Fact Sheet - Orthopaedics

What is Orthopaedics?

Orthopaedics is a medical speciality devoted to the treatment of bones, muscles, tendons, ligaments and nerves.

What is an Orthopaedic Surgeon?

An orthopaedic surgeon is a doctor who specialises in the surgical and non-surgical treatment of diseases, disorders, and injuries (including fractures) of the skeletal system: spine, joints, muscles, tendons, ligaments, and peripheral nerves. The orthopaedist is concerned with preserving and restoring the function of the skeletal system, its articulations (joints), and associated structures. Patients who have fractures; muscle pulls, tears or pain; sprains or strains; joint pains or arthralgias; injuries from work, sports, slips, falls, auto accidents or other causes would typically seek the care of an orthopaedist.

The areas of orthopaedic surgery include:

  • Paediatric Orthopaedics: Care of injuries, deformities and diseases of the bones, joints, muscles and tendons in children.
  • Sports Medicine: Care of injuries related to athletic activities.
  • Joint Replacement and Surgery in Arthritis: Care of patients with advanced arthritis including medical treatment, joint replacement and other procedures.
  • Foot and Ankle: Care of patients with injury and diseases of the foot and ankle.
  • Hand surgery: Surgical and non-surgical treatment of the hand and wrist.
  • Shoulder and Elbow: Care of diseases and injuries of the shoulder and elbow.
  • Spine: Surgical and non-surgical treatment of deformities, injuries and disorders of the back and neck.
  • Trauma and Fractures: Treatment of injuries to the bones, joints, muscles, tendons, nerves and vessels in the arms, legs, back and neck.
  • Musculoskeletal Oncology: Treatment of benign and malignant tumours of bones, joints and muscles.
  • Rehabilitation: Short and long-term programs to improve strength and mobility and to optimise recovery.
  • Arthroscopy and Arthroscopic Surgery: Diagnosis and treatment of joint diseases and injuries using arthroscopic methods.

Common Problems

Among the many musculoskeletal conditions that the orthopaedist treats most often are such common problems as those caused by injuries from accidents that occur at home, at work, in athletic contests, or on the highway. Some of the most frequent of these are:

  • Broken Bones
  • Torn Ligaments
  • Dislocations
  • Sprains
  • Tendon Injuries
  • Pulled Muscles
  • Ruptured Discs & Sciatica

In addition to injuries, the orthopaedic surgeon is also an expert in treating more chronic (long lasting) conditions, such as problems with the back, legs, and feet. These include:

  • Low back pain
  • Scoliosis (curvature of the spine)
  • Knock knees or bow legs
  • Bunions and hammer toes
  • Knee malfunction

Another important part of orthopaedic practice is the treatment of arthritis and bursitis.

Bursitis is acute or chronic inflammation of a bursa, or fluid sac, located close to a joint. In response to irritation or injury the bursa may become inflamed, causing pain, restricting motion, and producing more fluid than can be absorbed readily. Common areas of involvement include the shoulder and big toe.

Arthritis (joint inflammation) is one of the most common and most disabling disorders of the musculoskeletal system. It takes several forms:

  • Osteoarthritis - a degenerative condition of joints that causes pain and limits motion
  • Rheumatoid Arthritis - a generalised inflammation of joints that causes pain, impairment of function, and deformity
  • Pyogenic Arthritis - an infection in the joint which occurs less frequently than the other types of arthritis, but is a serious problem requiring immediate attention.

Other serious conditions often treated by the orthopaedic surgeon are:

  • Congenital deformities (deformities present at birth)
  • Growth abnormalities
  • Osteoporosis (porous bone)
  • Muscular dystrophy
  • Cerebral palsy

Imaging Tests

Special tests such as x-rays, and magnetic resonance imaging (MRI) help confirm the Orthopaedic Surgeon's diagnosis and rule out any additional problems. Depending on the symptoms of the patient, one or more of these tests may be necessary.

