Orthopedic surgery or orthopedic , also spelled orthopedic [s] , is a surgical branch associated with a condition involving the musculoskeletal system. Orthopedic surgeons use surgical and non-surgical means to treat musculoskeletal trauma, spinal diseases, sports injuries, degenerative diseases, infections, tumors, and congenital anomalies.
Video Orthopedic surgery
Etymology
Nicholas Andry creates the French word as orthopÃÆ' Â © die , derived from the Greek word ????? orthos ("right", "straight") and ??????? paidion ("child"), when he published Orthopedie (translated as OrthopÃÆ'Â|dia: Or Art Correcting and Preventing Flaws in Children ) in 1741. The word was assimilated into English as orthopÃÆ'Â|dics ; ligatur ÃÆ'Â| was common in that era for ae in Greek and Latin words. Although, as the name implies, the discipline originally developed with attention to children, correction of the spine and bone defects in all life stages eventually became the foundation of orthopedic practice.
Like many words derived with the "ÃÆ'Â|" ligature, the simplification of either "ae" or simply "e" is common, especially in North America. In the US, most college, university and residency programs, and even the American Orthopedic Orthopedic Academy, still use spelling with ae digraph, although hospitals usually use a short form. Elsewhere, uniform use: in Canada, both spellings are acceptable; orthopedics usually apply in the rest of the British Commonwealth, especially in the UK.
Maps Orthopedic surgery
History
Initial Orthopedics
Many developments in orthopedic surgery have been generated from experience during the war. In the medieval battlefield the injured were treated with bandages soaked in the dried blood of the horse to form a stiff, but not clean splint.
Initially, the term orthopedic means correcting muscle shape abnormalities in children. Nicolas Andry, a professor of medicine at the University of Paris coined this term in the first book written on the subject in 1741. He advocated the use of exercise, manipulation and splinting to treat deformities in children. His book is directed to parents, and while some topics will be familiar to today's orthopedists, it also includes 'excessive sweating of the palms' and spots.
Jean-Andrà ©  © Venel founded the first orthopedic institute in 1780, which was the first hospital dedicated to the treatment of bone deformities of children. He developed a foot-club footwear for children born with leg defects and various methods to treat curvature of the spine.
Advances made in surgical techniques during the 18th century, such as John Hunter's research on healing tendons and Percival Pott's work on spinal deformity continue to increase the range of new methods available for effective treatment. Antonius Mathijsen, a Dutch military surgeon, invented the Paris cast in 1851. However, until the 1890s, orthopedics was still a study restricted to deformity correction in children. One of the first surgical procedures developed was percutaneous tenotomy. This involves cutting the tendon, initially the Achilles tendon, to help treat joint deformity and strengthen exercises. In the late 1800s and first decades of the 1900s, there was significant controversy about whether orthopedics should include surgical procedures altogether.
Modern orthopedics
Examples of people who helped develop modern orthopedic surgery were Hugh Owen Thomas, surgeon from Wales, and his niece, Robert Jones. Thomas became interested in orthopedics and bone regulation at a young age and, after establishing his own practice, went on to expand the field into the general treatment of fractures and other musculoskeletal problems. He advocated a forced break as the best medicine for fractures and tuberculosis and created so-called 'Thomas Splint', to stabilize the fractured thighbone and prevent infection. He is also responsible for many other medical innovations that all carry his name: Thomas 'collar' to treat tuberculosis of the cervical spine, 'Thomas maneuver', orthopedic investigations for hip joint fractures, Thomas tests, methods of detecting hip deformity by making the patient lie on his back bed, Thomas 'wrench' to reduce fracture, as well as osteoclasts to break and reset bone.
Thomas's work was not fully appreciated in his own life. Only during the First World War was his technique used for wounded soldiers on the battlefield. His niece, Sir Robert Jones, has made great progress in the orthopedic field in his position as Chief-Inspector for the construction of the Manchester Shipbuilding in 1888. He was responsible for the wounded among the 20,000 workers, and he arranged the first comprehensive service crash in the world, site 36 miles into 3 parts, and set up hospitals and a series of first aid posts in each section. He has trained medical personnel in fracture management. He personally manages 3,000 cases and performs 300 operations in his own hospital. This position allows him to learn new techniques and improve fracture management standards. Doctors from around the world come to Jones's clinic to learn the technique. Along with Alfred Tubby, Jones founded the British Orthopedic Society in 1894.
