Physiotherapy June 2001/vol 87/no 6

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Book reviews

Martin Dunitz, London(available in USA from Blackwell Science)2000 (ISBN 1 85317 563 3). Illus. 688 pages

edited by Nikolaus Wülker MD, Michel Mansat MD andFreddie H Fu MD £175This is a comprehensive presentation of surgical techniquescurrently in practice in Europe and the USA. Eighty-eightauthors have in fact contributed to this large book, whichalso includes an in-depth look at a wide spectrum ofshoulder pathologies, giving specific attention to rotator cufftears. In addition, four chapters are included on shoulderjoint investigations, eg MRI and diagnostic arthroscopy, and32 pages are dedicated to shoulder rehabilitation for specificshoulder conditions, varying from minor and majorshoulder instability to post-operative management ofshoulder joint replacement.

The book is written specifically for shoulder surgeons butit would make a useful addition to any physiotherapyoutpatient/orthopaedic department or for any physiother-apist who is particularly interested in the shoulder joint. Notonly does the book give physiotherapists an insight into allthe various types of shoulder surgery, it also provides an in-depth review of other topics which will be morespecifically useful to physiotherapists, eg anatomy, bio-mechanics, pathology, rehabilitation.

In particular, I found the comprehensive chapter onrotator cuff tears very interesting and informative, since thisis one of the most common pathological conditions I treat.

I liked the format, which does not include long com-plicated chapters but short, succinct sections which are easyto follow.

A major component of the book is however dedicated tosurgery, and readers’ interest is drawn to the great variety ofsurgical approaches which are available. Procedures includea range of tendon and muscle transfers (eg latissimus dorsi,teres major and pectoralis major tendon transfers andtrapezius flaps) where rotator cuff disease has necessitatedsurgical repair, arthroscopic repair for shoulder instability,and amputation following a severely injured shoulder. It isalso interesting to note just how many types of surgicalapproaches can now be undertaken arthroscopically.

For physiotherapists who are looking for specific guidancein their rehabilitation of shoulder joints this book does offer

some helpful information. However, there is no mention of rehabilitation with regard to muscle or movementimbalance, which I find disappointing. Admittedly, a bookconcerning itself primarily with shoulder surgery is unlikelyto go into any great depth about physical re-education.Nevertheless, a reference to the re-education of scapulaposition and movement, as well as the use of specific musclelength tests and rotation control exercises, would haveshown that shoulder surgeons acknowledge the importanceof very specific rehabilitation and are also aware of thisapproach.

In general the book is well written and includes someexcellent colour photographs which not only help to conveya surgeon’s view of the shoulder joint to physiotherapists butalso greatly enhance understanding of the text.

There are, however, some statements within the writtentext which are confusing, eg ‘The posterior displacement ofthe scapula and the retroversion of the humeral head enablegrasping movements as well as motion to lateral andposterior’ and ‘During the normal course of movements inthe scapula region autonomous motions are possible neitherin the shoulder joint nor in the joints of the shoulder girdle.’The text has obviously not always translated well.

The book follows a reasonably logical progressionalthough chapter 3, on surgical incision points, is ratherstrangely located immediately after chapters on anatomyand biomechanics and precedes chapters on investigativetechniques such as MRI, US, etc. In addition, there is a largechapter under the title of ‘Rehabilitation’ which is placedbetween various pathological conditions. This chapterwould be more appropriately located after the shoulderpathology section.

Nevertheless, the book is presented in such a way thatreaders can choose relevant sections when needed ratherthan having to plod through the whole book. This isundoubtedly one of its strengths.

Although this is an excellent book it does not representgood value for money when compared to The Shoulder byRockwood and Matsen, which I believe is a better book andwhich comprises two large volumes covering 1,341 pages aswell as a CD ROM and costs £150. The illustrations inShoulder Surgery are excellent and in colour, but the book isnot as well written and comprehensive as that of Rockwoodand Matsen.

Nigel Wilson MSc MCSP

Shoulder Surgery An illustrated textbook