Orthopedics
is the branch of surgery that involves the skeletal system, including the
repair of joints, bones, ligaments and tendons. Orthopedic surgeons may also
perform surgery on the feet, hands and spine.
Purpose:
The musculoskeletal
system is comprised of the bones, muscles, joints, tendons and ligaments the
body needs for movement. An orthopedic surgeon diagnoses and treats injuries
and illnesses that affect some part of the musculoskeletal system. Treatment
may involve traditional surgery, but an orthopedic surgeon may use non-surgical
treatments in many cases as well.
The term “orthopedics”
was coined in 1741 with the publication of a work on correcting deformities in
children. Less than forty years later, the first European orthopedic institute
was established. The hospital focused on treating skeletal defects or
deformities in children.
Description:
The range of treatments done by
orthopedists is enormous. It can cover anything from traction to amputation, hand reconstruction to spinal
fusion or joint replacements. They also treat broken bones, strains and
sprains, and dislocations. Some specific procedures done by orthopedic surgeons
are listed as separate entries in this book, including arthroplasty,
arthroscopic surgery, bone grafting, fasciotomy, fracture repair, kneecap
removal, and traction.
In general orthopedists are attached
to a hospital, medical center, trauma center, or free-standing surgical center
where they work closely with a surgical team including an anesthesiologist and
surgical nurse. Orthopedic surgery can be performed under general, regional, or
local anesthesia.
Much of the work of the surgeon
involves adding foreign material to the body in the form of screws, wires,
pins, tongs, and prosthetics to hold damaged bones in their proper alignment or
to replace damaged bone or connective tissue. Great improvements have been made
in the development of artificial limbs and joints, and in the materials
available to repair damage to bones and connective tissue. As developments
occur in the fields of metallurgy and plastics, changes will take place in
orthopedic surgery that will allow the surgeon to more nearly duplicate the
natural functions of the bones, joints, and ligaments, and to more accurately
restore damaged parts to their original range of motion.
Preparation:
Patients are usually referred to an
orthopedic surgeon by a general physical or family doctor. Prior to any
surgery, the patient undergoes extensive testing to determine the proper
corrective procedure. Tests may include x rays, computed tomography scans magnetic resonance imaging (MRI), myelograms, diagnostic
arthroplasty, and blood tests. The orthopedist will determine the history of
the disorder and any treatments that were tried previously. A period of rest to
the injured part may be recommended before surgery is prescribed.
Patients undergo standard blood and
urine tests before surgery and, for major surgery, may be given an
electrocardiogram or other diagnostic tests prior to the operation. Patients
may choose to give some of their own blood to be held in reserve for their use
in major surgery, such as knee replacement, where heavy bleeding is common.
Aftercare:
Rehabilitation from orthopedic injuries can be a long, arduous task. The
doctor will work closely with physical therapists to assure that the patient is
receiving treatment that will enhance the range of motion and return function
to the affected part.
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