Orthopedics

The term orthopedics was coined by a French physician, Nicholas Andre, who published a book in 1741 on the prevention and correction of musculoskeletal deformities in children. He united the Greek term orthos, meaning straight, with paedeia, the rearing of children. The term orthopaedics remained in use, though the specialty has broadened much beyond the care of children. Andre's illustration at the beginning of his book, that of a strong post to which is tied a growing but crooked sapling, remains the symbol of orthopedic societies today.

Early orthopedics concentrated on the correction of such childhood conditions as scoliosis (curved back), paralysis as with poliomyelitis, tuberculosis of the bone, and congenital defects such as clubfoot or deformed hip. Gradually, orthopedists included fractures, dislocations, and trauma to the spine and skeleton within their specialty.

Bone is a living and functioning part of the body. A broken bone will generate new growth to repair the fracture and fill in any areas from which bone is removed. Therefore, a bone that is congenitally deformed (from birth) can be manipulated, cut, braced, or otherwise treated to provide a normal form. A broken bone held in alignment will heal and no physical deformity will result.

For decades orthopedics was a physical specialty. The physician provided therapy to manipulate bones and joints to restore alignment, and then applied casts or braces to maintain the structure until it healed. Fractures of the hip, among other injuries, were considered untreatable and they were ignored. The patient was made as comfortable as possible to allow the fracture to heal and then had to adjust his lifestyle to account for difficulty in walking, inability to bend, or other handicaps remaining from healing of the deformed joint.

In the 1930s a special nail was developed to hold bone fragments together to allow them to heal better. A few years later a metal device was invented to replace the head of a femur (thigh bone), which formed part of the hip joint and often would not heal after being fractured. A total hip joint was later invented and it continues to be revised and improved to allow the patient maximum use and flexibility of the leg.

Currently, the orthopedic specialist continues to apply physical methods to align fractures and restore a disrupted joint. Braces and casts still are used to hold injured bones in place to allow them to heal. Now, however, the physician can take x rays to be certain bones are aligned properly for healing to take place. X rays also can be taken during the healing process to ascertain alignment has not changed and healing is occurring apace.