Orthopedics is a branch of medicine concerned with the musculoskeletal system including muscles, bones, joints, tendons, and ligaments. The term “orthopaedics” or “orthopedics” is originally derived from a Greek term in which “ortho” means straight and “pedic” means child. The French In the 17th century formed the modern term of orthopedics and called it “orthopédie”. Doctors who are specialized in this branch are called orthopedists.
Orthopedic is one of the most challenging and indispensable branches of medicine. Statistics showed that approximately 6.6 million orthopedic surgeries are done every year. Communities with a high average median age are more likely to experience musculoskeletal illness as a part of the aging process. Athletes and young people are also more susceptible to injuries that may need medical care by an orthopedist.
Orthopedists
Doctors who chose to be orthopedists must pass multiple clinical training programs -after medical school- including residencies and fellowships that may take as long as 6 years as in the United Kingdom and the united states. Orthopedic surgeons can’t be totally in charge of an operation unless they practice many times under consultant supervision. Moreover, they must confirm their competency by passing a certifying exam, so if you are having surgery don’t worry about your orthopedic surgeon, he is well experienced.
Orthopedic doctors are highly paid as according to Forbes the average annual income for orthopedists in the United States is roughly 519,000 dollars. Orthopedic surgeons are used to be the most highly paid doctors until the last two decades in which plastic surgeons broke the record. We shall mention that orthopedic is a high-earning specialty because of the high physical and mental effort it put doctors into. Statistics estimated that the mean duration of the orthopedic operation is more than two hours.
Orthopedists’ duties (What does an orthopedic doctor do?)
People often limit orthopedists’ jobs into fixing fractured bones while they usually analyze patients’ complaints then have a look at their data and ask for the proper investigation to reach an accurate diagnosis. Orthopedists also determine whether patients need a surgical procedure or medications. Although the rehabilitation phase of patients who had surgery is usually done under the supervision of a physical therapist, patients should regularly visit an orthopedist to follow up and assess the progress.
The orthopedic specialty is not isolated from other branches of medicine as many people may suppose. Physicians who clinically practice orthopedics believe that it is well integrated with other specialties considering that a lot of patients get referred to orthopedists by doctors of other specialties to do further investigations and collect more data to help diagnose patients with unclear symptoms. In many clinics and health care centers orthopedists’ duties may overlap with radiologists’ duties by including interpretation of radiological tests findings such as X-ray, CT, and MRI.
Orthopedists assess rehabilitation results frequently as they are always aiming for the best outcome out of any procedure. Patients who find unexpected results after surgery like limited range of motion of the joints or pain or numbness are asked to pay a visit to an orthopedist. General practitioners can handle simple patients. If you have an advanced or complicated condition it is better to see a specialist.
» Orthopedic surgeries «
What conditions require surgical orthopedic interference?
Orthopedic surgeons usually do 5 to 8 surgeries on a daily basis for patients with different diseases. Orthopedic operations have a high success rate and patients get significantly improved afterward.
We summarized the most common medical conditions that often require a surgical correction:
1. Spinal injuries
Spinal injuries include any harm that involves the vertebral column and the spinal cord passing through it. the spinal cord is a fine structure that could be easily injured, so orthopedic surgeons find it a bit challenging to fix a diseased spinal column. Vertebral disc prolapse is a common spinal disease that often needs a surgical operation, this kind of operation requires a delicate and skillful hand. It is found that motor vehicles accidents are the leading cause of spinal injuries as trauma dislocates the vertebral bodies or the disc in between causing excruciating pain.
2. A joint subluxation
Means dislocation of the joint which is usually undermining the flexibility and integrity of the surrounding ligaments. The knee joint carries most of the body weight and bears extra tension when carrying heavy objects or exercising, therefore it is the most commonly subluxated joint.
Body joints are naturally fixed its position by ligaments and tendons, so joint dislocation is often accompanied by ligament tear. Shoulder and hip joint subluxation are the second most commonly affected joints particularly in bodybuilders. Patients with such a condition undergo orthopedic surgery as soon as possible to avoid further complication.
3. Spinal deformity
Spinal deformity is a medical condition including abnormal alignment and curves of the vertebral column in which the vertebra needs a surgical adjustment to be positioned in its proper state. Spinal deformity may be congenital or acquired. Kyphosis which is the forward curvature of the spinal column to be in a semi-bending position is the most common form of spinal deformity. People using their personal computers for much time or having a sedentary lifestyle are more susceptible to developing kyphosis. Mild kyphosis can only be corrected by eliminating the causative factors and physiotherapy sessions while patients with a severe form of kyphosis are elected to get orthopedic surgery.
Scoliosis is a form of spinal deformity in which the vertebral column has a sideways curvature to appear as s or c shaped. Scoliosis could be developed by maintaining improper sitting position for long periods, yet it is more often to be caused due to hereditary factors as it runs in families scoliosis causes limitation of trunk movement and may be presented with pain if the nerve root is compressed. Orthopedists usually recommend specific chiropractic sessions, exercising, and regular follow-up visits for patients with mild scoliosis. The complicated and severe form of scoliosis is preferred to be corrected surgically in an operation called spinal fusion in which the curved vertebra are simply readjusted and fused together.
