“Textbooks are the medium where knowledge is accumulated, evaluated and stored, and where, hopefully, wisdom grows”. This is the first sentence of the preface to this textbook by Hamlet A. Peterson. The book is a result of 30 years of orthopedic practice with children at the Mayo Clinic, where he has been collecting illustrative cases and difficult cases over the years. Peterson has written multiple journal articles and lectured extensively on the subject. This textbook is a summary of his experience, together with a review of all pertinent literature on the subject. The book has 900 pages, and nearly 2,000 figures.
The textbook is divided into 3 parts. In the first part, General Considerations, an interesting historical review is followed by a chapter on the anatomy and the mechanism of growth. In this chapter, as in the rest of the book, there are excellent drawings describing the anatomy and mechanism of the growth plate and different types of fractures involving the growth plate. In the chapters that follow, there is an overview of classification, epidemiology, evaluation, management, and complication of physeal fractures.
In the second part, Anatomical Sites, there are individual chapters dedicated to each growth plate. These describe the anatomy and growth, including growth charts for many physes showing remaining growth at different ages. A literature review on recommended treatment is presented and the author’s own viewpoint is given for each type of physeal fracture.
In the third part, “Physeal Arrest”, different methods of measuring leg length discrepancy and different methods for visualization of a physeal bar are described. The author’s preferred method is the slit scanogram for measuring leg length and angular deformity, and MRI for evaluation of physeal bars. Different techniques for bar excision are described, and also techniques that are available when the procedure fails. Finally, state-of-the-art methods for physeal distraction and physeal cartilage transplantation are presented.
This is a very well written book. Most information relating to fractures involving the growth plate is included in this book, and this information is accompanied by wise recommendations based on the author’s long experience. The book provides useful information for the doctor in the emergency room as well as for academic studies. The first sentence in the preface, mentioned above, is a good description of the book. This book should be available to everyone managing fractures in children.