I have both the paper and Skyscape Palm OS version and have to agree with Dingleberry... while the PDA version has the entire text including pictures, it's difficult to skim / scroll through large amounts of text quickly so if you're going to spend dedicated time to do some reading as you would from a textbook, the hard copy is definitely better. However, if you're working in the ED and need a quick reference for fracture classification, etc., the PDA version is great. It's organized like all other skyscape products with an index and then each topic is broken down by section like it is in the book (mechanism of injury, classification, operative / non-operative Tx...) The picture quality is adequate if you have a 320x320 resolution PDA.