The second edition of this book is good news for wrist surgeons. It is more informative and comprehensive than the previous edition, published in 1988. A coeditor has been added, and the text has been expanded to include nine general sections comprising forty-two chapters and an additional 250 pages. These improvements are noteworthy. The operative treatment of the wrist has progressed greatly in the last ten years. Many of the contributors, who are prominent practitioners in their respective areas, have rewritten their chapters to include the most current knowledge in the field.
The text is written from the orthopaedic viewpoint and encompasses a great deal of information about physiology, anatomy, and disease processes. Problems related to the wrist are well analyzed and discussed in six sections. The superb chapter on fractures of the distal part of the radius includes a discussion on how the treatment of fractures of the wrist may be determined according to the fracture pattern. Other excellent chapters cover the treatment of congenital, developmental, and acquired traumatic disorders of the wrist in children. However, these outstanding chapters should not overshadow the many other high-quality chapters.
A new chapter, on malunions of the radius, covers some of the frequently encountered problems that are associated with poor results after the treatment of fractures of the distal part of the radius. Similarly, the discussions about the distal radioulnar joint have been expanded into several chapters, each giving insight into the disorders themselves and the options for treatment. The carpometacarpal joint of the thumb is thoroughly discussed. Another informative chapter, entitled "Occupational and Sports Injuries of the Wrist," describes a potpourri of lesions that are not uncommon but that require a level of awareness to diagnose and treat.
The section on therapy clearly describes the preoperative and postoperative treatment options for a variety of problems. The chapters on arthritis and traumatic amputation are particularly well done. A notable change in the current edition is that most authors who advocated the use of silicone implants in the wrist in the earlier edition no longer use them. There has been a switch to treatment with use of soft-tissue techniques, bone stabilization, titanium implants, or grommet-shielding (if flexible-hinge silicone implants are used).
There are some disappointments in this otherwise valuable text. Although the chapter on arthroscopy of the wrist contains excellent descriptions of operative techniques, the chapter on the clinical applications of arthroscopy is unchanged from that in the earlier edition. Certainly there have been refinements in the area of operative arthroscopy in the last ten years that would have been appropriate for inclusion in this book. The treatment of instability of the wrist was well covered in the first edition. Although the current edition provides updated information on treatment, it supplies scant new data on the outcome of operations such as the Blatt procedure (soft-tissue stabilization for the treatment of instability of the scaphoid), despite the fact that this procedure has been widely employed in the last ten years. Also, techniques involving the use of newer bone anchors are not covered, and the new area of vascularized bone grafts is only touched on, in a fashion similar to that in the first edition.
Overall, this is an excellent book that offers in-depth coverage of problems related to the wrist. It is recommended for any orthopaedist who treats such problems. The authors are to be congratulated for producing such a high-quality text.
Craig R. Stirrat, M.D.
Longwood Hand
Chestnut Hill, Massachusetts