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