BOOK REVIEW RHEUMATOIDARTHRITIS. By Leonard Marmor, M.D., F.A.C.S., Associate Professor of Surgery/O?thopaedics, Department of Surgery/ Orthopaedics, UCLA School of Medicine, Los Angeles, California. Philadelphia, Lea and Febiger, 1967. 9%”X 6%”. 274 illustrations. $15.00. SURGERY OF This monograph is an attempt to present, in an orderly fashion, the surgical procedures available for patients with rheumatoid arthritis. The first 3 chapters discuss general aspects of the disease, medical treatment, ,and surgical problems. The remaining chapters discuss the surgical procedures applicable to the various regions of the body. In each chapter on the regional areas, the author discusses the anatomy, pathology, types of surgical procedures, and expected results. The style is generally good, and the book is short and easy to read. It is copiously illustrated, but unfortunately many of the illustrations are of poor quality and do not show what the author is trying to demonstrate. This is particularly true of the roentgenograms, and one of these (Fig. 12-9) is upside down. In critique of the content of this book, there are several features which greatly detract from its value. As indicated, it is a monograph, and to a large extent expresses the views and experiences of the author without documentation to justify his enthusiasm. There is a general tone of optimism toward the surgical procedures which begins in the Preface and carrier: throughout the book, which in many cases is unjustified by literature citation or by the experiences of other orthopaedic sur- geons. There are numerous statements expressed as fact which represent heavily biased opinion. There are a number of inaccuracies of nomenclature and description which, to the compulsive reader, detract from the readability. The chapter on surgical treatment (Chapter 3 ) , in which the general aspects of surgery are discussed, is woefully inadequate and does not indicate the complications so prevalent in the,e patients, nor the caution with which one should deal with them. The problems of wound healing, negative nitrogen and calcium balance, and vascular thrombosis are not mentioned, and the problems of the preoperative adrenal support are only briefly touched upon. In general, the chapters on regional surgery are uniformly enthusiastic, but leave gaps in information regarding indications, contraindications, complications, and experience of others, which detract from their value. The discussions of the pathology are generally superficial, and the anatomical presentations vary from sketchy and inaccurate to over-detailed and over illustrated. There is a great need for a book of this sort. The material it would cover would acquaint the rheumatologist with the possibilities for surgical procedure$, and provide the orthopaedist inexperienced in rheumatoid surgery with an atlas and reference text regarding each regional area. I t is nnfortun,ite that the inaccuracies and poor presenkition of the material prevent this book from becoming such a contribution. In its present form, this volume falls far short of these objectives and cannot be recommended for these purposes.Henry J. Mankin, M . D.
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