopaedics and Traumatology, were selected by the EFORT Educational Committee and the Chairman of the Scientific Committee. The purpose was apparently to publish authoritative articles promptly and to help to concentrate the energies of the trainee and the experienced surgeon so that they would not have to search for relevant, practical information in the mass of data now available. The book is divided into sections on adult and pediatric orthopaedics, traumatology, and miscellaneous topics. The topics will be of interest to the practicing orthopaedic surgeon. Each topic is briefly reviewed, and general information is provided. …

The senior authors, who are renowned authorities in the field of spinal surgery, have collaborated to produce a beautifully illustrated atlas. Each step of the operative procedures is described clearly. The illustrator, Andy Grivas, has done a superb job of depicting a very difficult subject. The diagrams …