Exposures of the wrist and distal radioulnar joint
Reviewed by Naomi D Deakin

The article Exposures of the Wrist and Distal Radioulnar Joint presents its anatomical material in a logical manner, with headings and sub-headings clearly delineating the subject matter. The ‘Pitfalls’ and ‘Pearls’ sections adequately summarise the material covered, in a format easily accessible to the clinician in a rush. Finally, the narrative style of the piece is easy to read, forming a body of prose which gives a broad overview of the topic. However, the impression from this article’s title is that this piece will deliver an appraisal of the exposures of both the wrist and the DRUJ; but what follows is simply a description of a ‘standard’ approach for each, with one alternative exposure of the two further described, finished with scaphoid bone grafting. Indeed, ‘alternative’ approaches are allocated very little text and described in far less detail than the ‘standard’ methods. Additionally, the final third of the article presents three clinical cases which each illustrate only one exposure, with no discussion as to the approach utilised, or the benefit from alternative methods. The reviewers feel that this may represent a missed opportunity, with no critical review of either exposures. The target audience of this piece is also somewhat ambiguous; one cannot help but feel that experienced consultants may not require such extensive anatomical review, with registrar / resident colleagues perhaps not fully comprehending the surgical techniques introduced in the middle third of the piece. Additionally, instead of the inclusion of illustrations at the end of the piece, the readers may have been better engaged if the lengthy blocks of text were broken up by the otherwise good quality images which are placed at the end of the review. Without doubt, the content of this article is of high quality, but we felt that this was somewhat lost in part due to poor formatting; the addition of generic subheadings may have allowed for direct comparison. In summary, ‘Exposures of the Wrist and Distal Radioulnar Joint’ provides useful insight into the surgical techniques available, but fails to critically appraise this material, nor initiate discussion regarding improvement in this field.

Exposures of the wrist and distal radioulnar joint.
Bickel KD.
HAND CLINICS
2014;30(4):435-44.