orthopedic surgery


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Orthopedic Surgery

 

Definition

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

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

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

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

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

As with any surgery, there is always the risk of excessive bleeding, infection, and allergic reaction to anesthesia. Risks specifically associated with orthopedic surgery include inflammation at the site where foreign material (pins, prosthesis) is introduced into the body, infection as the result of surgery, and damage to nerves or to the spinal cord.

Normal results

Thousands of people have successful orthopedic surgery each year to recover from injuries or restore lost function. The degree of success in individual recoveries depends on the age and general health of the patient, the medical problem being treated, and the patient's willingness to comply with rehabilitative therapy after the surgery.

Resources

Organizations

American Academy of Orthopaedic Surgeons. 6300 North River Road, Rosemont, IL 60018-4262. (800) 823-8125. http://www.AAOS.org.
American Osteopathic Board of Orthopedic Surgery. 〈http://www.netincom.com/aobos/about.html〉.

Other

Orthogate. 〈http://owl.orthogate.org/〉.

Key terms

Arthroplasty — The surgical reconstruction or replacement of a joint.
Prosthesis — A synthetic replacement for a missing part of the body, such as a knee or a hip.
Range of motion — The normal extent of movement (flexion and extension) of a joint.

surgery

 [sur´jer-e]
1. the branch of health science that treats diseases, injuries, and deformities by manual or operative methods.
2. the place where operative procedures are performed.
3. in Great Britain, a room or office where a doctor sees and treats patients.
4. the work performed by a surgeon; see also operation and procedure. adj., adj sur´gical.
ambulatory surgery any operative procedure not requiring an overnight stay in the hospital; it must be carefully planned to ensure that all necessary diagnostic tests are completed prior to admission. Discharge instructions must place a high priority on patient safety. Called also day surgery.
bench surgery surgery performed on an organ that has been removed from the body, after which it is reimplanted.
day surgery ambulatory surgery.
maxillofacial surgery oral and maxillofacial s.
minimal access surgery (minimally invasive surgery) a surgical procedure done in a manner that causes little or no trauma or injury to the patient, such as through a cannula using lasers, endoscopes, or laparoscopes; compared with other procedures, those in this category involve less bleeding, smaller amounts of anesthesia, less pain, and minimal scarring.
open heart surgery surgery that involves incision into one or more chambers of the heart, such as for repair or palliation of congenital heart defects, repair or replacement of defective heart valves, or coronary artery bypass.
oral and maxillofacial surgery that branch of dental practice that deals with the diagnosis and the surgical and adjunctive treatment of diseases, injuries, and defects of the human mouth and dental structures. Called also maxillofacial or oral surgery.
orthopedic surgery orthopedics.
plastic surgery see plastic surgery.
stereotaxic surgery the production of sharply localized lesions in the brain after precise localization of the target tissue by use of three-dimensional coordinates.

or·tho·pe·dic sur·ger·y

the branch of surgery that embraces the treatment of acute and chronic disorders of the musculoskeletal system, including injuries, diseases, dysfunction, and deformities (orig. deformities in children) in the extremities and spine.
See also: orthopaedics.

orthopedic surgery

Etymology: Gk, orthos, straight, pais, child, cheirourgia, surgery
the branch of medicine that is concerned with the treatment of the musculoskeletal system, mainly by manipulative and operative methods.

or·tho·pe·dic sur·ger·y

(ōr'thŏ-pē'dik sŭr'jĕr-ē)
Surgery that embraces treatment of acute and chronic disorders of the musculoskeletal system, including injuries, diseases, dysfunction, and deformities in the extremities and spine.
Synonym(s): orthopaedic surgery.
See also: orthopaedics
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