Author: Francisco del Pinal, MD
Illustrator: Max Crespi
Publisher: Thieme – 373 pages
Book Review by: Nano Khilnani

This is a highly practical book by a single author who has had many years of experience in surgeries involving the hand and the wrist. In this important work there are about 700 illustrations and detailed sketches, and in many cases, right below the images, you will find instructions on the procedures as well. These features make this a very useful see-to-learn book as well.

The back cover of this book describes the author of this book this way

“Francisco del Pinal is considered to be among the world’s best hand surgeons. His contributions in arthroscopic surgery techniques for wrist fractures are endorsed and used internationally. This book, written for hand surgeons, orthopedic surgeons, and plastic surgeons, provides essential insight to specialists and subspecialists.”    

Dr. Scott W. Wolfe, a professor of orthopedic surgery at Weill Medical at Cornell University and editor-in-chief of Green’s Operative Hand Surgery, describes the author in his Foreword as “a master of surgical technique and an inspired teacher who has who has translated decades of practice, patience, and pointers into a state-of-the-art resource that will challenge and inspire surgeons internationally to push the boundaries of surgical care for the benefit of their patients.”

Two other Foreword writers for this atlas with richly illustrated, case-based presentation of the management of distal radius fractures also give praise for this extraordinarily valuable atlas.

Dr. Diego L. Fernandez of Bern, Switzerland writes that the author “provides exhaustive and comprehensive information on his way of dealing with different fracture scenarios about the wrist joint. The techniques and therapeutic approaches are personal and innovative and require mastering open, percutaneous and arthroscopic skills.”

Harvard Medical School Professor Dr. Jesse B. Jupiter describes the author as a “marvelously skilled surgeon who has long demonstrated unique techniques in wrist arthroscopy and has applied them to acute and reconstructive problems related to the distal radius. Even a casual glance though this book will enable the reader to gain extraordinary insight into Dr. Pinal’s concepts, techniques, and surgical results.”

This book is unique in the fact that each of its chapters we list below (to provide you an overview of the contents) has a respective video where you can view the surgical procedures by going to and registering your copy at

Here below are the titles of the chapters:

  1. Prolegomena: Some Initial Thoughts and Facts – Video 1.1
  2. Some Dos and Don’ts Related to Approach and Management – Video 2.1
  3. Arthroscopy: Some Dos and Don’ts: – Video 3.1
  4. The Die-Punch – Video 4.1
  5. Management of an Anterior Sunken Fragment – Video 5.1
  6. Management of Small Fragments – Video 6.1
  7. Volar Shear Fractures – Video 7.1
  8. Free Osteochondrial Fragment – Video 8.1
  9. Rim Fractures – Video 9.1
  10. Ligamentous Injuries – Video 10.1
  11. Comminuted Metaphyseal-Diaphyseal Fractures – Video 11.1
  12. Ulnar Fractures – Video 12.1
  13. Management of Explosion-Type Fractures: Case 1 – Video 13.1
  14. Management of Explosion-Type Fractures: Case 2 – Video 14.1
  15. Management of Explosion-Type Fractures: Case 3 – Video 15.1
  16. Extra-articular Distal Radius Malunions: Arthroscopic Tips and Tricks – Video 16.1
  17. Intra-articular Maluuions: Basic Concepts – Video 17.1
  18. Intra-articular Maluuions: Jammed Fragments in the Metaphysis – Video 18.1
  19. Intra-articular Maluuions: Complex Cases – Video 19.1
  20. Intra- and Extra-articular Malunion – Video 20.1
  21. Intra-articular Malunion: A (Painful) Case – Video 21.1
  22. Corollary: Plates Are Not the Panacea – Video 22.1

To best understand what the author Dr. Francisco del Pinal had in mind to accomplish with this book, let us also read part of his own words in the Preface:

“This an atlas – a fully illustrated compendium of techniques – that in a stepwise manner deals with even the most difficult distal radius fracture. What I have set out to do with this atlas is to share the way I carry out the technical part of the operation and hope as a consequence that everyone can get consistently good results. I may be wrong, but I thought there was a need for a real technical book as I see how others struggle when trying to perform what is written in the textbooks. I also aimed with this textbook to make arthroscopy a friendly addition when dealing with distal radius fractures, rather than a nightmare experience.”

In summary, here are the most important features of this book:

  • Nearly 700 illustrations and intra-operative photographs guide the reader through procedures
  • Operative videos for all chapters narrated by the author, including detailed explanations and rationale for each maneuver
  • A focus on the “how” of surgical technique rather than the “why” keeps attention on the necessary steps, tools, procedures to address a specific type of fracture
  • Real cases, presented from beginning to end, cover all of the difficult aspects of fracture management


Francisco del Pinal, MD, DrMed is a hand, wrist, and micro-vascular surgeon in private practice in Madrid and in Santander in Spain.