Orthopedic surgery
Author/s: Tish Davidson
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 of orthopedic surgery
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 before orthopedic surgery
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 of orthopedic surgery
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 for orthopedic surgery
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
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