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A Practical Approach to Orthopaedic Medicine (Third ed.)

Elaine Atkins, Jill Kerr and Emily Goodlad pp. 462 Edinburgh: Churchill Livingstone, 2010 ISBN: 978-0-7020-3174-8

The third edition of this book follows a very similar format to the previous editions. Monica Kesson writes the foreword but is no longer involved as an author; Elaine Atkins is instead joined by Jill Kerr and Emily Goodlad. The authors aim to ensure that the Cyriax method survives by presenting it with a more evidence-based approach. This has been achieved to a certain extent; but with the exception of a few photographs, the majority of the text and illustrations are similar to those in the second edition. The main area which has been updated concerns safety, with emphasis on contraindications to treatment and attention to recent research such as 'red flags', national treatment guidelines and vertebral artery investigation. The book remains very clinically focused, with assessment and reassessment emphasised in the guidance of treatment. I noted the effective use of coloured boxes throughout the text, highlighting useful clinical tips. The addition of online access to learning resources using the Evolve learning system has brought this product up-to-date technologically.

The book is divided into two sections. The first covers the principles of orthopaedic medicine, and describes the process of clinical reasoning and the behaviour of soft tissues in the musculoskeletal system during injury and the healing process. The authors provide an overview of the treatment techniques used in orthopaedic medicine (mobilisation, manipulation, traction and injection) aimed at the restoration of full painless function. The second section adopts a regional approach, dividing the body into separate moving parts and describes the relevant anatomy, examination, diagnosis and treatment. Information is presented clearly in an easily understood fashion with explanatory photographs and diagrams of procedures and treatment techniques.

This book will be useful for physiotherapists in training and those starting out in orthopaedic/outpatients, and will help to develop skills in examination and treatment. However, the treatments described are essentially passive and compartmentalised. The growing acceptance of the need for a more holistic approach, encouraging active patient participation in the treatment process, means that this book offers only part of the wider picture.

R. Keer

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