During the First World War, Jones served as a Territorial Army surgeon. He observed that treatment of fractures both in front and in the hospital at home was inadequate, and his efforts led to the introduction of military orthopedic hospitals. He was appointed Inspector of Orthopedic Military, with the responsibility of more than 30,000 beds. The hospital on Ducane Road, Hammersmith became a model for British and American military orthopedic hospitals. His advocacy of the use of Thomas splint for the early treatment of femoral fracture reduced the mortality of fracture of the femur complex from 87% to less than 8% in the period 1916-1918.
The use of intramedullary stems to treat femur and tibia fractures was pioneered by Gerhard KÃÆ'¼ntscher from Germany. This made a real difference to the speed of recovery of wounded German soldiers during World War II and led to the widespread adoption of intramedullary fixation around the world. However, traction was the standard method for treating femur fractures until the late 1970s when the Harborview Medical Center in Seattle group popularized intramedullary fixation without opening the fracture.
A total modern hip replacement was pioneered by Sir John Charnley, an expert in tribology at Wrightington Hospital, England in the 1960s. He discovered that the joint's surface could be replaced by an implant cemented to the bone. The design consists of a stem and one-piece stainless steel femur and polyethylene, an acetabular component, both of which are attached to the bone using bone cement PMMA (acrylic). For more than two decades, Charnley Low Friction Arthroplasty and its derivative designs are the most widely used systems in the world. This forms the basis for all modern hip implants.
Exeter hip replacement systems (with slightly different geometry of rods) are developed at the same time. Since Charnley, there have been continuous improvements in the design and technique of joint replacement (arthroplasty) with many contributors, including W. H. Harris, the son of R. I. Harris, whose team at Harvard pioneered incurable arthroplasty techniques with direct binding to the implant.
Knee replacement using similar technology was started by McIntosh in patients with rheumatoid arthritis and then by Gunston and Marmor for osteoarthritis in the 1970s developed by Dr. John Insall in New York used a fixed bearing system, and Dr. Frederick Buechel and Dr. Michael Pappas utilizes a moving bearing system.
The external fixation of fractures was perfected by American surgeons during the Vietnam War but a major contribution was made by Gavril Abramovich Ilizarov at USSR. He was sent, without orthopedic training, to take care of wounded Russian soldiers in Siberia in the 1950s. Without equipment he was confronted with conditions paralyzing an incurable, infected, and malaligned broken bone. With the help of a local bike shop, he designed a tightened external ring-breaker such as a bicycle finger. With this equipment he achieves healing, rearrangement and elongation to levels unheard of elsewhere. Ilizarovnya equipment is still used today as one method of osteogenesis distraksi.
Modern orthopedic surgery and musculoskeletal research have attempted to make the operation less invasive and make the plant better and more durable.
Training
In the United States, orthopedic surgeons usually complete four years of undergraduate education and four years of medical school. Furthermore, these medical school graduates undergo residency training in orthopedic surgery. The five-year residence is a categorical orthopedic surgical training.
Selection for residency training in orthopedic surgery is highly competitive. About 700 doctors complete annual orthopedic residency training in the United States. About 10 percent of the current orthopedic surgery population is female; about 20 percent are members of minority groups. There are about 20,400 orthopedic practitioners and residents active in the United States. According to the latest Occupational Outlook Handbook (2011-2012) published by the US Department of Labor, between 3-4% of all practicing physicians are orthopedic surgeons.
Many orthopedic surgeons choose to undertake further training, or scholarships, upon completion of their residency training. Fellowship training in orthopedic subspecialties is usually one year in duration (sometimes two) and sometimes has a research component involved with clinical training and surgery. Examples of orthopedic sub-specialty training in the United States are:
- Hand operation
- Operation of shoulders and elbows
- Total joint reconstruction (arthroplasty)
- Skull reconstruction
- Orthopedic child
- Foot and ankle operation
- Spine surgery
- musculoskeletal oncology
- Surgical sports medicine
- Orthopedic trauma
The specialty of these drugs is not exclusive to orthopedic surgery. For example, hand surgery is performed by several plastic surgeons and spine surgery performed by most neurosurgeons. In addition, foot and ankle surgery is practiced by Doctor of Podiatric Medicine certified (D.P.M.) in the United States. Some family practice doctors practice sports medicine; However, the scope of their practice is non-operative.
After completing special residency/registrar training, an orthopedic surgeon is then eligible for board certification by the American Board of Medical Specialties or the American Osteopathic Association of Osteopathic Specialists. Certification by the American Board of Orthopedic Surgery or the American Osteopathic Board of Orthopedic Surgery means that the orthopedic surgeon has met the requirements of education, evaluation and examination specified by the Council. This process requires successful completion of a standard written exam followed by an oral exam focused on surgical and surgeon performance over a 6-month period. In Canada, the certification organization is the Royal College of Physicians and Surgeons of Canada; in Australia and New Zealand it is the Royal Australasian College of Surgeons.
