A Comparison of General and Specialised Orthopaedics

Feb 28, 2021 | Articles

Before attempting to conduct a comparison, one must first understand that despite the inclusion of the adjective general, orthopaedics, in all its forms, is a specialised medical discipline whose primary focus is on disease and injuries that may affect the musculoskeletal system. It is a discipline that provides the foundation for several subdisciplines and, while some medical professionals may confine their attention to one specific area of the system such as the knee or hip joints, others may choose to maintain a broader interest. In each case, the physician or surgeon in question remains, by definition, a specialist.

Fractures and dislocations are common injuries, especially among sports and exercise enthusiasts. Typically, a general orthopaedics specialist will be the person responsible for treating these. In the case of dislocations and simple fractures, an intern or registrar will often undertake the relocation of the joint components or realignment of the fractured bone and follow up with some form of immobilisation to assist the healing process.

Dealing with more complex fractures, however, will need a more rigorous approach. An operation to reconstruct the multiple pieces of bone using screws, nails, and rods as indicated will be necessary in such cases this will be the task of a surgeon who has qualified in the field of general orthopaedics.

In practice, it is not necessary for a medical professional who may wish to enter this field to hold a post-graduate surgical qualification. Although their efforts only attained the status of a specialist medical discipline relatively recently, physicians have been attempting to treat musculoskeletal disorders since the earliest days of medicine. Early Egyptian and Roman physicians demonstrated considerable success in treating simple fractures. But, in those early days and for several more centuries, the primary focus of the pursuit that would later become known as general orthopaedics was correcting spinal deformities in children. Their early practices of physical manipulation and the application of braces for this purpose are still in use today, albeit with considerably improved techniques, equipment, and outcomes.

As well as dealing with the dislocations and fractures, there is a wide range of additional responsibilities for the generalist practitioners within this discipline. Many of the patients they see will only require surgical intervention if their condition is too severe to respond to non-invasive treatments. For example, the diagnosis and treatment of sprains, strains and torn ligaments all fall under the heading of general orthopaedics.

Carpal tunnel syndrome (CTS) is another condition that falls into this category, and it is one that has become more prevalent in recent years. CTS is a painful and potentially debilitating condition that occurs when the median nerve in the wrist becomes compressed within the carpal canal. It is frequently a type of repetitive strain injury (RSI) that affects those who regularly spend long hours at a keyboard or working with handheld vibrating power tools. However, obesity, diabetes, thyroid dysfunction, hypertension, and rheumatoid arthritis have all been implicated as contributory factors. Consequently, the general orthopaedics specialist needs to rule out any underlying pathologies that might require a referral before proceeding further.