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Orthopaedic Examination, Evaluation, and Intervention: A Pocket Handbook

Todd Forman
Dutton M. New York, NY 10121, McGraw-Hill Co, 2005, paperback, 548 pp, illus, ISBN: 0-07-144786-5, $39.95.

This pocket handbook is designed to work in partnership with its parent text, Orthopaedic Examination, Evaluation, and Intervention, by the same author. Dutton's stated purpose is to provide a portable, quick reference on orthopedics for new graduates and student clinicians. The handbook is surprisingly detailed, given its size, and would serve both beginning and experienced clinicians well.

The text consists of 17 chapters. Chapter 1 includes a brief overview of tissue types and biomechanical principles and definitions. Dutton proceeds with a more detailed neuroanatomical review in chapter 2, including multiple innervation diagrams for the central and peripheral nervous systems, and tables that are ideal for quick reference.

Chapters 3 and 4 delineate a comprehensive format to follow while conducting an initial physical therapist examination and systems review. Dutton effectively and efficiently reviews the critical elements of taking the patient's history and performing the physical examination, accompanied by tables of critical questions and flow chart presentations that illustrate clinical “decision trees.” In the format for systems review, Dutton emphasizes the importance of medical screening questions during the physical therapist examination. Multiple tables categorize patient history findings with their common causes. Most clinicians, regardless of experience and background, will likely find these tables—which contain findings that suggest a pathology that requires a referral to another health care provider—particularly helpful. Dutton includes line drawings demonstrating manual muscle testing positions, tables outlining phases of gait, and an interesting table of gait deviations and their associated pathologies in these chapters.

In chapters 5 and 6, the author presents a framework for interpreting the examination findings and general principles of intervention planning. He introduces the preferred practice patterns outlined in the Guide to Physical Therapist Practice,second edition. Dutton reviews the indications and contraindications for various physical therapy interventions primarily through tables. He also outlines clinical decision-making processes based on the stage of tissue healing. These chapters review principles; they do not provide a cookbook approach to orthopedic rehabilitation. Students and new clinicians should find this information summarized effectively enough to use while formulating a plan of care in the clinical setting.

The chapters covering specific regional examinations form the bulk of clinical material in the text. Chapters 7 through 17 discuss the shoulder complex, the elbow and forearm, the wrist and hand, the hip joint, the knee joint complex, the ankle and foot, the craniovertebral junction, the cervical spine, the thoracic spine and rib cage, the lumbar spine, and the sacroiliac joint.

These region-specific chapters all follow the same basic format. Each begins with an overview of functional anatomy, presented by text, table, and diagram. Dutton then reviews the important aspects of the patient history and includes clues to common pathologies associated with specific injuries or historical findings. Each chapter includes more focused elements of a systems review and provides specific information on medical problems that commonly are associated with symptoms in the region. Each chapter includes a diagram of common pain patterns and the pathologies associated with each pattern. The author uses a mix of text, photographs, and line drawings to review techniques for measuring active and passive range of motion and performing special tests. Each chapter also includes a region-specific functional assessment, a differential diagnosis table, and a complete bibliography. The book ends with a detailed index.

This is a well-designed handbook that suits its intended audience effectively. Although not designed to serve as a primary educational text, the information is detailed enough to be practical and accurate for use in a clinical setting. Clinicians of all skill levels would find this book helpful as a quick, on-the-spot reference.

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