Functional Reconstruction of the Foot and Ankle

Functional Reconstruction of the Foot and Ankle

Sigvard T. Hansen, Jr., MD. 525 pages, illustrated. Lippincott Williams & Wilkins, Philadelphia, PA, 2000. $159.00.

Dr. Sigvard T. Hansen is a world authority on highenergy multi-trauma and internal fixation. Relatively early in his career, Dr. Hansen broke ranks with his peers and developed some astonishing protocols for dealing with these severe orthopedic injuries, protocols that have been expanded and universally adopted today. He has successfully married these interests to his intrigue with the complexity of foot and ankle surgery such that his focus is on restoring anatomy and function. His position in a respected tertiary care center has attracted a plethora of foot and ankle problems, from relatively difficult deformities and post-traumatic reconstruction to repairing surgical disasters.

This book, then, reflects the culmination of 30 years of experience; a universal interest in foot and ankle biomechanics, pathology, and reconstruction, regardless of the source of the information; a steady stream of interested visitors, scholars, and students; and above all, patient feedback. Clearly, it is the sharing of one person’s philosophy, principles, approaches, and techniques deemed successful, as the information is often expressed in the first person.

After expressing his principles of surgery for the foot and ankle in the first chapter, the author divides the bulk of his textbook into three sections: trauma, reconstruction, and an “atlas” of surgical techniques.

The author’s approaches to even the most difficult types of foot and ankle trauma are presented simply and clearly. The reconstruction section is a series of unique perspectives on such challenging areas as post-traumatic and degenerative problems, progressive flatfoot, the dysfunctional forefoot, the diabetic Charcot foot, and surgical revisions. Many useful and sometimes pioneering ideas are described. The final section on surgical techniques takes the surgeon directly to the operating table. Not only are the procedures clearly described and illustrated, but they are sprinkled with some of the author’s reasoning as well.

Refreshing is the simplicity and clarity of the illustrations for the often complex subjects presented. Most consist of anatomical line drawings, simple yet adequately labeled, that are supported by radiographs and associated studies. Unfortunately, there are very few clinical photographs and fewer intraoperative surgical field photographs. Despite these relatively minor deficiencies, this single-author textbook rises above its contemporaries, providing a great deal of useful information for the experienced foot and ankle surgeon, food for thought for specialty residents, and insights into complex foot and ankle problems for students. This book will be a valuable reference for years to come.

Textbook of Bunion Surgery

3rd Ed. Ed by Joshua Gerbert, DPM. 512 pages, illustrated. WB Saunders, Philadelphia, PA, 2001. $95.00.

Twenty years after its first edition, this textbook is the product of only seven contributing authors who, still from the Department of Podiatric Surgery at the California College of Podiatric Medicine, represent a broader background of training and philosophy than in the two previous editions. All of the chapters have been thoroughly reviewed and updated to reflect changes in the criteria and selection of procedures based on outcome studies and the authors’ personal experiences.

A chapter on first metatarsophalangeal joint arthrodesis is the lone new chapter while the large number of osteotomy procedures are presented with a good variety of fixation, including newer devices such as soft-tissue anchors and external fixators. Preoperative evaluation remains a strong feature, and there is a definitive reorganization and improvement in the chapters on lapidus and postoperative complications. Probably the most remarkable updates are evident in the ever-changing field of implant procedures, although the lack of a thorough evaluation of the newer two-component implants may be indicative of their general lack of acceptance to date.

Unfortunately, the chapter on implant complications is disappointingly shallow. Also lacking is an in-depth review of the anatomy of the deformity and the classic papers that defined it, as well as a chapter dealing with juvenile hallux abducto valgus. The illustrated drawings are generally clean and simple but lack uniformity, which can be distracting at times.

This reference textbook stands alone and has a nice format. Overall, it accomplishes the editor’s goal “to enable students, residents and foot surgeons to better understand, evaluate, and treat the various bunion deformities with more predictable and favorable outcomes.” In the future, look for good valid outcomes studies to better define the success of hallux abducto valgus surgery.