Medicine:Outline of trauma and orthopedics

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The following outline is provided as an overview of and topical guide to trauma and orthopaedics:

Orthopedic surgery – branch of surgery concerned with conditions involving the musculoskeletal system. Orthopedic surgeons use both surgical and nonsurgical means to treat musculoskeletal injuries, sports injuries, degenerative diseases, infections, bone tumours, and congenital limb deformities. Trauma surgery and traumatology is a sub-specialty dealing with the operative management of fractures, major trauma and the multiply-injured patient.


Overview

Have you ever wondered what happened to people when they experienced injuries and medicine was not as evolved as it is today? When exactly did medicine take a turn for the better with all the new inventions and technologies? Specifically, orthopedics comes to mind when thinking about a sprain or broken bone. The modern term "orthopedics[1]" was coined in the 1700s, but surgeries and medicine were practiced even before then. Let's take a look into the history of orthopedics, what exactly it is, and advances made in this area of medicine today.

The History of Orthopedics

The advancing world of orthopedics is constantly changing with new developments as time passes. However, it was not always this way. The medical field is nowhere compared to where it was in the 1700s. Few evidence suggests that there were proper techniques to help heal simple cracks and fractures. However, the ancient world kicked off the usage of orthopedic specialties that helped contribute into the world-renown field we all know today.

Ancient Egypt

Egyptians carried out the process known as splinting, and evidence suggests they were one of the first civilizations to use crutches. Splinting involves mobilizing a hurt bone or body part to help keep it in place to allow for proper blood flow and quick healing. Bamboo and reed padded with linen was used as a splint, and simple instructions were outlined in how to fix a proper splint. The directions on how to create the perfect splint were found in the Edwin Smith Papyrus, which states, "Instructors[2] on erring a break in his upper arm...Thou shouldst spread out with his two shoulders in order to stretch apart his upper arm until that break falls into its place. Thou shouldst make for him two splints of linen, and thou shouldst apply for him one of them both on the inside of his arm, and the other of them both on the underside of his arm."

Greeks and Romans

The Greeks are known to be the first who used the scientific approach to medicine, thanks to one man, Corpus Hippocrates. Hippocrates was full of scientific knowledge and had a deep understanding of the musculoskeletal system, along with reducing dislocations and treating open fractures. Deformities in the spine were found by the Greeks, and another famous Greek surgeon, Galen, described the musculoskeletal and nervous systems. He is known to be the father of sports medicine. According to the American Journal of Orthopedics, "He[2] is also credited with coining the terms scoliosis, kyphosis, and lordosis to denote the spinal deformities that were described by Hippocrates."

The Renaissance

There was rare progress in the advances of medicine during this time as everyone focused on the struggles of the Catholic Church. However, the Renaissance quickly followed and modern orthopedics started to grow. Many hospitals were built to help focus on those who were sick and disabled. The oldest hospital in the United States and special surgery was founded by James Knight in 1863 in New York City and named The Hospital for the Ruptured and Crippled.[2] It became known as the hospital for special surgery and was credited for beginning the first orthopedic training program.

The Modern Era

Advancements in orthopedics came in the 20th century with new technologies. The world wars were credited with orthopedic trauma, demonstrating the importance healing open wounds and injuries. Wilhelm Conrad Röntgen invented the X-Ray in 1985, and that has been a crucial tool in the world of orthopedics.

Orthopedic Surgery

As stated above, traces of orthopedics date way back to ancient Egypt. Orthopedics is a field that has rapidly advanced since being founded. Without this field, broken bones may not heal properly, ligaments and tears may not be fixed, and severe pain may never be suppressed. Orthopedics is dedicated to properly diagnosing disease and injury of the musculoskeletal system of all groups. According to Dr. Gehrig of the Bone, Spine, and Sports Clinic, "Not[3] only does this speciality protect human locomotion by protecting the skeleton and its form and function, but it also makes it better by ways and means of applying cutting-edge research and clinical knowledge to those who sustain musculoskeletal injuries and present with other conditions." Let's take a closer look into what groups orthopedics deals with.

  1. Pediatrics: Injuries or diseases of the bone regarding children.
  2. Sports Medicine: Injury related to athletics.
  3. Joint Replacement: Seen in cases with severe arthritis where the socket degrades and joint is replaced.
  4. Foot and Ankle
  5. Hand and Wrist
  6. Spine
  7. Trauma and Fractures: Emergency room cases of severe trauma to arms, legs, spine, or pelvic region.
  8. Musculoskeletal Oncology: Benign and malignant tumors of bones.
  9. Rehabilitation: Specific programs designed to help strengthen and build up specific regions.
  10. Arthroscopy: The advanced method using arthroscopic tools with minimally invasive surgery.

