Raymond T. Morrissy and Stuart L. Weinstein, editors.
Philadelphia: Lippincott Williams and Wilkins; 2001. 1600 pages. $295.00.
In creating the fifth edition of this pediatric orthopaedic classic,
Morrissy and Weinstein strive to bring the text into the scientific
milieu of the new millennium. They accent advances in molecular
genetics and discuss how these advances relate to pediatric orthopaedic
disorders, the natural history of these disorders, and the outcomes
of standard treatments. The authors of each chapter state their
evidence-based preferences for the treatment of various
diseases. Their goal is to provide pediatric orthopaedists, fellows,
and residents with access to the latest evidence regarding pediatric
musculoskeletal conditions in order to facilitate informed decisions
about treatment options.
The editors have enlisted new authors for twelve of the thirty-three
chapters, added a refreshing Euro-centered treatise on
growth (a chapter missing since the second edition), and included
cross-references to the corresponding surgical procedures
as presented in their recently published third edition of the Atlas
of Pediatric Orthopaedic Surgery. (A CD-ROM version
containing both books has electronic links between the indications
for the procedures in the text and the descriptions of the procedures
in the atlas.)
There are numerous improvements in the latest edition of this text.
The first chapter, on embryology, is staggering in content, with
current information on the genetic control of development and its
clinical implications. The chapter on growth and development contains
an excellent discussion of the radiographic determination of bone
age in adolescence. A new chapter on imaging presents the practical
aspects and risks of radiation exposure in easily understood terms.
The orthopaedic examination of the child and adolescent, based on eighteen
vignettes of typical presenting symptoms, is an excellent tool for
medical students, residents, and fellows.
The revised chapter on scoliosis demonstrates measurement of
the Cobb angle and provides examples of currently used spinal orthoses,
and the chapter on limb-length deficiency describes many commonly
used prosthetic devices. In addition to the new section concerning
fractures of the spine, the guidelines for acceptability for both-bone
forearm fractures are welcome.
I have a few suggestions for improvement as the editors plan the
sixth edition. First, most readers will seek information from individual
chapters on an as-needed basis. The topics of cervical
spine trauma, hand trauma, thoracolumbar spine fractures, and upper-extremity
fractures are written to complement each other. However, cross-references
to other chapters in the text are lacking, and their inclusion would
be useful.
Second, if one reads the entire work, he or she will encounter repetition
of common material. For example, several chapters cover such topics
as genetics, orthopaedic syndromes, skeletal dysplasias, and the
role of ultrasound in the evaluation of hip dysplasia. The authors
clearly intended for this information to be able to stand alone.
Again, cross-references for material that is repeated in more than
one chapter—such as the chapter on growth and the chapter
on limb-length discrepancy—would be helpful.
Finally, I was surprised by the relative lack of updating of
the chapter on genetics (the most current reference is from 1995) and
by the omission of mention of fetal surgery from the discussion
on myelomeningocele.
This text is a must-have for any orthopaedic library
and for the library of any pediatric orthopaedic practitioner or
fellow. Those who own the fourth edition might wish to investigate the
linked CD-ROM version of the 2001 editions of the text and
atlas.