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Adam's Outline of Orthopaedics (14th ed.)

Edited by David L. Hamblen and A. Hamish R. W. Simpson pp. 485 Edinburgh: Churchill-Livingstone Elsevier, 2010 ISBN: 978-0702-03061-1

This is the fourteenth edition of a classic which was first published in 1956. It is also the first in which John Crawford Adams has not had direct involvement, although he writes a masterly introductory note which shows that he has lost none of the clarity of expression which marks the previous editions.

The organisation of the book remains essentially unchanged. The first part is devoted to the principles of diagnosis and treatment which are concise but in no way incomplete. Dr Nigel Raby has contributed a new chapter on imaging which is welcome. The second part surveys orthopaedic disorders in general, taking the reader progressively through definition, pathology, clinical features, imaging, investigations, complications and treatment. Although, in some cases, these are little more than vignettes, the authors manage to extract the essence of each of the diseases they describe. Important or life-threatening diseases are described in much greater detail. The third part addresses the regional manifestations of the diseases described in the second part while also amplifying the finer points of history-taking and clinical examination applicable to the particular anatomical region.

Omissions, inaccuracies and infelicities are few. For example, a note on the clinical assessment of chronic glenohumeral instability would be helpful, particularly as the authors remind the reader to check for instability of the acromioclavicular and sternoclavicular joints when examining the shoulder. The Hill-Sachs lesion appears to have lost its final 's' at one point and 'thoracic outlet syndrome' is surely the preferred term for the condition in 2010 rather than 'scalenus syndrome'. These, however, are minor matters in the context of the whole volume.

One suprising feature: despite the rapid expansion of orthopaedics over the last fifty years, the book which was originally meant for undergraduates but may now be read with benefit up to registrar level and for pleasure thereafter, has increased in size by only sixty pages. This has been achieved not only by relaying the text but by strict adherence by the authors to the essentials.

The overall appearance of the book is excellent. The layout and line drawings are impeccable. If I have one reservation, it is about the quality of the half-tone illustrations. This is a constant gripe among authors and editors and is regularly, and on the whole appropriately, laid at the door of the publishers. The definition in some of the illustrations, particularly the radiographs, is less than one might wish. Figure 13.15 is particularly horrid.

While reviewing this volume, I had to hand my own student copy of the seventh edition, now nearly 40 years old. It is remarkable how much of Crawford Adams' original text remains unchanged in this new edition. This is not to say that the 14th edition is anything other than completely up-to-date, which it is. It merely emphasises the importance of basic principles and admiration for transparent exposition. David Hamblen and Hamish Simpson are to be congratulated on having held fast to that which is good while judiciously, but unobtrusively, updating it.

A. Ross

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