What Are the Responsibilities of a Specialist in General Orthopaedics?
To describe those who engage in general orthopaedics as specialists might seem, to the layman, something of a contradiction in terms. However, it is customary to divide practitioners in this particular field into those personnel whose task it is to conduct elective surgical procedures and those who are required to mainly deal with traumatic conditions of the musculoskeletal system in which delaying some form of surgical or medical intervention is, in most cases, not a viable option.
Among the elective interventions that are most in demand today are total and partial hip and knee replacements. While these procedures cannot really be classed as emergencies, the manipulation of a dislocated shoulder or the surgical repair of a fractured femur or tibia certainly can. As a result, there is a need within the overall field for specialists in the sub-discipline of arthroplasty, as well as in the more general practices employed in orthopaedics. That said, a practitioner who may have acquired the appropriate qualifications, skills, and sufficient experience will sometimes choose to divide his or her time between each of these specialities. Such is the case with Dr Jan De Vos who leads the team at the Life Wilgers Hospital in Pretoria.
In essence, what remains once one has ruled out the various surgical procedures that are normally performed by means of arthroscopy or those that may require more radical surgery for the insertion of a prosthetic joint, is everything else pertaining to the treatment of musculoskeletal injuries or disorders, which can be regarded as the responsibility of the general orthopaedic specialists. Not surprisingly, perhaps, the treatment of those suffering from severe and painful injuries resulting from accidents tends to account for much of their daily activity. Given the appallingly high incidence of road traffic accidents in South Africa, this is an area in which there have been many significant advances in treatment, as well as one in which many of the local physicians employed in this field have gained extensive experience over the years.
In practice, more often than not, surgical procedures tend to account for no more than half of the time spent by these healthcare professionals on the treatment of their patients. For the remainder of their time, the type of treatment undertaken by most general orthopaedic specialists will tend to be of a medical, physical, or rehabilitative nature.
In addition to their more obvious responsibilities, such as the reduction of fractures and attending to the various torn ligaments, pulled muscles, sprains, and strains that are the frequent consequence of sporting activities, their role includes the correction of assorted malformations of the skeletal system. This is reflected in the derivation of the name of their chosen discipline from the Greek words “orthos” and “paidion” meaning correct or straight child in reference to their earlier focus on efforts to correct spinal deformities in children.
This somewhat limited responsibility has gradually been extended to include the treatment of club foot, knock knees, bow legs, and legs of unequal length. Times have changed and the general orthopaedic specialists of today are required to have a much broader skillset than at any time before. It must include the differential diagnosis and subsequent treatment of lower back pain, sciatica, and ruptured intervertebral disks, as well as the correction of various abnormalities of the fingers and toes, postural problems such as kyphosis and lordosis, and other forms of anomalous growth. In effect, what was once a pursuit for the generalist has become a speciality in its own right.
Recognised as one of the nation’s leaders in all aspects of this exceptionally broad discipline, the team at the Pretoria hospital mentioned earlier has earned a reputation for excellence both for its prowess in the fields of arthroscopy and arthroplasty, and as a group of acclaimed specialists in general orthopaedic surgical, medical, and rehabilitative treatments.