Definition
Orthopedic (sometimes spelled orthopaedic) surgery is surgery
performed by a medical specialist, such as an orthopedist or orthopedic surgeon,
trained to deal with problems that develop in the bones, joints, and ligaments
of the human body.
Purpose
Orthopedic surgery corrects problems that arise in the skeleton
and its attachments, the ligaments and tendons. It may also deal with some
problems of the nervous system, such as those that arise from injury of the
spine. These problems can occur at birth, through injury, or as the result of
aging. They may be acute, as in injury, or chronic, as in many aging-related
problems.
Orthopedics comes from two Greek words, ortho, meaning straight
and pais, meaning child. Originally orthopedic surgeons dealt with bone
deformities in children, using braces to straighten the child's bones. With the
development of anesthesia and an understanding of the importance of aseptic
technique in surgery, orthopedic surgeons extended their role to include surgery
involving the bones and related nerves and connective tissue.
The terms orthopedic surgeon and orthopedist are used
interchangeably today to indicate a medical doctor with special certification in
orthopedics.
Many orthopedic surgeons maintain a general practice, while
some specialize in one particular aspect of orthopedics, such as hand surgery,
joint replacements, or disorders of the spine. Orthopedics treats both acute and
chronic disorders. Some orthopedists specialize in trauma medicine and can be
found in emergency rooms and trauma centers treating injuries. Others find their
work overlapping with plastic surgeons, geriatric specialists, pediatricians, or
podiatrists (foot care specialists). A rapidly growing area of orthopedics is
sports medicine, and many sports medicine doctors are board certified
orthopedists.
Precautions
Choosing an orthopedist is an important step in obtaining
appropriate treatment. Patients looking for a qualified orthopedist should
inquire if they are "board certified" by their accrediting organization.
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 (CT 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.
Risks
As with any surgery, there is always the risk of excessive
bleeding, infection, and allergic reaction to anesthesia. Risks specifically
associated with orthopedic surgery include inflammation at the site where
foreign material (pins, prosthesis) is introduced into the body, infection as
the result of surgery, and damage to nerves or to the spinal cord.
Normal Rresults
Thousands of people have successful orthopedic surgery each
year to recover from injuries or restore lost function. The degree of success in
individual recoveries depends on the age and general health of the patient, the
medical problem being treated, and the patient's willingness to comply with
rehabilitative therapy after the surgery.
Resources
National Medical Centre Located in 37 Civic Centre M Block
Model Town Ext. 54700 Lahore. Pakistan
Key terms
Arthroplasty — The surgical reconstruction or
replacement of a joint.
Prosthesis — A synthetic replacement
for a missing part of the body, such as a knee or a hip.
Range of
motion — The normal extent of movement (flexion and extension) of a
joint.
Orthopedic Surgery
The branch of medicine that is concerned with the treatment of
the musculoskeletal system, mainly by manipulative and operative methods.
SURGERY
1. The branch of health science that treats
diseases, injuries, and deformities by manual or operative methods.
2. The place where operative procedures are
performed.
3. In Great Britain, a room or office where a
doctor sees and treats patients.
4. The work performed by a SURGEON; see also
operation and procedure.
Ambulatory surgery any operative procedure not
requiring an overnight stay in the hospital; it must be carefully planned to
ensure that all necessary diagnostic tests are completed prior to admission.
Discharge instructions must place a high priority on patient safety. Called also
day surgery.
Bench surgery performed on an organ that has
been removed from the body, after which it is reimplanted.
Day surgery ambulatory
surgery.
Maxillofacial surgery oral and maxillofacial
s.
Minimal access surgery (minimally invasive surgery) a surgical procedure
done in a manner that causes little or no trauma or injury to the patient, such
as through a cannula using lasers, endoscopes, or laparoscopes; compared with
other procedures, those in this category involve less bleeding, smaller amounts
of anesthesia, less pain, and minimal scarring.
Open heart
surgery that involves incision into one or more chambers of the heart,
such as for repair or palliation of congenital heart defects, repair or
replacement of defective heart valves, or coronary artery
bypass.
Oral surgery oral and maxillofacial
s.
Oral and maxillofacial surgery that branch of dental
practice that deals with the diagnosis and the surgical and adjunctive treatment
of diseases, injuries, and defects of the human mouth and dental structures.
Called also maxillofacial or oral surgery.
Orthopedic surgery
orthopedics.
Plastic surgery see plastic
surgery.
Stereotaxic surgery the production of sharply
localized lesions in the brain after precise localization of the target tissue
by use of three-dimensional coordinates.
