The third edition of this text has been expanded and broadened. It includes fifteen chapters by twenty-five contributors and is divided into four major parts, with 225 illustrations.
Although the focus of the book is on a multidisciplinary approach to the upper extremity, the contributors are predominantly vascular surgeons, radiologists, neurosurgeons, neurologists, and rheumatologists. Hand surgeons, plastic surgeons, and orthopaedic surgeons have not contributed to the current edition.
Part I, "The Vascular Examination," comprises three chapters that cover clinical examination, noninvasive laboratory tests, and angiography. These chapters are well written and comprehensive.
Part II, "Cumulative Trauma Disorders," is new and is the largest section (comprising nine chapters). Seven chapters are devoted to the diagnosis and treatment of thoracic outlet syndrome. This topic is thoroughly covered, and the text provides a good review of current concepts involving diagnosis and treatment. However, the chapter on the complex topic of repetitive motion is relatively superficial. Similarly, the chapter on neuropathic pain, which includes an introduction to complex regional pain syndromes (reflex sympathetic dystrophy), provides a very basic overview of a very complex problem.
Part III, "Intrinsic and Acquired Disorders of the Upper Extremity," comprises four chapters. This section is well written and provides an overview of the diagnosis and treatment of occlusive, vasoocclusive, and vasospastic disease. The chapter on hemangiomas and vascular malformations is informative and comprehensive, and the discussion of complications related to vascular access is excellent.
Part IV covers vascular manifestations of systemic disease, including those of the upper extremity. Current techniques in thorascopic sympathectomy also are described.
Overall, this book is well written and well illustrated, and the organization of the material is in keeping with the vision and previous publications of the editor. It is an excellent basic text, with some multidisciplinary aspects. However, the failure to provide the perspectives of hand, plastic, and orthopaedic surgeons is a shortcoming, as is the uneven approach to cumulative trauma disorders. The target audience includes internists, general and vascular surgeons, rheumatologists, and neurologists.
L. Andrew Koman, M.D.
Department of Orthopaedic Surgery
Wake Forest University School of Medicine
Winston-Salem, North Carolina