The Fracture Classification Manual.

The Fracture Classification Manual

Gustilo RB. St Louis, MO 63146, Mosby-Year Book Inc, 1991, paperback, 175 pp, $45. The author states in the introduction that the primary goal in establishing a fracture classification system is to provide the following: "(1) a standard basis for treatment evaluation, relative to indications, results, and complications; (2) a basis for evaluating expense relative to type of fracture, severity, and mechanism of injury; (3) an educational tool in which reports and publications are taken from the database, thus rendering analysis meaningful; (4) a fracture classification using Expanded ICD-9 codes plus variable terminal codes for specific diagnosis." The author has formulated a manual that accomplishes the goals set forth. The manual contains only two pages of written text. These pages contain a brief description of the trauma registry and its basis, along with discussions of the categories, treatment codes, complication codes, and injury severity scores for the fracture classification system. The author also reviews the Orthopaedic Data Processing System, which is an IBM Personal Computer-based database system that provides management of patient records and access capabilities specifically designed for orthopedic departments. The majority of the book covers the classification system for fractures. The author presents a methodical approach that is easily followed and well illustrated, with 500 illustrations on practically every type of fracture and dislocation. The manual concludes with 15 pages of outpatient follow-up evaluation data sheets that can also be utilized for research purposes. The manual is well structured, easily understood, and represents a reasonable, orderly, and thorough method of classifying and coding fractures. I feel this book is particularly relevant and oriented to orthopedic departments to assist with their medical records and research. The manual will need a routine update every few years due to the active, developing nature of fracture classification. The physical therapist will not find this manual particularly useful in the clinic; however, it could serve as a worthwhile reference for identifying fractures and the methods of their treatment. Joseph M David, PT South Hills Sports Medicine Clinic Pittsburgh, Pa