500 Injury: International JoumaI of the Care of the Injured (1993) Vol. %&/No. 7

Discussion

Windowing a cast is often deferred after the primary application, depending on the material used and the circum- stances. The window may be made by different personnel from the original clinician. Charnley described the use of a piece of wool to raise the plaster and indicate the position of the wound, but this method is impractical with resin casts and often results in a poor placement of the window and resulting swelling of soft tissue into the zvindow cavity.

The method described requires that the metal detector is available in the plaster room, but guarantees a perfect window every time. The technique is equally effective with resin or plaster-of-Paris casts, and the aluminium strips are completely radiolucent. A variety of this type of inexpen- sive metal detector is available from DIY and hardware stores. We have been pleased with the use of this method, and have encountered no unforeseen difficulties. We con- tinue to use it, and recommend its wider acceptance.

Acknowledgements

The author would like to thank Mr Nicol Stenhouse for his help and for providing the enclosed photographs, and Mr John Shepperd for his comments on earlier drafts of this paper.

No benefits in any form have or wiU be received from a commercial party directly or indirectly to the subject of this article.

Reference

Charnley J. (1974) The C/o& Treafmmf of Common Frartrcre~. 3rd Ed. Edinburgh: Churchill Livingstone.

Paper accepted 28 October 1992.

Requests fur wprinfs should be addrpssed to: Mr J. H. Wilson FRCS, 67 Middle Lane, London N8 8PE, UK.

Book reviews

Saving children. A guide to injury prevention. M. H. Wilson, S. P. Baker, S. P. Teret, S. Shock and J. Garbarino. Oxford University Press. 0 19 506115 2. f30.00, 1991, 262~~. This is a fascinating book discussing all aspects of injury prevention in children. In the foreword it is described as a ‘brainstorming session filled with hundreds of injury prevention strategies’ and it lives up to that promise. This is not a book specifically aimed at the medical profession, but rather its audience is all those concerned with shaping the environment for children. It contains information of value not only to doctors, but also to health visitors, social workers, teaches, the police, architects, builders and industrialists. Road traffic accidents, accidents in the home and those occurring in school and recreational environment are considered and strategies for their prevention are presented.

The authors of the book are from the Johns Hopkins School of Medicine and its associated School of Public Health. Not unexpec- tedly, therefore, it has an American slant with statistics and sources of information more relevant to an American readership. Never- theless it contains a wealth of information and can be recom- mended as a reference book for all those concerned with injury prevention - whether they are considering crash helmets for cyclists or better designs of guns to prevent accidental firing.

C. Bradish

A Colour Atlas of Burn Injuries. J. A. Clarke. Chapman & Hall, 0 412 34840 3, f49.95, 1992, 116~~. There are few books on burns by British authors. As far as 1 know, this is the first colour atlas on this subject and it nicely fits a long-awaited need. The illustrations are, as would be expected, clear and beautifully produced. A bonus, however, is the accom- panying text which gives a straightforward, very readable, account of the diagnosis and early and late management of the burn injury. References, though few, are carefully chosen and will lead the reader into the appropriate area for further study.

This book is not intended for the burns specialist-although the bums specialist will buy it, if only to enjoy the illustrations - it is written for those who come in contact, at any time and in any way, with the burnt patient. I recommend this book highly. It should be in every library of any sizeable accident and emergency depart- ment and in every ward where burns are being treated. Doctors, at any stage of their training, nurses, physiotherapists and paramed-

icals will learn from and, more importantly, will enjoy reading and

looking through this book. At under f5O it is good value. Buy it!

D. S. Murray

A Colour Atlas of Mountain Medicine. J. VaJlatton and F. Dubas. Wolfe Publishing Ltd. 0 73240965 X, (no price given), 1991, 218pp. It is stated that a million accidents occur in the mountains every

year, and 100,000 involve air rescue operations. This is not only because outdoor sports have become more popular and available to increasing numbers, but sports people can now travel to areas of the world that are more dangerous and isolated. Within this large

group there is a smaller group of sportsmen and women who compete and push their activities to their near maximum physical and mental capacity, and this inevitably increases the risk of injury.

This is a timely and invaluable book, edited by two Swiss surgeons in collaboration with the International Society for Mountain Medicine. There are 48 excellent contributions from specialists working throughout Europe and the USA. The chapters cover a wide variety of subjects: up-to-date methods of rescue, the effects of climatic conditions and the pathologies they produce, for example, from altitude, on nutrition, metabolism, performance, sleep, mountain sickness, haematological disorders, cerebral oedema, eye damage and mental and neurological disturbances.

There follows discussion on solar radiation and cold with detailed descriptions of the course of frostbite and its manage- ment, injuries caused by avalanche and falls in cravasses and their

methods of rescue. The latter chapters cover more detailed descriptions of the mechanism of injury related to hiking and trekking and skiing covering hand and knee injuries. The book finishes with a range of injuries resulting from mountaineering accidents, for example head and spinal injuries, and gives valuable assistance in putting together a first-aid kit for climbers, guides and doctors, with advice on training and ways of avoiding injury.

The text is a pleasure to read and is supported by excellent, descriptive photographs, and the books fully justifies the title of colour atlas.

The book deserves a wide audience and is highly recom- mended, not only for all medical personnel involved in mountain accidents, but for every outdoor group, whatever their specific interest.

T. R. Fisher