The fully revised sixth edition carries on the legacy of Dr. In combination with a visit to the dissection hall, it will ensure that trainee surgeons operate with the confidence that they will do no damage operating on an unfamiliar region and fulfil Galen’s precept - “primum non nocere”.For nearly 40 years, Surgical Exposures in Orthopaedics: The Anatomic Approach has helped orthopaedic surgeons enhance their anatomic knowledge, increase safety, and improve patient outcomes. This volume is now essential for reference. The word ‘anatomic’ in the title jars slightly without the suffix ‘al’, commonly used on the East side of the Atlantic, but this does not detract from the content. There may be a typing error in the section on danger to the pre-sacral plexus, where damage it is said may cause ‘importance’. Although arthroscopy of the knee and shoulder is described, there is a place for the other major joints such as the elbow, wrist, hip and ankle to be included in the same context. With a text that is so well established, criticism can only be of details. Included is a useful chapter on approaches for external fixation with imaginative diagrams showing cross sectional relationships.

Each section describes the optimum positioning of the patient, landmarks, incision and superficial and deep dissection. The atlas is easy to read, systematically arranged with a consistent pattern which covers all regions of orthopaedic surgery in 13 chapters.

The pictures are first class, and great credit is due to the artist, Hugh A. The basic principle, “do not cut around structures”, is reinforced and clarified by adding colour to the nerves, arteries and veins, enhancing the clinical dimension of the illustrations. Henry, who wrote the classic book ‘Extensile Exposure’ (first published in 1945). These are useful because they relate to the entire length of the plane, avoiding danger to the nerve supply of either muscle. The concept of ‘internervous planes’ which lie between muscles supplied by different nerves is emphasised. The cost of this approach is a restricted view, and many of the techniques require the use of imaging with a C-arm to be safe. New approaches which involve minimal access are included for the upper arm, the distal thigh, and both ends of the tibia. The previous edition appeared in 2003, since when, the authors have revised the text to reflect current practice. Surgical Exposures, first published in 1984 and now in its fourth edition within 25 years, has clearly joined the ranks of standard texts.

Hoppenfeld orthopedics