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EMR >> EMR Specialty
Orthopedic Surgery
Electronic Medical Records
Orthopedic Specialty
Orthopaedic surgery or orthopaedics is the
branch of surgery concerned with acute, chronic, traumatic,
and recurrent injuries and other disorders of the
musculoskeletal system, its muscular and bone parts. Apart
from the mechanical considerations, it also is concerned
with the pathology, genetics, intrinsic, extrinsic, and
biomechanical factors involved.
Orthopaedic surgeons are M.D.s or D.O.s in the USA and
Canada and MBBSs in the United Kingdom, who have also taken
five to seven years of advanced post-graduate training. In
the United States an Orthopaedic Residency is an extremely
competitive match and consists of an internship year in
general surgery followed by four years of orthopaedic
surgery training. After completion of residency in the U.S.
or after obtaining a qualification such as Fellow of the
Royal College of Surgeons (UK) the Orthopaedic Surgeon may
start practice or may undergo additional fellowship training
in any of several sub-specialty areas, such as sports
medicine, traumatology, reconstructive surgery, hand
surgery, foot & ankle surgery, spine surgery, pediatric
orthopaedics, or orthopaedic oncology. In India, they are
either D'Ortho, MS(Ortho) or DNB(Ortho) and obtain their
degrees following two to three years of post-graduate
training. Many orthopaedic surgeons from developing
countries obtain qualifications in Europe or North America.
Prior to the 1960s most fractures were treated by general
surgeons but since then orthopaedic surgery has developed
into a specialty covering reconstruction and trauma in the
musculoskeletal system.
Orthopaedic surgeons treat patients using
surgical and non-surgical methods to correct musculoskeletal
problems. Orthopaedic 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.
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.
Many developments in orthopaedic surgery resulted from
experiences during war time. On the battlefields of the
Middle Ages the injured were treated with bandages soaked in
horses' blood which dried to form a stiff, but insanitary,
splint. Traction and splinting developed during World War I.
The use of intramedullary rods to treat fractures of the
femur and tibia was pioneered by Dr. Kunchner of Germany.
This made a noticeable difference to the speed of recovery
of injured German soldiers during World War II and led to
more widespread adoption of intramedullary fixation of
fractures in the rest of the world. However, traction was
the standard method of treating thighbone fractures until
the late 1970's when the Seattle Harborview group
popularized intramedullary fixation without opening up the
fracture. External fixation of fractures was refined by
American surgeons during the Vietnam War but a major
contribution was made by Grigor Ilizarov in the USSR. He was
sent, without much orthopaedic training, to look after
injured Russian soldiers in Siberia in the 1950's. With no
equipment he was confronted with crippling conditions of
unhealed, infected and malaligned fractures. With the help
of the local bicycle shop he devised ring external fixators
tensioned like the spokes of a bicycle. With this equipment
he achieved healing, realignment and lengthening to a degree
unheard of elsewhere.
Although orthopaedic surgery is remarkably successful in
treating pain and restoring function it causes problems in a
small proportion of patients. No branch of medicine is
exempt from complication (medicine). Infection of bone after
surgery and the development of blood clots DVT in limbs
injured or operated on, are common enough to be the focus of
much interest and research. The reasons (indications) for
orthopaedic surgery always have to be carefully considered.
An informed appreciation of the risks and benefits of the
proposed treatment is essential.
Source: Wikipedia contributors (2005). Orthopedic surgery. Wikipedia,
The Free Encyclopedia. Retrieved 12:04, December 26, 2005
from http://en.wikipedia.org/w/index.php?title=Orthopedic_surgery&oldid=31927377.
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