| Orthopedic surgery or orthopedics (also | | | | be recognized as a hand surgeon or sports |
| spelled orthopaedics, see below) is the | | | | surgeon, a practitioner must have completed |
| branch of surgery concerned with acute, | | | | an ACGME-accredited fellowship and obtained a |
| chronic, traumatic, and overuse injuries and | | | | Certificate of Added Qualifications (CAQ) |
| other disorders of the musculoskeletal | | | | which requires an additional standardized |
| system. Orthopaedic surgeons address most | | | | examination. |
| musculoskeletal ailments including arthritis, | | | | |
| trauma and congenital deformities using both | | | | Jean-Andre Venel established the first |
| surgical and non-surgical means. | | | | orthopedic institute in 1780, which was the |
| | | | first hospital dedicated to the treatment of |
| Orthopedic surgeons are physicians who have | | | | children's skeletal deformities. He is |
| completed additional training in orthopedic | | | | considered by some to be the father of |
| surgery after the completion of medical | | | | orthopedics or the first true orthopedist in |
| school, either M.D. or D.O. According to the | | | | consideraton of the establishment of his |
| latest Occupational Outlook Handbook | | | | hospital and for his published methods. |
| (2006-2007) published by the U.S. Department | | | | |
| of Labor, between 3-4% of all practicing | | | | Antonius Mathysen, a Dutch military surgeon, |
| physicians are orthopedic surgeons. | | | | invented the plaster of Paris cast in 1851. |
| | | | |
| In the United States and Canada orthopedic | | | | Many developments in orthopedic surgery |
| surgeons (also known as orthopedists) | | | | resulted from experiences during wartime. On |
| complete a minimum of 11 years of | | | | the battlefields of the Middle Ages the |
| postsecondary education and clinical | | | | injured were treated with bandages soaked in |
| training. This training includes obtaining an | | | | horses' blood which dried to form a stiff, |
| undergraduate degree(some medical schools | | | | but unsanitary, splint. Traction and |
| require as little as 2 years of undergraduate | | | | splinting developed during World War I. The |
| study, and many Canadian schools only require | | | | use of intramedullary rods to treat fractures |
| 3 years), a medical degree or osteopathic | | | | of the femur and tibia was pioneered by Dr. |
| degree, and then completing a five-year | | | | Kunchner of Germany. This made a noticeable |
| residency in orthopedic surgery. The | | | | difference to the speed of recovery of |
| five-year residency consists of one year of | | | | injured German soldiers during World War II |
| general surgery training followed by four | | | | and led to more widespread adoption of |
| years of training in orthopaedic surgery. | | | | intramedullary fixation of fractures in the |
| | | | rest of the world. However, traction was the |
| Many orthopedic surgeons elect to do further | | | | standard method of treating thigh bone |
| subspecialty training in programs known as | | | | fractures until the late 1970s when the |
| 'fellowships' after completing their | | | | Seattle Harborview group popularized |
| residency training. Fellowship training in an | | | | intramedullary fixation without opening up |
| orthopedic subspeciality is typically one | | | | the fracture. External fixation of fractures |
| year in duration (sometimes two) and usually | | | | was refined by American surgeons during the |
| has a research component involved with the | | | | Vietnam War but a major contribution was made |
| clinical and operative training. Examples of | | | | by Gavril Abramovich Ilizarov in the USSR. He |
| orthopedic subspecialty training in the US | | | | was sent, without much orthopedic training, |
| are: | | | | to look after injured Russian soldiers in |
| | | | Siberia in the 1950s. With no equipment he |
| Hand surgery | | | | was confronted with crippling conditions of |
| | | | unhealed, infected, and malaligned fractures. |
| Shoulder and elbow surgery | | | | With the help of the local bicycle shop he |
| | | | devised ring external fixators tensioned like |
| Total joint reconstruction (arthroplasty) | | | | the spokes of a bicycle. With this equipment |
| | | | he achieved healing, realignment and |
| Pediatric orthopedics | | | | lengthening to a degree unheard of elsewhere. |
| | | | His Ilizarov apparatus is still used today. |
| Foot and ankle surgery (Not to be confused | | | | |
| with podiatry) | | | | David L. MacIntosh pioneered the first |
| | | | successful surgery for the management of the |
| Spine surgery (Also performed by | | | | torn anterior cruciate ligament of the knee. |
| neurosurgeons) | | | | This common and serious injury in skiers, |
| | | | field athletes, and dancers invariably |
| Musculoskeletal oncology | | | | brought an end to their athletics due to |
| | | | permanent joint instability. Working with |
| Surgical sports medicine | | | | injured football players, Dr. MacIntosh |
| | | | devised a way to re-route viable ligament |
| Orthopaedic trauma | | | | from adjacent structures to preserve the |
| | | | strong and complex mechanics of the knee |
| These are also the nine main sub-specialty | | | | joint and restore stability. The subsequent |
| areas of orthopaedic surgery. | | | | development of ACL reconstruction surgery has |
| | | | allowed numerous athletes to return to the |
| Hand surgery, and more recently Sports | | | | demands of sports at all levels. |
| Medicine are the only truly recognized | | | | |
| sub-specialties within orthopaedic surgeryby | | | | Modern orthopaedic surgery and |
| the Accredited Council of Graduate Medical | | | | musculoskeletal research has sought to make |
| Education (ACGME). The other sub-specialities | | | | surgery less invasive and to make implanted |
| are informal concentrations of practice. To | | | | components better and more durable. |