Book Review
Surgical Disorders of the Peripheral Nerves
N Engl J Med 1999; 341:545August 12, 1999
- Article
Surgical Disorders of the Peripheral Nerves
By Rolfe Birch, George Bonney, and C.B. Wynn Perry. 539 pp. New York, Churchill Livingstone, 1998. (Distributed by W.B. Saunders, Philadelphia.) $150. ISBN: 0-443-04443-0About 10 years ago, because I had previously served as registrar to Sir Herbert Seddon at the Royal National Orthopaedic Hospital in London, I was asked whether his book on injuries to the nerves, Surgical Disorders of the Peripheral Nerves (2nd edition. New York: Churchill Livingstone, 1975), should be revised and updated. The thought that this classic would be altered, most probably for the worse, was immediately rejected by me as unacceptable. It was, therefore, with some anxiety that I took on the task of reviewing what I had previously rejected. I am very pleased to say that I was wrong. This is a marvelous book, one that Sir Herbert (who was a most severe critic) would have endorsed and thoroughly enjoyed.
Whereas most books on this complex subject are assembled by an editor who looks in the medical “yellow pages” under “peripheral-nerve surgeons” and then enlists several dozen experts to contribute chapters, this book had to be written by just a few who knew Seddon well and were themselves part of the history that unfolds in its chapters. This is exactly what happened, much to the credit of the authors, who have preserved the essence of the British experience and its unique influence on the treatment of nerve injuries.
The book's 19 chapters cover all aspects of peripheral-nerve pathology that can benefit from surgical treatment. Basic-science issues are presented in a pertinent and concise fashion, and there is an exhaustive reference list for those who wish to dig deeper. The orientation is definitely clinical, covering diagnostic maneuvers, alternative methods of management, and surgical technique. There are enough data from the Royal National Orthopaedic Hospital and Oxford as well as from the world literature to provide a solid foundation for most of what is advocated. As in Seddon's book, appropriate case histories are used for further clarification. In cases in which the authors have insufficient personal experience in a particular area, they simply say so and offer the experience of others. In other words, reading this book is like having a wise and very experienced colleague by your side to advise and guide you through a difficult subject. For these reasons, it is appropriate reading for students at all levels, from residents to senior surgeons. It should be in the library of any office or facility that treats nerve injuries.
There is humor in this book as well — for example, the diatribe against the perversion of the term “neurapraxia” and the list of dire punishments suggested for those who would spell it “neuropraxia.” Not all the humor is intentional, however, such as the gaffe of crediting a reference in the chapter on birth palsy to the authors “L'Episcopo and Brooklyn.” Unless you had been born in Brooklyn, as I was, you probably would not realize that Dr. L'Episcopo worked at St. Giles, a hospital for crippled children in Brooklyn, New York.
Can one rave about something and still be critical? Seddon's sense of fairness would have had it no other way. A number of the black-and-white photographs are of poor quality; the line drawings are superb, as are the photomicrographs. Having all the glossy color photos grouped together at the front of the book, immediately after the introduction, is disconcerting and confusing. These are minor points. The chief one is that this is a tremendously useful and enjoyable book, which I can recommend to you without hesitation.
Robert D. Leffert, M.D.
Massachusetts General Hospital, Boston, MA 02114- Citing Articles (1)
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