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  • Book Review
  • Medicine


REVIEWS AkRCH ITECTIURA L PRINCIPLES IN ARTHRODESIS. BIy H. A. Brittain, O.B.E., M.A., M.Ch., F.R.C.S. 2nd editiOn. (Pp. xi + 196; figs. 257. £2. 2s.). Edinburgh: E. & S. Livingstone, 1952. IN the second edition of his well-known book, Mr. Brittain has again emphasised -those principles of arthrodesis which he has practised for many years, and which the passage of time has not altered. Ischio-femoral arthrodesis of the hip is Brittain's lasting contribution to orthopiedic surgery. His preference for a blind lateral insertion of the extra-articular graft will not find general agreement amiong those surgeons who like to see just where a dangerous instrumelnt-in this case the osteotome -is going. Many prefer a posterior exposure of the hilp and operation Lol(+lr (lirect vision. He has demiionstrate(d in Ihis book, clearly and conxincingly, that l)one grafts place(l in compression along their long axis will hypertrophy often to an enormouLs extent. 'I'he atuthor still recommends the use of massive tibial grafts and, unlike many suLrgeons, is not undluly worried over the risks of fracture of the donor bone. l'ossibly the more widespread development of bone-bankcs will overcome this problem in the future. A new chapter in the secon(d edition is devoted to what is collocquially called the Norwich V -I combinedl extra- .irt icular graft and pinning operation in hip arthrodesix, wvhich diminishes the period of plaster imnlliobilisation afterwards, and thereby lessens the chances of a stiff knee developing. 11e high lights of the book have to do wvithl the hip, but arthrodesis of other joints is fully described, though there is a tendency in these to depart to sonme extent from the architectural principles laid -dovn in earlier chapter's.. T1his is an excellent book wvhiclh, in its production and illustrations, even SUrpasses the lhigh standards one nov expects from the firm of Livingstone. R. J. W. W. ENIERGENCIES IN MEDICAL PRACTICE. Edited by C. Allan Birch. Third edition. (Pp. xi + 587; figs. 14

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