This book, an in-depth review of the pathophysiology, and medical and surgical treatment of the pathologic conditions found in the diabetic foot, is aimed mainly at surgeons and physicians involved in treating the diabetic foot. The majority of the authors are from the Beth Israel Deaconess Medical Center in Boston, and the book has some extremely good chapters based on the vast experience accumulated by the diabetic clinic there. The outside authors are also experts in their fields; for example, Reiber from Seattle who contributed the chapter on epidemiology. Notable chapters include the clinical examination, biomechanics and local care of the diabetic foot and principles of treatment of the chronic wound. Two valuable chapters are the down-to-earth, sensible approach to microbiology and treatment of diabetic foot infections and a similar approach to the radiographic changes of the diabetic foot.
Although the medical side of this book is strong, the surgical side is weak apart from the chapter on vascular surgery. As a multidisciplinary disorder, there is a notable absence of input from orthopedic surgeons, and podiatrists have written chapters they are ill-qualified to write. In general, the surgical chapters are atlases of procedures and case reports without in-depth discussion into the indications and outcomes. Since up to 40% of transmetatarsal amputations fail, it is not how to perform the procedure that is important, but understanding the risks and benefits of the procedure, who should perform it, and a discussion of outcomes that are of most value.
The book lacks organization, with no particular rhyme or reason to the order of chapters. The nonoperative treatment of ulcers appears in the surgical chapters and the last chapter, footwear in the prevention of diabetic foot problems, should logically have been placed at the beginning of the book.
The book is too detailed to be of value to medical students and residents but would make a useful addition to medical school and departmental libraries. It should be part of a complete library of diabetic foot care. However, if a book on the diabetic foot is to be purchased as a single reference, there are other books with a much broader authorship that are preferable.
In summary, this book is an excellent text on the medical and nonsurgical aspects of the diabetic foot and ankle care but, with one notable exception, leaves much to be desired with respect to surgical treatment.