This crisp, compact text covers the complete array of problems of the ankle and foot in recreational and high-performance athletes. The chapters are arranged according to regional anatomy, and each includes a concise description of the pathoanatomical and clinical features of each injury as well as a discussion of the appropriate diagnostic tests. The accompanying illustrations are simple and clear. Given the excellent description of the mechanisms of the various injuries, the book will be of particular interest and value to orthopaedic residents and will serve as a concise reference manual.
Most of the treatment strategies that are described are quite standard; the surgeon who is looking for innovative approaches will not find them here. For instance, none of the reconstructive procedures currently used to correct a flexible planovalgus deformity are discussed. Similarly, the presentation of decompressive procedures for heel pain needs more anatomical explanation and justification. Nevertheless, the authors are to be credited for their useful description of a rehabilitation program for the ankle and for a very timely chapter that correctly recognizes the limitations and drawbacks of rigid orthoses.
The real challenge in managing athletes who have these injuries is that, although traditional treatment strategies generally can be used to achieve a stable plantigrade foot, such measures often contribute to lost flexibility and compromised athletic performance. Quality outcome studies are needed to define the impact that so many of our common procedures undoubtedly have on the level of performance. The foundation in this endeavor will be an understanding of the epidemiology and pathomechanics of sports injuries. Marder and Lian have provided us with an important initial step along the way.
Michael Wilson, M.D.
Department of Orthopaedic Surgery
Brigham and Women's Hospital
Boston, Massachusetts