General Orthopaedics Is Still the Realm of a Specialist

Feb 1, 2021 | Articles

While we might tend to, quite unfairly, think of a general practitioner as a sort of medical “Jack of all trades” this is certainly not true of those doctors who have chosen to pursue a career in general orthopaedics. The sole focus of those who practice this relatively new discipline of medicine is on injuries and diseases that affect the components of the musculoskeletal system. Though they are often referred to as bone doctors, their purview is not restricted to repairing damaged bones but extends to include the joints, nerves, cartilage and the various muscles, tendons and ligaments associated with them.


Nevertheless, the treatment of traumatic injuries arising from motor accidents or sporting activities can often account for a significant portion of a general orthopaedics specialist’s daily workload. However, given that a recent report suggests that one of every two adults in the United States has a musculoskeletal disorder, treating simple fractures and dislocations is a task often allocated to an intern. Delegation allows a registrar or consultant to concentrate on those requiring more specialised treatments by a more experienced physician or surgeon.


The discipline as a whole calls for the knowledge and skills of both physicians and surgeons. However, the general orthopaedics specialist is not compelled to be proficient in surgery. Many of the conditions they may be required to treat can be tackled with medication and manipulation alone. Those orthopaedic specialists who do wish to undertake surgical procedures must undergo the relevant additional training.


It was a French professor of medicine who, in the mid-18th century, coined the name of this discipline from a pair of Greek words. Until then, most of its focus had been on correcting various skeletal deformities found in children. Accordingly, Nicholas Andry published a book on the topic named “Orthopedia”. This title would later give rise to terms such as general orthopaedics and was formed from the fusion of the words “orthos” and “paidion”, meaning “straight” or “correct” and “child”, respectively. In practice, the treatment of spinal anomalies, such as scoliosis and kyphosis, still constitutes an important element of this specialist discipline.


The discipline has a colourful history and includes several centuries during which much of its work was carried out by laypeople who were known as bonesetters. Practice makes perfect, and thus many of these bonesetters became highly proficient, often using their skills to conduct a profitable family business. Surprisingly, it was only in the mid-19th century that surgeons engaged in general orthopaedics and other disciplines were first required to complete a medical degree like physicians before they were entitled to practice.


Since then, there have been numerous advances in the technology available to both physicians and surgeons. These, in turn, have led to the creation of several new specialisms within this discipline. Many in this field now choose to focus on specific fields such as sports medicine, and joint replacement, or particular elements of the musculoskeletal system such as the foot and ankle, hand, or spine. Nevertheless, the demand for specialists in general orthopaedics remains an ongoing one.


The orthopaedic department of the Life Wilgers Hospital in Pretoria combines a range of general services with a range of specialised surgical procedures, including arthroplasty, with an emphasis on the hip, knee, and shoulder joints.