Concepts in Hand Rehabilitation.

Stanleyy BG, Tribuzi Sm, eds. Philadelphia, PA 19103-1493, FA Davis Co, 1992, hardback, 582 pp, illus, $42.

This book is a fine addition to the Contemporary Perspectives in Rehabilitation series. Twenty-three authors contributed to this comprehensive volume. The content of the book is divided into four sections. The first, "Fundamentals of Hand Therapy," includes chapters entitled "Functional Anatomy" and "Wound Healing."

These chapters present a readable and pertinent introduction to the functioning of the hand and to the process of wound healing that is so critical with the hand, The second section, "Evaluation of the Hand," has chapters entitled "Clinical Evaluation," "Sensibility Testing," and "Functional Evaluation." The information related to evaluation is practical, well-organized, and useful. The third section relates to concepts in clinical treatment. This section addresses wound management, therapeutic exercise, physical agents (including electrotherapy), and splinting. All of these chapters are presented in a manner that shows the reader to take the basic principles and apply them to a wide variety of patients. The value of examples, however, is not ignored; many illustrations and examples are provided throughout the text.

The final section is dedicated to clinical treatment by diagnosis. In this section, the general areas of skeletal injuries, nerve injuries, and tendon injuries each have a chapter dedicated to them. In addition, rheumatoid arthritis, cumulative trauma, reflex sympathetic dystrophy, and crush injuries and amputations are also covered in separate chapters. The final chapter is dedicated to returning the patient with hand injury to work. These sections are followed by four appendixes, two of which give detailed information on goniometry of the forearm, wrist, and hand and on pinch and grip strength testing.

The editors state their intent is to "... in addition to providing the relevant facts, ... [emphasize] the reasoning process necessary to develop an effective rehabilitation program." The editors and authors succeed in this goal. Information on problems related to hand injuries, methods of differential diagnosis for the problems, and principles of treatment are presented in such a way that the reader can then apply the information to patients and develop an appropriate treatment program. This book provides a great deal of information about treating persons with hand involvement, and it successfully avoids a "cookbook format."

The last portion of each of the chapters in the last three sections includes a case study. These case studies are provided to demonstrate the author's clinical reasoning process. These cases are not presented as the only correct approach, but rather as one of a variety of choices that might be made. These cases also serve to provide a concrete example or application of some of the information presented in each chapter. Overall, the format of this book enhances its usefulness.

This book would be appropriate for a wide variety of consumers. All physical therapy practitioners who treat people wide hand injuries, either in specialty or general practice settings, could benefit from the information included. Faculty who teach in the area of hand injuries, especially at the graduate level, could also utilize this book. Concepts in Hand Rehabilitation could easily serve as a text in a graduate course on hand therapy. The modest cost makes this a feasible addition to personal and departmental libraries.