4. Bone fractures
Bone fractures are often fixed and stabilized with a cast without making a surgical procedure, yet patients with severe limb fractures in which the bones are fragmented must undergo surgery to fix in their position using nails and rods. Internal bone fixation is commonly done for thigh, hip, and arm bones. It is important to mention that people who have survived an accident as in a car crash should see an orthopedist to make sure that there isn’t inapparent musculoskeletal damage.
5. Bone inflammation
It is a medical condition that is usually part of a degenerative process due to malnutrition or aging and it is called osteoarthritis. Osteoarthritis is the most common disease that orthopedists daily deal with. Osteoarthritis is controlled remarkably with conservative treatment including anti-inflammatory, analgesics, and good nutrition. In a few cases of osteoarthritis, the joint affection is fulminant and severe that couldn’t be managed with drugs so orthopedic surgical interference is a must.
Joint replacement surgery is the operation of choice in complicated cases of osteoarthritis and rheumatoid arthritis. The surgery involves the partial or complete replacement of the joint with a metal, plastic, or ceramic device called prosthesis. According to the severity of the joint damage, the orthopedist determines the type of operation. Weight-bearing joints as hip, knee and ankle joints are the most replaced joints.
6. Primary tumors arising from the bone and cartilage
Primary tumors arising from the bone and cartilage may be removed by a surgical operation done by a specialized orthopedic oncologist surgeon. Orthopedists prefer surgical excision rather than chemotherapy or radiotherapy for patients who are early diagnosed with bone malignancy.
Osteosarcoma is the most common malignant bone tumor followed by chondrosarcoma (cartilage tumor).almost all Benign bone tumors as osteochondromas are recommended to be excised otherwise it may turn malignant and spread to other organs.
⇒ Now, let’s discuss when to see an orthopedist & treatment options.
Then when shall I see an orthopedist?
Bone diseases are usually expressed by some symptoms that should stimulate you to seek medical attention. Bone pain is the major symptom that drives patients to pay a visit to an orthopedist. Patients with acute infection or inflammation often complain of unendurable bone ache that interferes with their daily activities. Bone pain with an acute onset may be accompanied by swelling and tenderness over the affected bone as a result of inflammatory response.
Chronic diseases as rheumatoid (RA) arthritis may also be presented with pain-causing limitation of movement. Morning joint stiffness is a characteristic symptom that directs orthopedists to suspect RA. If you noticed recurrent bone fractures even from the slightest injuries you might be experiencing calcium/vitamin deficiency and need to see an orthopedist to assess your condition. The growth of an abnormal lump over the joint may be a sign of underlying disease even if it doesn’t cause any pain.
Orthopedic treatment
Orthopedists have multiple options of treatment that are mainly divided into surgical (discussed before), medications, and physiotherapy. Orthopedics most used drugs are anti-inflammatories to suppress the inflammatory process in bones and joints. Corticosteroids, as well as NSAIDs (non-steroidal anti-inflammatory drugs), are widely used in osteoarthritis and RA. Some bone diseases need extra specific treatment as gout which is controlled with colchicine.
General supportive medications such as supplemental calcium, vitamin D, and minerals are prescribed by orthopedists in almost all bone diseases however it may be the only definitive treatment for rickets and osteoporosis. A healthy lifestyle with a balanced nutrition plan will significantly contribute to getting well sooner.
Physiotherapy is an important non-surgical approach that helps in restoring the function of joints and muscles completely. Patients who underwent orthopedic surgery may be referred to a physical therapist to promote the mobility of the affected limb. A physiotherapist performs massaging and passive exercising for the patients. Electric muscle stimulation (EMS) which is a modality used in physiotherapy may be used for multiple purposes. EMS is completely safe and painless.
How effective is the early orthopedic treatment?
There is no doubt that early diagnosis and treatment have a significant effect on the prognosis and shape the course of the patient progress. Physicians always expect the fate of the medical condition upon how long the patient took to see a doctor after getting ill. Early diagnosis helps orthopedists detect accurately the cause of the illness and know what to expect.
The earlier to assess the patient’s health condition the more available treatment options therefore the patient could involve in making his medical decisions. Not to mention that early treatment reduce dramatically the risk of getting complications. Patients who are presented late or with complications may necessitate them having an aggressive or invasive medical approach.
Orthopedists believe that patients who have been treated early show better results and lead healthier lives. Psychological support has an indispensable role in patients’ progress particularly those who have chronic diseases, so it could be provided by early diagnosis.
Rehabilitation and recovery phase
People may overlook the impact of the recovery and rehabilitation phase on the result of the orthopedic surgery, whereas it is as important as the surgical operation. Rehabilitation is the typical care service for patients who find difficulty in performing daily activities. Rehabilitation involves majorly the restoration of the potentials of the muscle-skeletal system, its maximum capacity, and how to obtain neuro-cognitive functions.
Complete rehabilitation includes mainly four stages which are:
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- Rest and protect the injury from further damage.
- Restoring the normal range of motion.
- Recovery of muscle strength and function.
- Recovery of the coordination to perform complex movements.
Although rehabilitation may be challenging for patients, orthopedists always advise putting as much effort as possible into it. It is believed that patients’ discipline and determination through rehab define their results and shorten the recovery.