The first edition of this text appeared in 1990 (published by Churchill Livingstone) and since that time has been one of the most comprehensive texts to have been produced giving detail, as it does, of all aspects of the maintenance of the foot and lower limb. However, since 16 years have elapsed until the appearance of this second edition, and although it follows the model set by its predecessor, it is better viewed as a new addition to the scientific literature of pathologies and their management in the foot and lower limb.
The two volumes of the second edition comprise over 1500 pages and 55 chapters written by 70 contributors, all of whom are acknowledged specialists in their field. In general the chapters deal with single subjects or similar topics grouped together, which enables a strong focus to be made on that area. This is good and works well but there are also some puzzling aspects and apparent overlaps. An example of this is chapter 10 entitled “General Radiology of the Foot and Ankle” and included in this is a section on MRI, which describes this area exhaustively and well. However, the reader will find that chapter 55 is entitled “Clinical Indication of MRI: Use in Podiatry”, which seems to cover almost the same area as in chapter 10. Both of these chapters contain good clinical material, which is complementary and one wonders why they are separated out.
Another example of this is the inclusion of a chapter detailing the historical development of podiatry, which is very interesting, but its inclusion in an overwhelmingly clinically based text is a little puzzling.
Most of the chapters are well referenced, in many cases using references from articles in work published in referenced publications, although some chapters are sparsely referenced. In general those falling into the latter category are in subject areas where there is little current research. The page numbering is not continuous with each chapter being numbered separately. This convention makes it more difficult to locate topics in a text as large as this when using the index to identify topics.
The illustrations in the text are good and there are many good clinical photographs. However the impact of some of them is lost because they are all in black and white and sometimes the quality of the reproduction is poor. This is a little sad as the impact and the value of the illustration is lost. In a large text like this, difficult decisions have to be made to avoid the cost spiralling but this is one area where it would have been better to allow the cost to rise.
The subject range within the text is enormous with applied anatomy of the foot and ankle to the diagnosis and management of diseases and disorders of the lower limb. There have been some considerable enlargements made to the chapters which tends to reflect the changes that have taken place in the provision of health care of the foot and lower limb in the last 16 years. The coverage of diabetes is very comprehensive and describes the pathology as related to the foot in a very concise manner as does the chapter on arthritis.
The way in which the text is set out is also useful to the student and practitioner alike, separating out as it does the normal and moving on to discuss the various pathologies. The inclusion of specialised chapters is also valuable and provides the practitioner with a handy reference. Examples of this are the chapters on Lower Extremity Oedema, Infectious Diseases, the four chapters on tumours and also one on Foot Disorders Associated with Ageing. These chapters, in concentrating on either areas or common themes, provide a useful focus for the practitioner around pathological themes. The use of themes continues with chapters on the paediatric patients, sports medicine and the handicapped. In a more thought provoking sense there are chapters on the handicapped and disabled patient, behavioural medicine and the role of podiatric medicine in the management of patients with HIV/AIDS.
The chapter on behavioural medicine looks in some detail at an area, which has not been given much attention hitherto, and cites some interesting case studies. Similarly the chapter on the handicapped and disabled patients raises some interesting aspects of patient care.
Surgery does not figure too largely in this text, as indicated by the title, but the chapters on surgery and matters surgical are very comprehensive but place the modality clearly as part of a range of options. An important aspect of the text shows the increasing effectiveness of non-invasive techniques in the management of foot problems while at the same time avoiding treatment strategies that tie the patient into patterns of treatment over a long period. This is particularly evident in the chapters on orthodigita techniques and basic concepts of rehabilitation.
Although this text is directed towards podiatrists its scope and attention to detail is great and it provides a resource for all of those whose clinical caseload involves the management of conditions of the foot and lower limb. It is a text, which is a must for all practising podiatrists and provides the ideal reference for foot conditions and their management for all health professionals.
FULL TEXT