This paper by Watt and Chung gives the reader an overview of hand anatomy, comments upon the aesthetics of hand surgery and summarizes some surgical approaches to the hand. The introduction presents a concise overview of the relevant anatomy of the hand with clarity; the narrative style and logical approach make the content easy to read and digest. There is some discussion of the value of the aesthetic subunits of the hand, although this is brief, and we note that the authors have further work on this subject in the process of publication. Surgical approaches are summarized by structure; there is limited discussion of the merits of different approaches, rather the authors present an experienced opinion and state their own operative preferences in detail. Two cases are presented at the end of the article; they feel slightly disconnected from the main body of text, and it would have been interesting to see the final aesthetic outcome of these operations given the references to this in the article itself and the ‘Key Findings’. This is a well-structured and elegantly written article from an author of renown. This piece discusses the expert opinion of the authors rather than an objective comparison of approaches in the published literature. The summary of hand anatomy is likely to be of interest to core surgical trainees and junior registrars / residents. The presentation of approaches to the hand may assist those preparing for fellowship examinations or interest those consultants wishing to review and compare their own practice. 

Surgical exposures of the hand.
Watt AJ, Chung KC.
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Megan Anderson

Department of Plastic Surgery, St John's Hospital of Howden, Livingston, UK.

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