In the United States, specialists in hand and orthopedic surgery can obtain a Certificate of Supplementary Certificate (CAQ) in addition to their main board certification by successfully completing a separate standardized examination. There is no additional certification process for other sub-specialties.
Practice
According to the application for board certification from 1999 to 2003, the 25 most common (in order) procedures performed by orthopedic surgeons are as follows:
- Knee arthroscopy and menisectomy
- Shoulder arthroscopy and decompression
- Carpal tunnel release
- Knee and chondroplasty arthroscopy
- Eliminate implant support
- Knee arthroscopy and ligament anterior cruciate ligament reconstruction
- Knee replacement
- Repair femoral neck fracture
- Repair trochanter fracture
- Skin/muscle/bone/fracture debris
- Knee good knee arthroscopy repair
- Pelvic replacement
- Shoulders of arthroscopy/excision of the distal clavicle
- Rotator cuff tendon improvement
- Fixed fracture of radius (bone)/ulna
- Laminectomy
- Repair an ankle fracture (bimalleolar type)
- Shoulder arthroscopy and debridement
- Merge of lumbar spine
- Fixed fracture from the distal part of the radius
- Operation of the lower back intervertebral disk
- The incisions of the incision finger tendon
- Repair an ankle fracture (fibula)
- Repair femur shaft fracture
- Repair trochanter fracture
Typical schedules for orthopedic surgeons involve 50-55 working hours per week divided between clinics, surgery, various administrative tasks and perhaps teaching and/or research if in an academic setting.
Arthroscopy
The use of artroscopic techniques is essential for injured patients. Arthroscopy was pioneered in the early 1950s by Dr. Masaki Watanabe from Japan to perform minimally invasive cartilage surgery and reconstruction of a torn ligament. Arthroscopy allows patients to recover from surgery in a matter of days, rather than weeks to months required by conventional 'open' surgery. This is a very popular technique. Knee arthroscopy is one of the most common surgeries performed by orthopedic surgeons today and is often combined with menisectomy or condroplasty. The majority of upper limb orthopedic outpatient procedures are now performed arthroscopically.
Arthroplasty
Arthroplasty is an orthopedic surgery in which the articular surface of the musculoskeletal joint is replaced, overhauled, or adapted to osteotomy or some other procedure. This is an elective procedure performed to reduce pain and restore function to the joint after damage by arthritis (rheumasurgery) or some other type of trauma. As well as the total standard knee replacement operation, a uni-compartmental knee replacement, in which only one surface holds the load from the replaced rheumatic knee, is a popular alternative.
Replacement of joints available to other joints is limited, especially the knees, hips, shoulders, elbows, wrists, ankles, spine, and finger joints.
In recent years, joint surface replacement, especially hip joints, has become more popular among younger and more active patients. This type of surgery postpones the need for more traditional and less bone-conservative total hip replacements, but carries significant risks of early failure of fractures and bone death.
One of the main problems with joint replacement is the wear of the component bearing surfaces. This can cause damage to the surrounding bone and contribute to implant failure. The use of alternative bearing surfaces has increased in recent years, especially in younger patients, in an effort to improve wear characteristics of joint replacement components. These include ceramic implants and all metals (as opposed to the original metal-on-plastic). Plastics (in fact ultra high-molecular-weight polyethylene) can also be altered in a way that enhances wear characteristics.
Epidemiology
Between 2001 and 2016, the prevalence of musculoskeletal procedures increased dramatically in the US, from 17.9% to 24.2% of all operating room procedures performed during the hospital stay.
In a study of hospitalization in the United States in 2012, spinal and joint procedures are common among all age groups except infants. Spinal fusion is one of the five most common OR procedures performed in any age group except infants younger than 1 year and adults aged 85 years or older. Laminectomy is common in adults aged 18-84 years. Knee and hip replacement hipoplasty is in the top five OR procedures for adults aged 45 years and older.
See also
- Trauma & amp; orthopedics
- American Orthopedic Surgery Academy
- Osteopathic Board of Orthopedic Surgery United States
- Arbeitsgemeinschaft fÃÆ'¼r Osteosynthesefragen
- Bone transplant
- Orthopedic Surgery with Computer Help
- Gait analysis
- Hello Brace
- Hand operation
- Intramedullary trunks
- Ischemia-reperfusion injury to the appendicular musculoskeletal system
- List of orthopedic implants
- orthopedic treatment
- Podiatric surgery
- Reconstructive surgery
- Traction
References
External links
- Media related to Orthopedics on Wikimedia Commons
Source of the article : Wikipedia
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