Menelaus and Broughton have combined decades of experience in the treatment of spina bifida with a fresh review of the current knowledge in the latest edition of this book. The second edition was a touchstone of principles regarding the treatment of myelodysplasia, and its readers will not be disappointed by this equally compact edition.
The ample illustrations and diagrams will help readers at all levels to comprehend the complexities involved in the orthopaedic treatment of myelodysplasia. The strong chapters on physical examination and principles of treatment will be equally well received by residents and attending physicians who deal with clinical problems. Region-specific chapters on the leg and foot, the knee, the hip, and the spine will be useful in the treatment of deformities and muscle imbalance. The chapter on gait explains many abnormalities that are seen in association with myelodysplasia, while that on neurological deterioration addresses the complex topic of progressive neurological loss and tethering of the spinal cord.
Throughout the text, emphasis is placed on the rationales for observation, nonoperative or operative treatment, and the decision-making process. Menelaus' wisdom and experience permeate the book. In this era of evidence-based writing, it is refreshing to read the authors' synthesis of their own experience with that published elsewhere.
This book belongs in the library of every orthopaedic surgical department. It will be useful for those first encountering patients who have spina bifida as well as for those who manage them frequently. Surgeons will have to look elsewhere for descriptions of operative technique and up-to-date procedures, but they will find useful information on principles and indications here.
As the consumption of folic acid by women of childbearing age becomes widespread, the prevalence of spina bifida and other neural tube defects will continue to decline. Orthopaedic surgeons who are faced with this increasingly uncommon condition will be well served by the collective knowledge contained in this book.
John B. Emans, M.D.
Department of Orthopaedic Surgery
Children's Hospital
Boston, Massachusetts