Review of Hand Surgery

This book's major focus is on surgical management of the hand and distal upper extremity. This book is intended to serve as a primary resource for hand surgery fellows and as a test preparation for orthopedic and plastic surgery residents (ie, boards, certificate for added qualifications, and residency examinations). In addition, it is intended to serve as a reference for hand surgeons, physical therapists, and occupational therapists involved in the care of patients with hand and distal upper-extremity disorders. For the physical therapist, the text provides insight into the medical and surgical management of the patient with a hand disorder, and, in turn, helps to provide a better understanding and rationale for therapeutic management of this patient population. However, keeping within the scope of hand surgery, this work provides very little substance for the physical therapist looking for specific information on the therapeutic management and rehabilitation of this particular patient population.

From a physical therapist's perspective, the scope and content of the book appears comprehensive. The chapter titles are: “Anatomy,” “Tendon,” “Skin and Soft Tissue Defects,” “Vascular Disorders of the Hand and Upper Extremity,” “Nerve,” “FracturesoftheHand,Wrist,andForearm Axis,” “Dislocations/Instability,” “Micro-vascular Hand Surgery,” “Arthritis,” “Tumors,” “Infection,” “Pediatric Hand Surgery,” and “Rehabilitation.” Each chapter is written by one or more physicians. Although the depth of coverage appears sufficient, the technical nature of the material may not be sufficient for the primary audience. The last chapter, “Rehabilitation,” appears to be a misnomer. Written by 3 physicians, the content is essentially limited to orthoses and prostheses. The depth of coverage of orthoses is very general, providing essentially a description of the types of orthoses and their indications. Similarly, the section on prostheses includes a basic description of the various device components and also touches on prosthetic training and spasticity management.

Some of the content of the book can be quite technical, as it relates to surgical management of the hand and distal upper extremity. For example, the chapter on fractures discusses recommended screw width relative to size of fracture spike and the remodeling capabilities of various materials to use for bone grafts, while the chapter on microvascular hand surgery delves into the area of medical-grade leeches and their desired and undesirable effects in managing venous congestion. So although some of the content appears correct and up-to-date based on my clinical experience, much of the content is purely specific and technical to the field of hand surgery. Each chapter includes a bibliography of primary, peer-reviewed literature. Unfortunately, references are not cited within the text, which would have easily assisted the inquiring reader with further research on specific information presented in the chapter. In addition, many of the references are more than 10 years old, with few being less than 5 years old.

Despite the technical nature of the content, the book is easy to read, well written, and well organized. Although there are over 25 contributing authors, the presentation of the material is consistent throughout the chapters. There are many excellent illustrations and figures that complement and clarify the written material within each chapter.

The focus of this work is clearly on the surgical management of the hand and distal upper extremity. For the experienced physical therapist involved with treating this specialized population, this book could be a useful resource for information on complications, diagnostic testing, and clinical assessment and differential diagnosis, as well as a resource for further understanding of surgical management. However, it is not recommended as a primary resource for the beginning physical therapist or occupational therapist seeking information on rehabilitation of the patient with a distal upper-extremity diagnosis.

• Physical Therapy