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Children’s Upper and Lower Limb Fractures

Children’s Upper and Lower Limb Fractures Edited by Michael Benson, John Fixsen, Malcolm Macnicol, and Klaus Parsch 171 pp, $39.95 New York, NY, Springer, 2011 ISBN-13: 978-0-8572-9554-5 This textbook has been designed to present a concise summary of current techniques in the management of pediatric fractures. The editors state that they have designed the text for residents or for the general orthopedic surgeon who wants to stay current on the latest trends in management. The first third of the book discusses global principles; the remaining 9 chapters discuss specific fractures. Each chapter provides excellent radiographs, with first-rate examples of each fracture discussed. The bibliography for each chapter is fairly comprehensive. The book is easy to read and not overly technical. Some chapters are exceptionally well done, especially the chapter on ankle fractures. The textbook definitely provides a European perspective on the treatment of these fractures. Elastic nailing, which is much more widely used in Europe than in North America, is given a great deal of attention throughout, but not enough space is given to discussion of other methods. For example, the chapter on femoral shaft fractures only briefly mentions submuscular plate techniques. An even more glaring omission is that the trochanteric entry femoral nail is not mentioned at all. In the United States, the trochanteric nail is one of the most popular methods of treating pediatric femur fractures in the child who weighs more than 50 kg and should be part of any treatment algorithm for femur fractures. In another instance, a passage describing treatment of proximal humerus fractures dismisses Kirschner wire fixation, which is widely used for this fracture, in favor of elastic nails, which are “more elegant.” In general, the chapter authors' preferred method of treatment is given the vast amount of attention. One overall problem is that the book tries to do too much and too little at the same time. With a total length of 164 pages, too much space is devoted to going over concepts such as epidemiology and management of growth plate arrest, which are best left to more comprehensive textbooks on fracture. As a result, the remaining chapters on individual fracture types are not given enough space to adequately discuss all of the treatment options. For example, the authors of the discussion on operative treatment of forearm fractures do not spend enough time discussing how to avoid compartment syndrome when using intramedullary nails. The risk factors for developing this major complication have been well described in the literature and would be important information for any surgeon attempting this technique. The authors cite articles describing the risk factors in their bibliography but do not discuss these factors in the text. One suspects that space limitations prevented adequate discussion. Plate fixation is not even discussed as an option for these fractures. The same chapter describes open reduction of radial neck fractures but does not adequately address the high rate of resulting complications. For the resident or practicing orthopedic surgeon in North America, Children's Upper and Lower Limb Fractures does not adequately review all treatment options. Other recent texts provide a better overview of current pediatric fracture care. For example, Surgical Management of Pediatric Long-Bone Fractures (American Academy of Orthopaedic Surgeons, 2009) provides an excellent review of current management of pediatric fractures. It is also a small volume not meant to be a comprehensive textbook, but it does a better job of summarizing current fracture care. There is better balance in the presentation of treatment methods. Another good alternative is the third edition of Rang's Children's Fractures (Lippincott Williams & Wilkins, 2005), an easy-to-read update of Mercer Rang's classic pediatric fracture textbook. For an even more in-depth look at these fractures, the excellent fourth edition of Skeletal Trauma in Children (Saunders, 2008) provides more detail on surgical technique, with abundant illustrations. Back to top Article Information Conflict of Interest Disclosures: The author has completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA American Medical Association

Children’s Upper and Lower Limb Fractures

JAMA , Volume 307 (8) – Feb 22, 2012

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Publisher
American Medical Association
Copyright
Copyright © 2012 American Medical Association. All Rights Reserved.
ISSN
0098-7484
eISSN
1538-3598
DOI
10.1001/jama.2012.208
Publisher site
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Abstract

Edited by Michael Benson, John Fixsen, Malcolm Macnicol, and Klaus Parsch 171 pp, $39.95 New York, NY, Springer, 2011 ISBN-13: 978-0-8572-9554-5 This textbook has been designed to present a concise summary of current techniques in the management of pediatric fractures. The editors state that they have designed the text for residents or for the general orthopedic surgeon who wants to stay current on the latest trends in management. The first third of the book discusses global principles; the remaining 9 chapters discuss specific fractures. Each chapter provides excellent radiographs, with first-rate examples of each fracture discussed. The bibliography for each chapter is fairly comprehensive. The book is easy to read and not overly technical. Some chapters are exceptionally well done, especially the chapter on ankle fractures. The textbook definitely provides a European perspective on the treatment of these fractures. Elastic nailing, which is much more widely used in Europe than in North America, is given a great deal of attention throughout, but not enough space is given to discussion of other methods. For example, the chapter on femoral shaft fractures only briefly mentions submuscular plate techniques. An even more glaring omission is that the trochanteric entry femoral nail is not mentioned at all. In the United States, the trochanteric nail is one of the most popular methods of treating pediatric femur fractures in the child who weighs more than 50 kg and should be part of any treatment algorithm for femur fractures. In another instance, a passage describing treatment of proximal humerus fractures dismisses Kirschner wire fixation, which is widely used for this fracture, in favor of elastic nails, which are “more elegant.” In general, the chapter authors' preferred method of treatment is given the vast amount of attention. One overall problem is that the book tries to do too much and too little at the same time. With a total length of 164 pages, too much space is devoted to going over concepts such as epidemiology and management of growth plate arrest, which are best left to more comprehensive textbooks on fracture. As a result, the remaining chapters on individual fracture types are not given enough space to adequately discuss all of the treatment options. For example, the authors of the discussion on operative treatment of forearm fractures do not spend enough time discussing how to avoid compartment syndrome when using intramedullary nails. The risk factors for developing this major complication have been well described in the literature and would be important information for any surgeon attempting this technique. The authors cite articles describing the risk factors in their bibliography but do not discuss these factors in the text. One suspects that space limitations prevented adequate discussion. Plate fixation is not even discussed as an option for these fractures. The same chapter describes open reduction of radial neck fractures but does not adequately address the high rate of resulting complications. For the resident or practicing orthopedic surgeon in North America, Children's Upper and Lower Limb Fractures does not adequately review all treatment options. Other recent texts provide a better overview of current pediatric fracture care. For example, Surgical Management of Pediatric Long-Bone Fractures (American Academy of Orthopaedic Surgeons, 2009) provides an excellent review of current management of pediatric fractures. It is also a small volume not meant to be a comprehensive textbook, but it does a better job of summarizing current fracture care. There is better balance in the presentation of treatment methods. Another good alternative is the third edition of Rang's Children's Fractures (Lippincott Williams & Wilkins, 2005), an easy-to-read update of Mercer Rang's classic pediatric fracture textbook. For an even more in-depth look at these fractures, the excellent fourth edition of Skeletal Trauma in Children (Saunders, 2008) provides more detail on surgical technique, with abundant illustrations. Back to top Article Information Conflict of Interest Disclosures: The author has completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.

Journal

JAMAAmerican Medical Association

Published: Feb 22, 2012

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