Mayo Clin Proc, March 1985, Vol 60 BOOK REVIEWS 215

Overall, this is an excellent text and is highly recom-mended for inclusion in the library of general surgeons. It should be particularly helpful to the maturing general surgical resident in training and to the practicing general surgeon charged with the care of patients who have sustained multiple-system trauma.

Michael B. Farnell, M.D. Division of Gastroenterologic

and General Surgery

Orthopaedics: Principles and Their Application, 4th ed (in 2 vols), by Samuel L. Turek, 1,726 pp, with illus, $125, Philadelphia, J. B. Lippincott Company, 1984

This is the fourth edition of Orthopaedics, a general orthopedic text. For the past several editions, the author has updated and expanded the material, and the current edition is in two volumes. In the first volume, the basic science of the discipline of orthopedics is addressed, whereas in the second volume, specific diseases are reviewed in an anatomic format. Today, any attempt to produce a comprehensive orthopedic text is somewhat presumptuous because the body of information changes so rapidly. Thus, the author indicates in the foreword that he has exercised an author's "prerogative to exclude" information that he considers of minor relevance and thus has quoted only the literature that has stood the test of time. The subject matter includes the broad scope of basic and applied orthopedic knowledge. This very fea-ture of the book, however, precludes in-depth coverage of certain areas and hence makes this text less suitable to the experienced practicing orthopedic surgeon.

In the fourth edition, moderate revising and updating have been undertaken. In the first section involving the basic sciences, the histologic features of normal bone and soft tissue, as well as selected pathologic conditions, are updated. New chapters dealing with collagen and compartment syndromes are introduced. Information about the pathogenesis of various diseases—for example, rheumatoid arthritis—is updated. In the second volume, joint replacement is emphasized, especially procedures for the hip and knee. Additional aspects of surgical treatment of conditions of the knee, including knee in-stability, are presented, and a revised chapter involves spinal conditions and their treatment.

An undertaking of this magnitude usually has some shortcomings. The tone of the discussion on various topics is somewhat dogmatic without an extensive, cur-rent, or possibly even adequate review of the literature.

For example, in a chapter that deals with septic joints, no references about this pathologic entity are cited, al-though some references associated with acute and chronic osteomyelitis are included. The limited bibliog-raphy is reflected by the fact that less than 15% of the references in the chapters dealing with the elbow and shoulder were published within the past 10 years. In both these areas, important current studies that deserve noting have been published.

Because of the extent of the body of knowledge that constitutes the discipline of orthopedic surgery, certain topics have intentionally been excluded, as previously mentioned. In my opinion, however, some topics not covered probably deserve recognition—for example, en-trapment syndromes of the nerves and cartilage nutrition and viability as a function of motion.

In summary, this text presents an impressive amount of information for the orthopedic surgeon. Furthermore, this edition, in comparison with the previous ones, repre-sents a rather extensive improvement in subject content of a rapidly changing profession. Because of the ten-dency of subspecialization and proliferation of informa-tion in each of these subareas, however, this textbook should be considered as one that defines the scope, not the state of the art, of orthopedics and, as such, is more appropriate for the student, resident, or surgeon just beginning practice.

Bernard F. Morrey, M.D. Department of Orthopedics

Dandy of Johns Hopkins, by Wil l iam Lloyd Fox, 293 pp, with illus, $20, Baltimore, Williams & Wilkins, 1984

This book is scholarly and thorough. The material is well researched, and all of the bibliographic listings of the sources of information are annotated. The volume reports the early years, student days, and career of Walter Dandy, one of the pioneers in American neurologic surgery. It describes him from the perspective of a pro-fessional and a family man and details his professional and avocational interests.

Walter Dandy was a midwesterner, born in Sedalia, Missouri. He had simple loyalties and simple diversions. He was devoted to his family. His favorite sports were golf and tennis, and he had an interest in baseball. In contrast, his professional life was more complex; as a neurosurgeon, he was ambitious and unique.

Dandy's career in neurosurgery began in 1910, when he was appointed instructor in the Hunterian Laboratory