Thursday, August 4, 2016

Orthopedic Surgery: A Brief History

Orthopedic surgery is the area of medicine concerned with the musculoskeletal system. While the name may seem to imply only surgical procedures, doctors work to correct orthopedic issues using both surgical and non-surgical means. Physicians who specialize in this area treat trauma, sports injuries, infections, degenerative diseases, congenital disorders, and tumors.
Beginning With Children
Nicholas Andry coined the name orthopedic surgery in 1741. The word comes from the Greek "orthros," which means "straight" or "correct," and "paidion," which means "child." The term was first seen in his book, "The Art of Correcting and Preventing Deformities in Children," which was designed to help parents understand their child's malformation. Initially, the field was geared towards identifying and correcting spinal and bone deformities in children. Andry advocated the use of manipulation, splinting, and exercise as treatments.
Andry wasn't alone in his quest to help children. One of the first orthopedic surgery institutes was opened in 1780 by Jean-Andre Venel. Physicians working there dedicated their talents to assisting children with skeletal deformities. At this institute, Venel and his staff created ways to treat spine curvature and even developed the first club shoe for children suffering from foot malformations.
Into the 1800s, the practice remained limited to helping children. New techniques to correct spinal problems were continually developed. Surgical procedures such as the percutaneous tenotomy became popular as a means to correct problems with the foot and leg.
Growing to Encompass Adults
It wasn't until the early 1900s that physicians began investigating the possibilities of orthopedic surgery for teens and adults. The man credited with bringing orthopedics into the modern age is Hugh Owen Thomas. Thomas expanded the field through his interest in treating fractures. He created the Thomas Splint to stabilize broken bones and advocated bed rest in order to heal wounds and prevent infection.
In addition to the splint, Thomas created the Thomas Maneuver to help those with hip joint fractures. In order to treat the fractures, he would perform a test to detect the deformity by having his patients lie flat on a bed. Then, he would use his "wrench" method to reduce the fracture and reset the bone.
During the First World War, Thomas's techniques became mainstream when his nephew, Robert Jones, used the Thomas Splint to reduce the mortality rate for compound fractures of the femur from 87 percent to just 8 percent.
Post World War One
After World War One, German doctor Gerhard Kuntcher started using intramedullary rods to help fix fractures in the tibia and femur. However, it wasn't until the late 1970s that intramedullary fixation became possible without having to open the fracture. Prior to this time, it was common to use traction in order to repair the damage.
Since the 1970s, the field of orthopedic surgery continues to grow. Today, common techniques include joint replacements, bone grafts for severe fractures, and foot, ankle, shoulder, hand, and elbow procedures. Sports injuries also now fall under this category of medicine.
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