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Surgical Exposures in Foot & Ankle Surgery: The Anatomic Approach

P. deBoer, R. Buckley, S. Hoppenfeld pp. 192 China: Lippincott Williams and Wilkins 2012 ISBN: 978-1-4511-4450-5

Surgical Exposures In Foot And Ankle Surgery - The Anatomic Approach takes the short chapter in the popular Anatomic Approach series and quadruples its length – to the delight of the foot and ankle surgical community.

It has been nearly 30 years since the first edition of Surgical Exposures in Orthopaedics - The Anatomic Approach. The book was very successful, and the latest edition is the fourth, published in 2009. It was always my favourite surgical anatomy book, and accompanied me through training. I appreciated the well-structured format, step-by-step description of each approach and the clear illustrations. However, when I received further training in foot and ankle surgery, I found it did not contain enough foot and ankle material. Unfortunately most of the foot and ankle books are more focused on the overall treatment foot and ankle conditions or surgical techniques rather than details of surgical exposure. This new book fills the need for detailed surgical exposures of the foot and ankle.

Surgical Exposures in Orthopaedics - The Anatomic Approach, has only 69 pages for the whole foot and ankle section, whereas the new book contains 245 pages. Thirty-five new approaches have been added and it contains over 200 full-colour illustrations. The book is divided into five anatomical areas: ankle, hindfoot, midfoot, forefoot and toes. In each area, it includes most of the open surgical exposures. Consistent with the parent volume, for each surgical exposure it has a brief but clear introduction, position of patient, surgical landmarks, superficial to deep surgical dissection, dangers encountered and the method to extend the exposure. After the presentation of a group of related approaches there is a section that covers the regional anatomy encountered during these approaches.

In common with the parent volume, it contains beautiful illustrations of the anatomy from the surgeon’s perspective, by the same illustrator, Hugh Thomas.

The authors believe that internervous planes, as described by Henry, are important to surgical approaches, and, although they are less important in the foot and ankle because of the distance from the nerve bifurcations, they maintain consistency with the parent volume by highlighting the internervous planes.

My only criticism is that it is light on endoscopic anatomy – only ankle arthroscopy is covered, and this is not a suitable book for surgeons planning tendoscopy or subtalalar, mid-foot or small joint arthroscopy – perhaps future editions will cover this material as the procedures become more popular.

There have been great advances in the foot and ankle field in the last two decades and it has become one of the highly developed sub-specialties, especially with the development of minimally invasive techniques such as arthroscopy and tendoscopy and percutaneous procedures.  To exploit these new techniques a consolidated knowledge of surgical anatomy is key, and, though the surgical techniques will evolve, the surgical anatomy is permanent. This new book provides the permanent knowledge in good detail, and I highly commended this book to all, not only foot and ankle surgeons, but also to general orthopedic surgeons, fellows and trainees who treat foot and ankle problems. The techniques in this book are applicable worldwide, and I look forward to seeing it translated into other languages.

S. W. Kong

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