Page 90 - ASOP ROT Study Guide

UUNNITIT1 -2J–OJINoTinCt OCNoDndITiItOioNnSs

1. INTRODUCTION -THE SCOPE OF ORTHOPEDICS

1 . 1 A Brief History

Orthopedics literally means "straight children". The title of the subject reflects its history of dealing with
musculoskeletal abnormalities occurring at birth or in children as they grow and develop. Birth abnormalities
are far less common now than in the past, probably due to improvements in the nutrition and general health
of pregnant women. Childhood disease related to diet, such as vitamin C and D deficiency causing scurvy
and rickets, is also less common, reflecting improvements in the nutrition of growing children. Other diseases
such as Tuberculosis and Polio, which affected the musculoskeletal systems, were much more common in
children in the past. Indeed, bone infections and tuberculosis (TB) were very frequently fatal before the
second world war. These conditions are less common now because of improvements in treatment (due to the
use of antibiotics) and immunization programs.

Nowadays the field of orthopedics has grown to encompass the whole range of diseases affecting the
musculoskeletal system.

If you are interested in reading more about the history of orthopedics, the introductory chapter in your
recommended text is useful, and "A Source Book of Orthopaedics" by Bick is fascinating (although not
available for sale, it may be found in any hospital library).

1 . 2 Terminology

The following terms are very commonly used in the field of orthopedic medicine:

An acute disease is one that strikes the patient suddenly. It is characterized by a certain reaction by the body's
immune system whereby the illness is counteracted by the production of a type of body cell found in the blood
known as the polymorphonuclear leucocyte or polymorph for short. The polymorph is so called because
its nucleus is in many sections and it is called a leucocyte because it appears white.

A chronic disease takes a long time to develop and may last a long time. It can be distinguished from an
acute illness because the immune system reacts by producing a different sort of cell in the defense of the body.
This cell is the lymphocyte which is produced in the bone marrow and also in the spleen (an organ in the left
of the abdomen, opposite the liver).

The terms acute and chronic are strictly applied when describing the type of cell produced in response to
illness.

When surgeons operate and open something up we tend to add the term"...otomy" to such an operation. For
example, opening a joint is anarthrotomy. If something is removed at an operation the term "...ectomy" is
added, for example, if we remove a meniscus the procedure is called it a meniscectomy.

Definitions of all new terms in the module units will be highlighted as key words.

1 . 3 The Orthopedic Management Team

When you develop pain or stiffness affecting a joint who will help you?

The answer to this question is becoming increasingly complex as treatment becomes more sophisticated
and also much more expensive. The simple answer is that there is no individual who can treat you on their
own! The orthopedic surgeon is dependent on theatre nurses and porters, orthopedic nurses, other doctors
such as GPs, anesthetists, rheumatologists and general surgeons and paramedical specialists such as