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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.
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
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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