Transfixation: Atlas of Anatomical Sections for the External Fixation of Limbs
Transfixation: Atlas of Anatomical Sections for the External Fixation of Limbs
By Claude Faure, Philippe Merloz
surgeons using external fixation devices and consists of a series of photographs of cross sections
of fixed specimens of the limbs (excluding the hand and foot) matched with labelled diagrams
identifying the structures present and indicating the 'safe zones' though which a fixation pin may
transfix the limb (hence 'transfixation'). There are some rather poor CT scans together with
additional notes on the levels of the sections and on reference lines for defining the safe zones.
Unfortunately the book falls between two approaches without completely satisfying either. If it is
intended simply to present the anatomical information and let the surgeon work out for himself
the best position and direction to insert his pins, then there are not enough sections (particularly
in the arm) to provide the detail required. If, on the other hand, the authors expect the surgeon
to follow their instructions for safe zones directly, then there should be more discussion of the
identification of hazards by surface landmarks, some mention of the range of variation and, above
all, correction of the potentially dangerous omission of any mention of the radial nerve in the
spiral groove passing across the middle of one of the 'safe zones'. There are other minor criticisms;
one section is described as being 'above the insertion of the deltoid' but there is no sign of the
deltoid or its tendon in the section; the axillary vessels and cords of the brachial plexus are twice
described as 'some distance apart' when it is clear from the photographs and diagrams that they
are not.For an anatomist, the usefulness of the book is further limited by the photographs which,
although well presented and printed, show only a fraction of the detail which must have been
present in the original. It is often difficult to distinguish muscle from muscle, artery from vein and
nerve from tendon or fat. Many of the nerves, even though localised from the diagrams, are not
visible in the photographs. Most of the joints are not illustrated (they must not be transfixed by
the surgeon) but there are some useful views of the shoulder and elbow. The book is attractive in
concept and is very well printed and presented. In spite of its limitations it would be of value for
consolidation and testing of knowledge. For the surgeon, it provides a different perspective on the
anatomy of the limbs but contains at least one potential danger and so must be used with care and
a good basic knowledge of anatomy
Part1 http://www.medicalto.com/71998
Part2 http://www.medicalto.com/35161
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