Janey Krehnbrink

Mr. Rhodes

Advanced Placement English Language and Composition

22 February 2018

From Boards to Bionics: A Career in Orthopedics

Five o’clock on a dark October evening, a young American soldier hides in the makeshift

barrack of his base in Iraq. Laying across the floor with the tip of his gun out a small hole in the

wall, he silently gazes through the eyeglass with an unbreakable focus. Anticipating a move from

the enemy, he keeps a sharp lookout for any sign of light in the pitch-black distance, hearing

nothing but the sound of his own heartbeat. The young soldier’s mind trickles with anxiety as he

hears a faint whistle and sees the outline of a missile fly through the air. The soldier makes a

rapid effort to dive into the nearest shelter but before he can fit his leg in, a huge blast of heat and

light engulfs the air around him. The soldier struggles into the shelter and slams the door. Yelling

out of pain and desperation, he looks down to see waterfalls of blood gushing out of his

cracked-open knee. As the soldier begins to lose consciousness, a faint ringing in his ears turns

into the piercing sound of sirens. Paramedics quickly rush him to the hospital, where they

proceed to amputate his left leg. Unlike wounded soldiers of the past, this man will walk again,

as a result of hundreds of years of groundbreaking work by pioneers in the orthopedic field. The

evolution of medical technology within orthopedics has made possible the treatment of people

like this wounded soldier. A career in orthopedics involves an extensive education, the study of

major historical developments, and constant attention to the changing use of technology.

Though the gradual development of the orthopedic subspecialty has occurred over the
 Krehnbrink 2

last two centuries, the concept of fixing physical impairments dates back to the brink of human

existence. Ancient clinical records of primitive congenial and skeletal abnormalities, though

informal and non-diagnostic accounts, indicate the earliest efforts of orthopedic practice (Peltier

xxv). In fact, the basic understanding of human anatomy stems back to primitive times where,

according to recent evidence, the earliest orthopedic procedures took place. Cranial trephining,

the cutting open of the skull, first occurred among neolithic tribes where skull fractures resulted

from intertribal warfare, as well as hunting practices (Prioreschi 28). Despite the complexity of

the operation for the time, anthropologists recently discovered over 1,500 trephined skulls living

during the Neolithic Age spread over four different continents, demonstrating the quick diffusion

of the operation (22).

As humans evolved, so did the practice of skeletal correction. Many common orthopedic

treatments, such as splints and amputations, originated in ancient Egypt, a region that fostered a

great deal of advancements in orthopedic treatment. Records from 1,300 BC offer the first look

at humans’ attempt to treat injuries in a more methodical manner (Blomstedt 671). One of the

many cases from the records describes a fracture to the collar bone, where a physician uses two

leather splints to bind the patient’s bones to his arms. In a similar case, a patient experiences a

fracture to the humerus, in which leather stabilizes the disjointed bones. The study also reveals

the first use of wooden splints, typically reserved for the more extreme cases such as open

wound fractures (671). Alongside the expansion of splints came the development of prosthetics.

Similar to the splint, the earliest known artificial limb dates back to Egypt, where in the fifth

century BC, a skilled artisan created a wooden toe allowing a person who previously had his or

her toe amputated to walk again (674). Though a seemingly simple task, the toe’s complex
 Krehnbrink 3

design allowed for proper balance and free movement, features thought unattainable for the time

(Shier 9). Within a few centuries, the use of prosthetics spread rapidly, with different versions of

artificial limbs developing all over Europe by the fifteenth century AD (Peltier 10). Though

orthopedic operations continued to evolve over time, the major growth of the profession occurred

in the middle of the eighteenth century, in the midst of the Industrial Revolution (xxv). Around

this time, medicine branched off into different specialties, largely due to the influx of people into

metropolitan areas (xxv). This led to larger hospitals, and in order to more efficiently examine

and compare patients, doctors grouped them by their physical ailments. Moreover, doctors had

more opportunities to perform autopsies as the negative health impacts of urban life increased the

overall death rate. Exposure to more people with skeletal abnormalities allowed doctors to make

new observations and discoveries (xxv). Not long after the Industrial Revolution, orthopedics, as

well as healthcare in general, greatly expanded.