SHOULDER Common injuries include:

  • Dislocation - Shoulder dislocations occur most often when the arm is stretched backward, pulling the humerus out of the socket.
  • Sprain or Separation - A shoulder sprain - often caused by a fall on the shoulder - occurs when ligaments are torn, usually the AC joint. A separation will cause the clavicle to pop up, pushing up the skin.
  • Shoulder Fractures - A fracture most often occurs along with a dislocation, but they can occur alone. The fracture is usually of the clavicle or of the surgical head of the humerus.
  • Wear & Tear Problems - bursitis, tendonitis(including calcific tendonitis), and arthritis.

ELBOW Common injuries include:

  • Epicondylitis - Improper use or overuse of the elbow (or hand) gradually inflames and frays muscle tendons at the inside or outside of the elbow. The elbow may swell, redden, or feel warm, and sharp pain can make it hard to grip, turn the hand, or swing the arm.
  • Fractures - "Breaking" a fall with the elbow outstretched or hitting a hard object can crack or shatter bones. Pain and swelling make motion nearly impossible.
  • Bursitis - A sharp blow or constant banging can cause swelling and sometimes pain in the bursa, a fluid-filled cushion at the tip of the elbow.

BACK The lower back (lumbar curve) is composed of five vertebrae ( L1 through L5) with their associated disks, nerve roots, muscles, and ligaments. The vertebrae and disks in the lower back have the greatest load to bear and are the largest. Common injuries of the back include:

  • Lower back pain due to poor posture, lack of exercise, and overeating.
  • Back strains or sprains.
  • Ruptured disks - the soft centre of the disk may bulge and press on nerve endings in its tough capsule, or it may rupture(herniate) through the capsule and pinch the spinal nerves.
  • Osteoarthritis - Osteoarthritis affects the disks and bones of our back in varying degrees. It narrows the disks and can cause irritating spurs on the vertebral bodies, producing pain.
  • Tension & emotional problems - The tension of everyday living can cause back spasms.

HAND & WRIST Because of the frequent activity, the hand is often prone to injuries of the tendons, nerves, and bones. Orthopaedic Surgeons are well trained to handle hand and wrist injuries as well as tumours and common maladies including ganglion cysts, bumps, tendonitis and overuse problems such as carpal tunnel syndrome.

  • Carpal Tunnel Syndrome(CTS) is a common condition that interferes with the use of the hand. It is caused when too much pressure is put on a nerve that runs through the wrist. A variety of anatomical abnormalities may be responsible for this squeezing pressure.

FOOT & ANKLE Many adults will eventually suffer from some sort of foot disorder including bunions, hammertoes, arthritis, bursitis, burning feet, cold feet, foot cramps, spasms and other ailments.

KNEE Common injuries include:

  • Mild to Moderate Knee Sprains - A twist or injury may produce a mild sprain or a moderate stretching or splitting of the ligaments. Pain usually follows injury; swelling may occur. Later symptoms may include "giving way" or instability.
  • Severe Tears - A severe injury can partially or completely tear one or more ligaments. Immediate, intense pain and swelling occur, generally due to bleeding inside the joint. Instability or "giving way" may result.
  • Fractures - A very severe blow or injury, as in traffic accidents, may break, crack, or chip the ends of the tibia or femur, or the kneecap. Symptoms include severe pain, swelling, and inability to move the knee or bear weight.
  • Meniscus Injuries - A blow or fall when the knee is bent, with the foot fixed and bearing weight, often causes meniscus injuries. Such sudden twisting oft he leg pinches the meniscus between the femur and tibia and causes the cartilage to split and tear. Pain, swelling , locking, and instability are sign of torn cartilage. The knee may also make a "clunking" noise. A split meniscus may open into a "bucket handle" tear and, if part of the torn cartilage gets caught inside the joint, the knee can lock.
  • Other Injuries - Other types of common injuries or problems include: Osgood-Schlatter's Disease, dislocated patella, chondromalacia, bursitis, osteoarthritis, rheumatoid and arthritis.