BOOK REVIEWS
Book Reviews HANDBOOK O F M E D I C O L E G A L PRACTICE Edited by John P. W. Varian. 182pages. Butterworth Heinemann,
Oxford, 1991. ISBN O-7506-1238-X. Price s This short book provides clear guidance on the preparation of medicolegal reports, courtwork and aspects of medical negligence in general. There are chapters on specific specialities which are possibly more prone to medicolegal contact than others, e.g. orthopaedics, obstetrics and gynaecology. The book is well written, the messages are clearly stated and above all it is very easily read. By virtue of its brevity it is primarily directed at those doctors who have not been exposed to medicolegal work, e.g. junior hospital doctors and general practitioners. Having read the book there is no doubt they will conduct themselves more effectively in court and will prepare more meaningful reports. Senior Registrars and Consultants would be more likely to consult one of the increasing number of books written with a specialist readership in mind. Brian Roper
FINGERTIP AND NAILBED INJURIES (Hand and Upper Limb Series, Volume 7) Edited by Guy Foncher. 151 pages, extensively illustrated. Churchill Livingstone, Edinburgh, 199]. ISBN 0-443-04]08-3. Price s 31 authors have contributed to this volume in the Hand and Upper Limb Series. France fields a strong team but there are excellent contributions from many well-known surgeons from elsewhere including Italy, U.S.A., Canada, Australia and the U.K. The standard of chapters is on the whole high and the subject is covered thoroughly. The book starts in a rather curious way with a study of the vascular anatomy of the distal phalanx. The hoped-for general discussion of fingertip injuries with an overview of their management does not appear until the third chapter and is then disguised under the title "The histology of sensibililty: relationship to clinical care"! The final chapter (number 20) draws together all the techniques in a management overview. The rest of the book largely consists of descriptions of the available management options and reconstructive techniques, ranging from dressing care to replantation. These are all well described and I do not think that anything of importance is missing. There is occasionally a tendency to refer readers to previously published literature, rather than to describe techniques adequately and thus make the book a "stand alone" reference source. This criticism applies especially to chapter 15 "Free pulp transfer," although the reference list is extensive. In addition to the individual reconstructive methods which include grafts, local and regional flaps, replantation and free tissue transfer, there are useful presentations on sensory education, prosthetic management and specific management of children's injuries. Overall this is a high quality publication which covers the subject matter thoroughly and well. The book is of course written in English and the standard is very satisfactory. M. J. M. Black
491
Letters to the Editor Dear Sir, I would like to respond to the letter from Mr C. Balakarishnan (Journal of Hand Surgery 16B :4:469) about our article "Subcutaneous release of trigger thumb and fingers in 210 fingers" (Journal of Hand Surgery 15B :4:463-465). In our method of evaluation two points were given for limitation of motion and a score of two points was classed as a good result. However if limitation of movement had been due to inadequate release of the tendon there would have been additional symptoms of locking, snapping or pain and the score would have been more than two points, placing these patients in the "fair" or "poor" categories. We therefore regard our method of evaluation as satisfactory. No nerve injuries were observed with our technique, probably because the scalpel was small and inserted in the line of the tendon, unlike the conventional method in which a transverse incision is made over the tendon. Yours sincerely Juichi Tanaka, M D Hyogo College of Medicine 1-1, Mukogawa-cho, Nishinomiya Hyogo 663 Japan
Dear Sir, In their article "Does training reduce the incidence of industrial hand injuries?" (Journal of Hand Surgery 16B :3:323-326), Mr Tan and his colleagues made no reference to our paper in which we discussed the disproportionately high incidence of industrial injuries in the 18-25 age group, possibly due to: 1. Lack of proper training during the initiation period. 2. The fact that sometimes helpers were allowed to operate machines in the engineering industry without proper training. 3. Laxity in provision and implementation ofsafety measures in industry since there was no obligation on the management to investigate cases of injury. Medical care and compensation was the responsibility of the Employee's State Insurance Corporation, rather than the employer. Yours sincerely Dr N. Mathur University Hospital Queen's Medical Centre Nottingham N G 7 2UH
Reference MATHUR, N. and SHARMA, K. K. R. (1988). Medico-economic implications of industrial hand injuries in India. Journal of Hand Surgery, 13B :3:325327.