Modern orthopedic practice stems from the work of a variety of pioneer physicians who,

during this time, collectively laid down the foundation of musculoskeletal treatment. Dr. Hugh

Owen Thomas, one of the first with the official title of an “orthopedic surgeon,” made significant

contributions. After finishing his early education, Thomas attended Edinburgh University for

specialized medical training (Ashwood and Wren 198). Inspired by his medical professors, as

well as the exposure from his studies, Thomas believed he could apply his extensive knowledge

of musculoskeletal treatment to conventional medicine. In 1866, he transformed his home into a

private hospital containing only eight beds (198). Dedicated to his practice, the physician spent

day and night performing extensive research, notably on prosthetic devices and the use of silver

wire to fix internal fractures (199). As a result of this dedication, Thomas made two significant
 Krehnbrink 4

contributions that have heavily influenced the medical technology today. First, he invented

Thomas’ Splint, a unique contraption incorporating a metal ring, two rigid rods, and a leather

strap to hold a broken leg in place (199). Though the design did not gain popularity until after his

death, its structure remains the foundation of the modern splint. Additionally, Thomas created a

specific medical assessment known as the Thomas Test, which tested patients for hip deformities

through a series of physical examinations of the back and pelvis (199). The validity of the test

proved remarkable for its time and has many uses in orthopedic diagnoses today. Despite his

expertise, however, Thomas faced harsh criticism from the community for steering away from

traditional amputation practices. His works did not gain recognition until almost 50 years after

his death, when his nephew published a series of books describing his findings. As they

resurfaced, the advancements Thomas made over his lifetime paved the way to several other

remarkable breakthroughs. His hard work, dedication and contributions to the field would earn

him the title “the father of orthopedics” in the years to come (200).

A series of discoveries in the late 1860s prompted yet another time of change within

orthopedics. With the back-to-back creation of aseptic surgery and anesthesia, surgeons could

perform longer and more complex operations (Markatos et al. 162). In response to these

creations, many surgeons worldwide began designing and testing orthopedic implants made of

different materials. In the early twentieth century, British surgeon Sir William Arbuthnot Lane,

along with a team of orthopedists, created the first fracture plate made of stainless steel (163). As

the design evolved, the materials changed based on test results and new research. Vanadium, a

very elastic material, replaced steel for its ability to adjust to the conditions of the human body.

Stellite then replaced Vanadium, for its chemical inertness. The trend continued until Vitallium,
 Krehnbrink 5

a metal alloy containing chromium and copper, became the main material used in the creation of

fracture plates (163).

During World Wars I and II, an extensive amount of operative progress occurred as a

result of the vast experience acquired by surgeons working on the battlefields. One particular

researcher, Dr. Ernest Hay Groves, introduced the idea of common carpentry screws as a way to

treat femoral neck fractures. Groves tested his new methods of intramedullary nailing on

wounded soldiers, thereby establishing the quickest method of neck fracture repair ever. Not

only did the use of screws prevent further injury to vascular connective tissue, but it also allowed

the fracture to heal without the use of plaster (Markatos et al. 164). In the period following

World War II, larger and more incremental changes began to take hold in orthopedic practice.

With the creation of antibiotics, surgeons could perform procedures without the risk of bacterial

infection. Additionally, the first version of the computerized axial tomography (CAT) scan

allowed doctors to diagnose a skeletal deformity without needing to cut open skin (165). These

gradual developments led to a large expansion of the field, with women beginning to break into

professional medicine. In 1983, a group of orthopedists founded the Ruth Jackson Orthopedic

Society in order to foster professional development for women orthopedists. This society greatly

contributed to a steady increase in the number of women pursuing medicine (Mazloom et al.

114).

Despite a net increase in the number of women practicing medicine in the past several

decades, the field of orthopedics experienced very slow growth in its number of female doctors.