Branches of trauma and orthopaedics

History of trauma and orthopaedics

History of trauma and orthopaedics

General trauma and orthopaedics concepts

Technological Advances Today

Orthopedics is a rapidly-advancing field filled with numerous subcategories. Even through there are many different groups orthopedics is associated with, all of the groups share a common goal: to better the health of their patients and ensure a pain-free life post-operation. There are strong innovations that continue to shape the advancing field of orthopedics, and those include arthroscopy, robotics, 3D printing, and biologics.

Arthroscopy

When breaking down the word "Arthroscopy," "arthro" translates to joint and "skopein" translates to look in Greek. Therefore, arthroscopy literally means "to look within the joint." Arthroscopy involves a making small incision targeting the problematic area, and then inserting small, fine tools that contain a small lens and lighting system to magnify and illuminate the inside of the joint. With the small incision, surgeons are able to thoroughly see the inside of the joint. The camera displays the inside of the joint on a video screen and the surgeon can make a decision to fix the issue however. necessary. Conditions[4] that are done with this procedure include inflammation of tissues, rotator cuff tear, meniscal tear, dislocation, carpal tunnel, and loose cartilage.

Robotics and Biologics

Robotics and Biologics are two growing areas within the world of orthopedics. Robotic-arm assisted surgery is used for partial and total hip and knee replacements. New technologies even include high-class systems for MRI, CT and X-Ray machines to ensure the best readings for the patient and surgeons to receive the best information so they know what they are dealing with. Biologics uses exosomes, which are types of biologics, that would deliver treatments into joints and tissues and make them usable by the body. If this proven to be a successful method within the coming years, surgery may be avoided altogether and the patient could heal without surgery.

3D Printing

3D printing is the next major advancement for this field. It will eliminate the normal screws and plates inserted to joints for hip and knee replacements. Instead, 3D printing involves printing an implant and using the new version in the patient. According to Dr. Lisa Lattanza, Chair of the Department of Orthopaedics and Rehabilitation, "We[5] will print the exact plate or implant that will work the best for the individual patient for that problem. This is happening already at a small scale in Europe and other countries but will likely become the standard of care."

Trauma and Orthopaedics organizations

  • British Orthopaedic Association
  • American Academy of Orthopaedic Surgeons
  • AO Foundation

Trauma and Orthopaedics publications

  • Journal of Bone and Joint Surgery
  • Journal of Orthopedics
  • Journal of Orthopedic Trauma
  • Journal of the American Academy of Orthopedic Sciences
  • Journal of the American Podiatric Medical Association
  • Clinical Journal of Sport medicine
  • New England Journal of medicine

Persons influential in trauma and orthopaedics

  • Hugh Owen Thomas, b. 1834, d. 1891 (aged 56), Welsh surgeon considered the father of orthopaedic surgery in Britain
  • Jean-Andre Venel, b. 1740, d. 1791 (aged 50), Swiss doctor and a pioneer in the field of orthopedics
  • John Hunter, b. 1728, d. 1793 (aged 64), Scottish surgeon
  • Percivall Pott, b. 1714, d. 1788 (aged 73), English surgeon, one of the founders of orthopedy
  • Robert Jones, b. 1857, d. 1933 (aged 75), British surgeon pioneering the use of x-rays
  • John Charnley, b. 1911, d. 1982 (aged 70), English pioneer of hip replacements
  • Nicolas Andry, b. 1658, d. 1742 (aged 83), French physician


References

  1. ↑ "Mead, Dr Margaret, (16 Dec. 1901–15 Nov. 1978), American Anthropologist; Adjunct Professor of Anthropology, Columbia University; Curator Emeritus of Ethnology, American Museum of Natural History, New York (Curator, 1964–69)", Who Was Who (Oxford University Press), 2007-12-01, doi:10.1093/ww/9780199540884.013.u157462, http://dx.doi.org/10.1093/ww/9780199540884.013.u157462, retrieved 2023-02-09 
  2. ↑ 2.0 2.1 2.2 Swarup, Ishaan; O'Donnell, Joseph F. (2016). "An Overview of the History of Orthopedic Surgery". American Journal of Orthopedics (Belle Mead, N.j.) 45 (7): E434–E438. PMID 28005119. https://cdn.mdedge.com/files/s3fs-public/ajo04511434e.pdf. 
  3. ↑ Gehrig, Laura M. B. (2011-09-01). "Orthopedic surgery" (in en). The American Journal of Surgery 202 (3): 364–368. doi:10.1016/j.amjsurg.2011.06.007. ISSN 0002-9610. PMID 21871990. https://www.sciencedirect.com/science/article/pii/S0002961011003783. 
  4. ↑ "Arthroscopy - OrthoInfo - AAOS". https://www.orthoinfo.org/en/treatment/arthroscopy/. 
  5. ↑ O'Rourke, Matt. "Shaping Surgical Innovation and the Future of Orthopaedics" (in en). https://medicine.yale.edu/news-article/shaping-surgical-innovation-and-the-future-of-orthopaedics/. 

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