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Doody's Review ServiceReviewer: Vincent F Carr, DO, MSA, FACC, FACP (Uniformed Services University of the Health Sciences)
Description: This third edition of an extensive review for primary care providers on how to care for patients with fractures includes access to a website with videos and additional resources. The previous edition was published in 2003.
Purpose: The purpose is to provide physicians, nurse practitioners, and physician assistants with training and continuing education in fracture care.
Audience: It is intended for all primary care providers who may see patients with fractures in their daily practice of medicine.
Features: The book covers most fractures primary care physicians may encounter, but it also discusses others, such as facial and skull fractures, that are generally beyond the training and experience of this audience. This information could be helpful if the book included guidelines about when to refer patients with these complicated fractures to specialists. Some chapters do include a section on "Indications for Referral," but I got the impression that referral was the choice of last resort, despite some statements in the first chapter. For example, the video accessible at the website describes examining for neurovascular integrity before performing a procedure, but does not suggest referral for any compromised findings. My concern is for inexperienced clinicians who do not understand the limitations of their experience and may not refer patients in a timely manner. The videos are technically well done and play easily with an Internet connection, but the print quality of the x-rays leaves a bit to be desired.
Assessment: This is a worthwhile reference in a primary care provider's personal library. My concern is that the book does not emphasize that some fractures need to be referred to specialty care and may give inexperienced providers an incorrect impression of the scope of care required to treat some complex fractures.