About orthopedic's
Orthopedics is a surgical specialty practiced by an orthopedic surgeon. It concerns the treatment of all diseases of the musculoskeletal system (bones, joints, muscles, tendons and nerves). It includes the surgical treatment of disorders of the upper limb (shoulder, elbow and hand), lower limb (hip, knee and foot) and the spine.
This surgical discipline has made considerable progress in the 20th century.
History
Although the practice of the discipline probably goes back to a distant time, the word 'orthopedics' was created in 1741, from two Greek words: "orthos" meaning 'right' and "paidon" which means "child".
Originally, the objective is the prevention more than the correction of "deformities" of the body in children.
The first orthopedic devices appear in the 4th century BC with orthopedics who devoted their lives to medicine. Orthopedics, developed a wooden bench that reduces the dislocations and fractures. The principle of this unit is to immobilize the bone or joint so that it is reestablished or snaps in place as appropriate.
In 1741, Nicolas Andry Boisregard, Professor of medicine at the royal college of Lyon, coined the word 'orthopedics' with his book: orthopedics the art of prevent and correct the deformities of the body in children.
Orthopedics is exercised in the 18th and early 19th century only by physicians in institutions such as those of James (1740-1791) in Switzerland, by Debra in Montpellier, by Pravaz in Paris and Lyon, etc.
In 1779, Jean-Pierre David written Dissertation on the effects of movement and rest in surgical diseases, which will be a classic of Orthopedics.
In 1830, appears fashionable orthotic insoles to straighten the feet, and even the orthotics for scoliosis and various vicious attitudes. But the orthopedic surgery term still reserved to the child or the young person.
In the 19th century, Louis Xavier Édouard, as early as 1858, dedicated his life to problems of ossification. He designates himself as bone and joint surgeon or reconstructive surgery. It follows the example of his Professor Amédée Bonnet and practical bone surgery with relief devices. These devices guide the bones so that they take the form it takes.
Until 1860, the orthopedist term is reserved for bandagers, manufacturers of corsets and insoles for feet.
The corset straightens the spinal column. It treats (twisted vertebral column) scoliosis and kyphosis (round back).
The orthotic insoles for clubfoot (invertebrate foot) molds yo deformation without correction but allows a painless and easier way of life.
The bandages immobilize or protect fragile joints and reduce dislocations.
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In 1881, the British general surgeon Arbuthnot Lane advocates a surgical technique for the treatment of fractures: osteosynthesis. It is set on the bone of the plates with screws to secure it until the bone is reestablished.
In 1890, Głuch develops the first internal knee prosthesis. It is ivory and operates with a hinge.
During the first world war, the meaning of Orthopaedics just for children disappears. Surgeons of children, on the battlefield, prefer conservative treatments to the systematic amputations. François Calot, surgeon at Berck, creates the term "orthopedic surgery of war." It applies development orthotics to treat the war wounded.
Pediatric orthopedists and surgeons for adults. It is also in 1918 the first society's of orthopaedic and traumatologic surgery are founded for the promotion and development of knowledge in this surgical specialty, it is also designed to relieve and improve functional status of patients following trauma or disease of the musculoskeletal system for all ages of life.
In 1919, we create prosthetics that can replace a missing limbs. Initially, these are just pieces of wood . The idea of replacing a joint by an internal unit is very old but it has really applied at hip level in 1945.
It is in November 1962, as a result of numerous works on the cemented fixation implants in bone that John Charnley (1911-1982) established its first total artificial hip joint (also called PTH). For the first time, it cements in the bone cavity, a cup made of polyethylene which comes to articulate a gauge 22.25 mm steel ball.
There were 582 settlements made at Writington from November 1962 to December 1965 which represents approximately 200 implants per year.
Thirty-six years later, the PTH is always regarded worldwide as one of the best PTH. Its longevity is very large. His success was immediate and rapid and important development. There were about one million of settlements made in the world and the copies were many also.
In 1963 the Sheffield hybrid Fixer kit is invented, designed as a simple system allowing a maximum immobilization of bone or joint. Pins provide high stability, even in the joints. It is this characteristic that is at the origin of its successful use in articular fractures. Four-pin retained by a ring ensures a very high stability. They can support very unstable fractures. The rings are connected by threaded rods. Sheffield hybrid Fixer kit is composed of reinforced rings and circles capable of supporting up to four pins.
In 1970, C. Neer advocates resurfacing the glenoid with an implant polyethylene cemented to the shoulder prostheses. This system allows to solve the erosions of the glenoid. There are two reasons: the first is to avoid aggravating the glenoid bone erosion, the second is to facilitate the reorientation and the stabilization of the shoulder prosthesis.
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