Practical Orthopaedic Medicine.

Practical Orthopaedic Medicine By Corrigan B, Maitland GD. Stoneham, MA 02180, Butterworth Publishers, 1983 (reprinted 1987), paper, 421 pp, illus, $39

The authors have provided a practical guide to the clinical management of patients with orthopedic problems. The combination of authors, one a rheumatologist and one a physical therapist, resulted in a book that has a broad scope of application. The book will be of interest and value both to physical therapists and to physicians involved in the care of patients with orthopedic problems.

The book is divided into two major sections: "Peripheral Joints" and "The Spine." The section on the peripheral joints has 14 chapters. Four introductory chapters cover basic terms, subjective assessment, objective assessment, and general management principles; the remaining chapters are devoted to examination and treatment of specific peripheral joints. Each chapter on peripheral joints follows the same general outline: an initial overview of functional anatomy and a few important biomechanical principles, an outline and description of examination techniques, and a discussion of common lesions and the suggested management of these lesions. The section on the spine includes 3 chapters on the examination of the cervical, thoracic, and lumbar areas of the spine; also included are separate chapters on the pathology and management of spinal problems. The examination and treatment techniques advocated by Maitland form the basis for much of the book. The authors assume that readers have either 1) a basic understanding of Maitland's concepts and principles related to the evaluation and treatment of musculoskeletal problems, or 2) have access to Maitland's books on peripheral and vertebral manipulation. Physical therapists who are unfamiliar with Maitland's approach will find it necessary to consult other sources for a more in-depth explanation of specific techniques. Other methods of treatment, such as injection and medication, also are discussed.

A major strength of the book is the discussion of differential diagnosis of common musculoskeletal problems. These discussions are grounded in the relevant literature, the authors' clinical experience, and clinical findings. The authors take a conservative, nonsurgical approach to the management of patients with orthopedic problems; management includes both physical and medical treatment. Some of the chapters in the section on the spine are quite brief and lack sufficient depth for physical therapists (eg, lumbar spine management and spinal traction), but they would be beneficial for other health professionals who are less familiar with these areas. Physical therapists who are familiar with Maitland's approach will find this book to be an excellent resource for clinical practice. Those therapists who are unfamiliar with Maitland's work will have to seek other sources to enhance their understanding, but they may benefit immediately from the discussions of differential diagnosis. Because the book primarily represents one philosophical approach and lacks sufficient detail on examination techniques, I do not recommend it as a text for first-professional-degree students; however, the book could serve as a text for advanced graduate students. The text also could benefit health care professionals who work with orthopedic physical therapists and want to understand more about manual techniques.

Gail M Jensen, PhD