Dear Sir, Dr Mathur thinks that the high incidence of hand injuries in a younger age group is possibly due to lack of training when starting work although his paper did not give details about training. We specifically looked at this to see if training status
Book Reviews HANDBOOK O F M E D I C O L E G A L PRACTICE Edited by John P. W. Varian. 182pages. Butterworth Heinemann,
Oxford, 1991. ISBN O-7506-1238-X. Price s This short book provides clear guidance on the preparation of medicolegal reports, courtwork and aspects of medical negligence in general. There are chapters on specific specialities which are possibly more prone to medicolegal contact than others, e.g. orthopaedics, obstetrics and gynaecology. The book is well written, the messages are clearly stated and above all it is very easily read. By virtue of its brevity it is primarily directed at those doctors who have not been exposed to medicolegal work, e.g. junior hospital doctors and general practitioners. Having read the book there is no doubt they will conduct themselves more effectively in court and will prepare more meaningful reports. Senior Registrars and Consultants would be more likely to consult one of the increasing number of books written with a specialist readership in mind. Brian Roper
FINGERTIP AND NAILBED INJURIES (Hand and Upper Limb Series, Volume 7) Edited by Guy Foncher. 151 pages, extensively illustrated. Churchill Livingstone, Edinburgh, 199]. ISBN 0-443-04]08-3. Price s 31 authors have contributed to this volume in the Hand and Upper Limb Series. France fields a strong team but there are excellent contributions from many well-known surgeons from elsewhere including Italy, U.S.A., Canada, Australia and the U.K. The standard of chapters is on the whole high and the subject is covered thoroughly. The book starts in a rather curious way with a study of the vascular anatomy of the distal phalanx. The hoped-for general discussion of fingertip injuries with an overview of their management does not appear until the third chapter and is then disguised under the title "The histology of sensibililty: relationship to clinical care"! The final chapter (number 20) draws together all the techniques in a management overview. The rest of the book largely consists of descriptions of the available management options and reconstructive techniques, ranging from dressing care to replantation. These are all well described and I do not think that anything of importance is missing. There is occasionally a tendency to refer readers to previously published literature, rather than to describe techniques adequately and thus make the book a "stand alone" reference source. This criticism applies especially to chapter 15 "Free pulp transfer," although the reference list is extensive. In addition to the individual reconstructive methods which include grafts, local and regional flaps, replantation and free tissue transfer, there are useful presentations on sensory education, prosthetic management and specific management of children's injuries. Overall this is a high quality publication which covers the subject matter thoroughly and well. The book is of course written in English and the standard is very satisfactory. M. J. M. Black
491
Letters to the Editor Dear Sir, I would like to respond to the letter from Mr C. Balakarishnan (Journal of Hand Surgery 16B :4:469) about our article "Subcutaneous release of trigger thumb and fingers in 210 fingers" (Journal of Hand Surgery 15B :4:463-465). In our method of evaluation two points were given for limitation of motion and a score of two points was classed as a good result. However if limitation of movement had been due to inadequate release of the tendon there would have been additional symptoms of locking, snapping or pain and the score would have been more than two points, placing these patients in the "fair" or "poor" categories. We therefore regard our method of evaluation as satisfactory. No nerve injuries were observed with our technique, probably because the scalpel was small and inserted in the line of the tendon, unlike the conventional method in which a transverse incision is made over the tendon. Yours sincerely Juichi Tanaka, M D Hyogo College of Medicine 1-1, Mukogawa-cho, Nishinomiya Hyogo 663 Japan
Dear Sir, In their article "Does training reduce the incidence of industrial hand injuries?" (Journal of Hand Surgery 16B :3:323-326), Mr Tan and his colleagues made no reference to our paper in which we discussed the disproportionately high incidence of industrial injuries in the 18-25 age group, possibly due to: 1. Lack of proper training during the initiation period. 2. The fact that sometimes helpers were allowed to operate machines in the engineering industry without proper training. 3. Laxity in provision and implementation ofsafety measures in industry since there was no obligation on the management to investigate cases of injury. Medical care and compensation was the responsibility of the Employee's State Insurance Corporation, rather than the employer. Yours sincerely Dr N. Mathur University Hospital Queen's Medical Centre Nottingham N G 7 2UH
Reference MATHUR, N. and SHARMA, K. K. R. (1988). Medico-economic implications of industrial hand injuries in India. Journal of Hand Surgery, 13B :3:325327.
Dear Sir, Dr Mathur thinks that the high incidence of hand injuries in a younger age group is possibly due to lack of training when starting work although his paper did not give details about training. We specifically looked at this to see if training status
