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System of Orthopaedics and Fractures 50 years ago he saw it as an aid to accompany the courses that he conducted for aspiring surgeons who were preparing for the FRCS exams. With characteristic humour, he
called the book ‘a prophylactic against writer’s cramp’. Pictures were unnecessary: if you had any sense (and were quick enough to get on the heavily oversubscribed Apley Course) you would be treated
to an unforgettable display of clinical signs by one of the most gifted of teachers. You also learnt how to elicit those signs by using a methodical clinical approach – the Apley System. The Fellowship exam was heavily weighted towards clinical skills. Miss an important sign or stumble over how to examine a knee or a finger and you could fail outright. What Apley taught you was how to order the steps in physical examination in a way that could be applied to every part of the musculoskeletal system. ‘Look, Feel, Move’ was the mantra. He liked to say that he had a preference for four-letter words. And always in that order! Deviate from the System by grasping a patient’s leg before you look at it minutely, or by testing the movements in a joint before you feel its contours and establish the exact site of tenderness and you risked becoming an unwilling participant in a theatrical comedy.
