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Logo of mjafiGuide for AuthorsAbout this journalExplore this journalMedical Journal, Armed Forces India
Med J Armed Forces India. 2001 October; 57(4): 344.
Published online 2011 July 21. doi:  10.1016/S0377-1237(01)80023-X
PMCID: PMC4924148

Surgical Exposures in Orthopaedics : The Anatomic Approach

Reviewed by VP PATHANIA

Stanley Hoppenfeld, Piet deBoer Surgical Exposures in Orthopaedics : The Anatomic Approach 2nd Edition 1999 Lippencot-Raven Philadelphia 604

The surgical exposure of the part in orthopaedic surgery is next in importance to the procedure itself and sound anatomical knowledge forms the basis for the right approaches. This book has thirteen chapters each dealing with particular part of the body. Though this book does not describe all the approaches in an extremity, the commonly used incisions have been well described. The authors of this book have tried to explain every approach in a very methodical way by describing the indication, position of the patient. land marks, incision, superficial and deep dissection. The possible dangers of dissection during the approach to the nerves, vessels, muscles and tendons have been explained and how to avoid them. At the end of each approach, how to enlarge the incision, often the dilemma of young surgeon has been discussed either by employing local measures like detaching the muscles or repositioning of retractors or by extensile approaches. The description of regional approach ends with surgical anatomy of the part. Every step has been explained by linear and shaded drawings, there are in all 864 diagrams. Though these plain diagrams are very illustrative they fail to provide depth to the dissections, color plates could have been added to make it more realistic. Another shortcoming of the book is that the authors have only explained the exposures of the part and have failed to highlight the special points on the closure and repair of divided structures. The last chapter deals with approaches for external pin fixation in long bones through “safe zones”, this is helpful for the students and surgeons while applying external fixators. Throughout the book the authors have emphasised the concept of inter nervous approach, which is helpful in exposing the part and extending the incision along the entire length of the muscle without denervating the muscle. Overall the book is recommended as reference book for students and surgeons.

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