Orthopedic surgery
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Orthopedic surgery or orthopedics (BE: orthopaedics) is the branch of surgery concerned with acute, chronic, traumatic and recurrent injuries and other disorders of the locomotor system, its muscular and bone parts. Apart from the mechanical considerations, it is also concerned with the pathology, genetics, intrinsic, extrinsic and biomechanical factors involved.
Orthopedic surgeons are MDs or DOs in the USA and MBBSs in the United Kingdom, and generally have a five to seven years of advanced postgraduate training and may serve a fellowship for training in any of several sub-specialty areas, such as sports medicine, traumatology, reconstructive surgery, hand surgery, foot & ankle surgery, spine Surgery, rheumatological surgery, pediatric orthopedics, geriatric orthopedics, or industrial medicine.
Orthopedic surgeons treat patients using surgical and non-surgical methods to correct problems. Orthopedic surgeons work closely with many allied health professionals, such as athletic trainers, physical therapists, occupational therapists, physical medicine & rehabilitation physcians and other physicians in related fields in the treatment of patients.
Many developments in orthopedic surgery resulted from experiences during wartime. The use of intramedullary rods to treat fractures of the femur and tibia was pioneered by Dr. Kirschner of Germany during WWII. External fixation of fractures was refined by American surgeons during the Vietnam War.
Toronto, Canada, was an early centre of excellence in orthopedic surgery, renowned for training and creative development since orthopedics was defined as a distinct surgical specialty by the pioneer surgeon Robert I Harris in the 1950s. Generations of orthopaedic surgeons graduating from the University of Toronto program have since contributed to many of the important achievements in orthopedics that have improved the lives of people with bone and joint injuries and diseases.
One eminent example is the work of David L. MacIntosh who pioneered the first successful surgery for the management of the torn anterior cruciate ligament of the knee. This common and serious injury in skiers, field athletes and dancers had invariably brought an end to their pursuits due to permanent joint instability. Working especially with injured football players in his role as sports surgeon for the University of Toronto, he devised a way to reroute viable ligament from adjacent structures to preserve the strong and complex mechanics of the knee joint and restore stability throughout its range of motion, conferring a fully functional joint. This for the first time in history could reliably permit the athlete to return to the demands of (even professional) sport or dance after a period of healing. The two major variants of this repair that MacIntosh developed in the 1960’s and 1970’s for the torn anterior cruciate ligament are still the operations of choice performed today.
The modern total hip replacement was developed by Sir John Charnley in England, and the modern condylar total knee replacement was developed by Dr. John Insall and Dr. Chitranjan Ranawat in New York.
Scoliosis surgery was revolutionized by Dr. Harrington's introduction of hook-rods which could maintain the straightening of the spine long enough for a bone fusion to develop.
Particularly important for injured athletes was the use of arthroscopic tools by Dr. Watanabe of Japan to perform minimally invasive cartilage surgery and reconstructions of torn ligaments. This advance helped ligament repair patients recover in a few hours instead of a few weeks, as was the case with open-joint surgery.
History
Nicholas Andry coined the word "orthopaedics", derived from Greek words for "straight" and "child", in 1741, when at the age of 81 he published Orthopaedia: or the Art of Correcting and Preventing Deformities in Children.
Jean-Andre Venel established the first orthopaedic institute in 1780, which was the first hospital dedicated to the treatment of children's skeletal deformities. He is considered by some to be the father of orthopaedics or first true orthopaedist in consideraton of the establishment of his hospital and for his published methods.
Antonius Mathysen, a Dutch military surgeon, invented the plaster of Paris cast in 1851.
See also
External links
- The History of Orthopaedics (http://www.worldortho.com/history.html)
- Orthopaedics in WikiMed (http://www.wikimed.de/bilder/wiki.cgi?Orthop%e4die)
- Traumatology in WikiMed (http://www.wikimed.de/bilder/wiki.cgi?Unfallchirurgie)
- Wheeless' Textbook of Orthopedics (http://www.wheelessonline.com/index.htm)
- The International Society of Orthopaedic Surgery and Traumatology (http://www.sicot.org/)
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