THE WRIST AND ITS DISORDERS. 2nd edition. David M. Lichtenstein and A. Herbert Alexander. 738 pp. Illust. W.B. Saunders Company, Philadelphia; Harcourt Brace & Co. Canada, Ltd., Toronto. 1997. Can$293. ISBN 0-7216-4774-X
This book is a follow-up to the widely read and well-established first edition published 10 years ago, also edited by Lichtenstein and Alexander. I found the first edition to be a comprehensive review of clinical wrist disorders whose only deficit, in recent years, was the lack of sections on more recently described disorders and magnetic resonance imaging. Those omissions have been corrected in this second edition, and there are additional chapters on occupational disorders, sports medicine and advanced imaging of the carpus (which focuses on MRI and other special investigations), and an expanded pediatric section. I especially enjoyed the chapter on malunion of the distal radius, an all-too-prevalent clinical problem that is rarely given appropriate space in most textbooks.
In general, each chapter is well illustrated, comprehensive and has an exhaustive list of references. The book has been expanded to almost 700 pages, covering 42 chapters. The list of contributors includes recognized leaders in many areas of clinical and academic wrist research.
One of the benefits of a multiauthored text such as this is the ability to allow experts in widely varying fields to disseminate information on the topics germane to them. One of the major drawbacks of such a text is the repetition that inevitably creeps into the substance of the work. This book is no exception; for example, the treatment of scaphoid nonunion and partial or limited wrist fusion are described in detail in many chapters. However, an interesting benefit of this approach is to see how the results of widely different procedures for similar conditions can, in various authors’ hands, be startlingly similar. Obviously this supports the notion that there is more than one way to deal successfully with a particular problem and the wrist is no exception.
Although there is a section on nerve entrapment, a minor criticism is that the discussion on entrapment neuropathy such as carpal tunnel syndrome and ulnar nerve entrapment could be expanded.
There are 2 separate chapters on arthroscopy of the wrist; only 1 is needed. Also there is a paucity of objective, structured clinical information relating to the risks and benefits of operative wrist arthroscopy for the majority of patients. Succinctly put, although the advent of arthroscopy of the wrist has dramatically increased the wrist surgeon’s ability to detect and diagnose intra-articular disease, the clinical benefit derived from such information has yet to be shown clearly and conclusively in proper prospective trials that compare it to the standard treatment.
In summary, I found this book to be a complete, comprehensive and authoritative review of the wrist and its disorders and I believe it makes an excellent additon to the armamentarium of the orthopedic or plastic surgeon who specializes in this field. Although it is too advanced and detailed for medical students and perhaps even for most residents, any trainee seeking to improve his or her knowledge in this field is advised to obtain a copy of the work for personal use.