This is such a fantastic book as an introduction to the concepts of achieving good exposure in orthopedic surgery!
Of particular note to medical students about to start buying books for this fall's away rotations: I didn't, and I wouldn't, really fool much with Netter's Concise Orthopaedic Anatomy, 2e (Netter Basic Science), since the level of detail just doesn't compare. If you're gonna read about an exposure, you may as well do it right and read about it in Hoppenfeld. Throw down the coin, since--after all--you'd expect that you'll be needing this book for a few years to come anyway! Look at it as an investment in the Match! Read on for reasons why...
I write this as an about-to-start intern who used this book extensively on my third- and fourth-year orthopedics rotations during medical school, so it is mostly medical students who will find this review useful. This book almost definitely was over my head in large parts during my third year but started to click early in my fourth-year rotations after I had spent a good bit of time in the OR. I see residents referring to this book often, even the seniors sometimes, for a great broad overview of the "large menu of options" to "get to the bone and stay there", especially for fractures. Discussion of the rationale for particular approaches is somewhat limited (and is probably a discussion more suited to books written about particular injuries that would spark such a debate), but the "how-to" and the lending of understanding of the anatomy while in a particular approach is spectacular.
The artwork is truly great and gives a good sense of three-dimensional anatomy, via "overlaying" layers of tissue overtop the dissection plane of interest. This is definitely contributory towards relating surface anatomy and palpable landmarks to where you'll be on deeper planes, as well as "just how far away that posterior interosseous nerve is that you don't exactly wanna go looking for." The setup of the chapters is highly consistent, organized, intuitive, and excellent for the thought processes in starting a case and gaining exposure, starting with an overview in each chapter briefly comparing and contrasting the utility of each of the discussed approaches, and within each section starting with the incision, going through the internervous planes, superficial and deep dissection planes, and ending with "what to avoid". The pictures tend to be far more helpful and superior than what is usually in Rockwood and Green's much more prose-based descriptions of exposures specifically relevant to a particular fracture, and I would very highly recommend this book as a supplement to that, for understanding sake, as well as for "looking good in the OR" sake.
Many sections are included on "applied surgical anatomy" (a great place for third- and fourth-year medical students to start, reviewing the "just ortho-pertinent gross anatomy topics", if you will, and in a way that is highly applicable to the approaches).
Chapters are manageable length, and the pictures give a great conceptual basis for what you'll see in the OR. Very possible and also absolutely critical to read these chapters the night before a case (and Handbook of Fractures or, if there's time, Rockwood and Green), before getting pimped by trauma attendings. Knowing as much as possible of the contents of Hoppenfeld made an excellent impression on my rotations. Pretty reasonable to "get surprised" in the AM by the post-call admitting resident presenting an operative fracture/patient you didn't know about last night, and "hurry up and read about this exposure real quick before the case starts" on my iPad, too, which was a bonus.
Regarding pictures, indeed, intraoperative photos are notably absent from this book (unlike C. Jordan's "Atlas of Orthopaedic Exposures", which is based exclusively on photographic images, albeit in cadavers which make things uncharacteristically easy to visualize). However, I refer much more often to Hoppenfeld than to Jordan's book, which I also own, since Jordan's book lacks some of the conceptual and functional explanations of the anatomy. Jordan's book, like Hoppenfeld, is written from a highly practical perspective, and I like that part of both of these books. Both contain an element of "how to stay out of trouble", which is all so critical in surgical fields. Another point of comparison is that Hoppenfeld's kindle edition is much more viewer-friendly than Jordan's book, which did not translate well at all from print to kindle edition. The Hoppenfeld kindle edition is overall better (albeit not perfect, since there is still some flipping back and forth from images to captions).
I have thumbed through older editions of Hoppenfeld that did not include full-color, and I think that this new edition is a full order of magnitude better. Indeed two-tone black-and-white in older editions may have been good conceptually, but it is nice to have something that registers better visually in your brain when you're just trying to memorize the images... Worth every penny for the new edition.
One caveat to note is that Hoppenfeld, while very broad in scope, is not 100% all-inclusive. Perhaps nor should it be... There are a couple of exposures in Jordan's book that aren't very well detailed in Hoppenfeld, but I'd say Hoppenfeld outnumbers Jordan in terms of the overall completeness. I would recommend looking at the table of contents via the kindle sample to get an idea of what all is included. Reading the first chapter via kindle is pretty representative of the rest of the book's content. Hoppenfeld also has a couple sections on hip and knee arthroscopy for very basic principles and where to put ports, which is very helpful for medical students and perhaps very junior residents. Importantly, this obviated the need for me to get an additional esoteric book on arthroscopy just to know what was going on anatomically on the monitor. Obviously, readers would do better with other books for more advanced arthroscopic anatomy later in residency(my sports experience is also limited, aside from thumbing through Stephen Burkhart's fantastic technical manuals shoulders--The Cowboy's Companion: A Trail Guide for the Arthroscopic Shoulder Surgeon and the newer Burkhart's View of the Shoulder: A Cowboy's Guide to Advanced Shoulder Arthroscopy) but Hoppenfeld was notably great for my foot & ankle rotations. Definitely a semi-dizzying array of different approaches in the foot and ankle depending on the structure of interest, and most are covered superbly.
I cannot compare this book to the Master series book on orthopedic exposures Master Techniques in Orthopaedic Surgery: Relevant Surgical Exposures, nor to Mark Miller's book on exposures Orthopaedic Surgical Approaches, 1e . Fellows would almost certainly be familiar with Hoppenfeld's atlas and would know the following information, but I'll state it: that more specialized topics as far as surgical exposure may be better covered in other books, namely in hand surgery with Schmidt's Surgical Anatomy of the Hand, Doyle's 2002 book (http://www.amazon.com/Surgical-Anatomy-Hand-Upper-Extremity/dp/0397517254/ref=wl_it_dp_o_pC_nS_nC?ie=UTF8&colid=2BRCVY7BFOBCH&coliid=I3MF5P2VUYPH7B), and the classic from 1984 Kaplan's Functional and Surgical Anatomy of the Hand. I am less familiar with these books, since I spent very minimal time during my rotations doing hand surgery.
As a bottom line, if you want to do well both for your understanding and looking good during medical school rotations, as well as get a book you'll refer back to again and again prepping for the early years in the OR, get this book. It is worth every penny, and I have it both in hard copy for making drawings on pictures as well as on kindle for quick reference at the hospital. Get this book, and get Handbook of Fractures. Two absolutely fundamental bodies of knowledge with which to be familiar as a burgeoning almost-orthopod.
Hope this helps. Happy learning!
Par ggosey
- Publié sur Amazon.com