This is a uniquely systematic and highly organized text outlining an entire method of taking a history, and a system for examining and investigating a patient. The secret of its success lay in its origin as the hand-out notes of the most successful orthopaedic training course in the English languagea course that ran for three weekends twice a year for half a century. After taking the history, LOOK FEEL MOVE became the orthopaedic examination credo for a whole generation of surgeons and not a few rheumatologists. My audit at St Thomas' showed that a quarter of rheumatology out-patients have medical orthopaedic problems and just under another quarter, spine disorders, so this volume is clearly of interest to us, our colleagues and their trainees.
This textbook arose as three slender volumes, one for each weekend of the course becoming the germ centre of the first single-bound foolscap volume, of which my copy is dated 1958. This ripened for publication as the first edition of the textbook in 1959. Apley chose a publisher with characteristic logic. He thumbed his way through the telephone book and wrote to the first publisher he found: Arnold. They did not reply so he repeated the process and wrote to the next. This was Butterworth, with whom he was to remain for the rest of his life. It is ironic that the latter has now been subsumed by the former. Success made for high demand. As a picture is worth a thousand words, an illustrated edition was called for and arrived in 1968.
The publishers allowed 300 or so illustrations. Apley needed thousands. A satisfactory compromise was hammered out in which 1802 separate illustration were grouped into 312 montages that were skillfully trimmed and mounted into composites. Despite his wealth of clinical material and collection of tens of thousands of slides, several members of Apley's family, colleagues and friends appear anonymously as illustrations. The book flourished and with the passage of time acquired a co-author, Louis Solomon, who strengthened the theoretical and medical basis of the text.
The book won some highly valued accolades. Internationally it appeared in a pirate edition. Locally I saw its dust jacket on display in the entrance of the St Thomas' Hospital Medical School library as the example of that category of book which attracted the highest rate of fine for being overdue. New editions appeared, slightly increasing in girth with middle age. I treasure my 7th edition, the last under Alan Apley's personal guidance.
Orthopaedic training requirements have changed and the course that was the fons et origo of the book is no more. What is now needed is a textbook based on a uniquely clear system. This is satisfied here by a single volume in three main sections: General Orthopaedics, Regional Orthopaedics, and Fractures and Joint Injuries. The authors set out to cover the field of musculo-skeletal disorders and trauma describing operations only in outline, with the emphasis on indications, pitfalls, complications and outcome.
It amply fills those niches appearing in rheumatology training with the expansion of other aspects of our specialty, and will be of practical help in liaising with our hard-pressed orthopaedic surgical colleagues.
I know of no other work in its class. It is a pleasure to browse through its pages, gaze at its unique and spectacular series of illustrations, or just to enjoy writing this review in memory of the most lasting achievement of the greatest teacher of orthopaedics in the English language. No rheumatologist should fail to have it by his or her side. It is a must for every departmental library.