The term ‘orthopaedics’, derived from the Greek ‘Orthos’ meaning straight and ‘Paedion’ meaning child, is credited to the French physician Nicholas Andrywhen he published the book Orthopaedia: or the Art of Correcting and Preventing Deformities in Children. The book drew attention to his belief that prevention of deformity in adults lay in the development of straight children. It also contained an
illustration of the ‘Tree of Andry’which has become an internationally recognised symbol for orthopaedic surgery.
Although treatment of orthopaedic problems date back to antiquity, with references to reduction of fractures and dislocations in both ancient Greek and Egyptian texts, the major conflicts of the 20th
century have perhaps provided the greatest advances and influence on modern day orthopaedics including; management of wounds, fracture fixation and treatment of open fractures.
Several figures have shaped the course of orthopaedics but perhaps the two major pioneers of modern day orthopaedic surgery are Huw Owen Thomas and Robert Jones. The ‘Thomas splint’ invented by Huw Owen Thomas andpopularised by Robert Jones during World War I helped reduce mortality of open femur fractures from 87% to 8% during the course of the war. This was further improved by continuing advances in wound debridement techniques by military trauma surgeons over subsequent conflicts. Another key development in warfare wasintra-meduallry nailing of long bone fractures developed by GerhardKüntscherduring World War II. Prior to this treatment consisted of traction or plaster which required long periods of inactivity. Küntschers IM nail revolutionised treatment of long bone fractures and variations of his IM nail are still in use today.
Trauma and orthopaedic surgery has seen many changes over recent times both in terms of technology and delivery of service. One crucial aspect is the increasing roleof evidence based practice and is hugely emphasized in everyday practice. In terms of technology, the future promises further changeswith advances in the areas of materials science, computer aided manufacturing technology and molecular biology.
Trauma and Orthopaedicsis a speciality of great breadth and variety. Workloadis generally split between trauma and elective work, with increasing subspecialisation in recent years.
Subspecialty interests include:
- Lower limb joint reconstruction
- Hip surgery
- Knee surgery
- Ankle and foot
- Upper limb
- Hand surgery
- Bone tumour surgery
- Paediatric orthopaedics
- Sports surgery
- Complex trauma surgery
There are currently 28 Trauma and Orthopaedic themed Core surgical trainees in the North West deanery spread across the region with excellent exposure to both trauma and elective orthopaedics.
The deanery currently holds a subspecialty teaching programme run by trainees aiming to supplement the comprehensive teaching programme with sessions planned throughout the year.