The discipline of medicine known as orthopaedics derives its name from the amalgamation of two Greek words “orthos” and “paedia”. Together, they translate literally as “straight child”. Despite having its roots in Ancient Greece, the title of this specialism was only adopted officially when introduced in the first textbook on the topic, written by Professor Andry of the University of Paris in the mid-eighteenth century. In addition to the treatment of fractures and dislocations, the orthopaedic specialists of the time also focussed on the use of traction and binding to correct (or “straighten”) skeletal deformities, particularly of the spine, in children.
Naturally, activities such as these still represent an important aspect of this discipline. However, a greater knowledge of the musculoskeletal system, combined with new technologies, new materials and improved instrumentation has resulted in a greatly expanded role for the orthopaedic specialist of today. In the process, these developments have also led to the establishment of some new sub-specialisms.
The treatment of conditions of the musculoskeletal system calls for both surgical and non-surgical interventions and it is not unusual for these engaged in this discipline to focus on just one of these two options. Quite often, however, those who choose the life of a surgeon may elect to focus their attention on treating either trauma or elective patients. The latter category includes the relatively new procedures know as arthroplasty in which badly damaged or diseased joints are replaced with prosthetic components. These procedures demand extensive new skills and experience on the part of an orthopaedic specialist.
That said, there have also been some significant advances in the treatment of trauma cases. Severe fractures of the femur and the tibia which, at one time, may have left a patient minus a limb or, at best, with impaired mobility can now be repaired routinely. Today’ surgeons employ nails, screws and intramedullary rods that can be inserted into the central portion of a bone in order to provide the patient with an exceptionally stable and permanent repair. Replacing traction, intramedullary fixation has since become the preferred choice of the modern orthopaedic specialist.
Invented at the turn of the nineteenth century, the X-ray machine was a welcome addition to most disciplines of medicine and quickly proved to be an especially useful tool for the evaluation of fractures to limbs and joints. Though, as an aid to arthroplasty, in particular, a more detailed view of the interior of an affected joint and the surrounding tissue became necessary. Consequently, many surgeons within this field have since become experts in the use of the arthroscope.
Seen originally as a diagnostic tool, when inserted into a joint through a tiny incision, it provides the orthopaedic specialist with a close-up view of its interior via an eyepiece or a monitor screen. By providing a more detailed assessment of any damage present, arthroscopy offers a more reliable means for a surgeon to determine the most appropriate intervention.
The process has since been adapted as a less-invasive option than open surgery for a number of common procedures. These not only include repairs to a torn meniscus or an anterior cruciate ligament (ACL) but some of the more experienced orthopaedic specialists now also employ arthroscopic procedures to perform partial and total joint replacements.