In fact, of all surgical specialties, orthopedics has the lowest number of female participation,

women comprising only 14 percent of all orthopedic medical residents (“Stepping to the Front”
 Krehnbrink 6

6). In a study exploring this statistic, the Women’s Professional Development Symposium for

Emerging Leaders in Orthopedics conducted a roundtable discussion with a group of female

orthopedic doctors to discuss possible reasons why females have continued to turn away from the

field. The panel participants suggested the primary factors discouraging women include negative

perceptions of the field, the fear of an inability to balance work and life, and the male stereotype

in the field (6). In addressing these issues, the women primarily recommended that beginning

orthopedists make an effort to achieve a work-life balance early in their career.

Despite the male-dominated label, many women pioneers in orthopedics have expanded

their horizons and paved the way to greatness for prospective women orthopedists. Dr. Carrie

Diulus, a practicing spinal surgeon from Cleveland, Ohio, has worked to defy this label by

developing the Multidisciplinary Spine Center at the Cleveland Clinic’s Medina Hospital (Park).

After completing her residency at the same hospital, Diulus saw the need for such a center, and

used her knowledge and resources to successfully build the practice. For her determination and

strong will, she has earned a superior reputation from her mentors, coworkers, and patients

(Park). Dr. Martha Murray, another woman pioneer in orthopedics, has also taken on the role of a

female leader. An associate professor of orthopedic surgery at Harvard University, Dr. Murray’s

achievements do not stop at her prestigious title (Romero 92). Recently, she conducted a small

study on the bridge-enhanced ACL repair (BEAR) procedure, an operation that makes normal

ACL reconstructive surgery much simpler by placing a blood-soaked sponge inside the torn

ligament (92). After observing patients who underwent the BEAR procedure, Dr. Murray

concluded the operation offers a much quicker recovery time and, because of its simplicity, costs

much less than normal ACL reconstruction (92). Just as Dr. Diulus made a profound impact on
 Krehnbrink 7

the orthopedic community, Dr. Murray’s work has contributed to the rise of this revolutionary

procedure.

As Dr. Diulus and Dr. Murray exhibit, one has many options when choosing a specific

track within orthopedics. The most popular subspecialties include sports medicine, prosthetics,

orthopedic nursing and orthopedic surgery, each career offering a unique application of

musculoskeletal knowledge obtained in university study (“Orthopedic Surgery”). Generally,

sports medicine professionals have a wide range of jobs, including certified athletic trainers for

high school, collegiate, or professional sports teams, chiropractic practitioners, and physical

therapists (Emeagwali 19). These professionals deal largely with athletes and treat temporary

musculoskeletal injuries (17). Sports medicine professionals typically work in a school or office

environment, but can also spend extensive time on the court, on the field, or in the gym (19).

Orthopedic nursing, on the other hand, has a more straightforward career path and traditionally

takes place in a hospital or clinical setting. Known for specializing in the broad treatment of

musculoskeletal injuries and disorders, orthopedic nurses have an array of responsibilities within

surgical units of hospitals and clinics. These include patient communication, surgery preparation,

surgical assistance and the oversight of patient rehabilitation (De Araujo and Eiras Cameron

1392).

If a student has an interest in orthopedics but does not want the one-on-one patient

interaction that comes with sports medicine or nursing, a career in prosthetics offers a great and

equally rewarding alternative. Prosthetics, a branch of surgery dealing with the artificial

replacement of missing or ill-suited body parts, has a few subspecialties, such as prosthetists and

prosthetic technicians (“Prosthetics”). A prosthetist focuses on the mechanical aspect of

 Krehnbrink 8

orthopedics, primarily dealing with the design and implantation of artificial limbs to replace

amputated, damaged, or otherwise functionless body parts (Goggins et al. 2). Prosthetic

technicians, on the other hand, make and repair the braces and limbs prosthetists design. Unlike

the majority of sports medicine professionals and orthopedic nurses, prosthetists and prosthetic

technicians work in clinical lab settings ("Orthotic and Prosthetic Technician” 58).

Orthopedic surgery, perhaps the most rigorous subspecialty within orthopedics, comes

with many challenges that, once overcome, can make the profession extremely rewarding. The

branch of surgery dealing with the detection and treatment of musculoskeletal injuries and

deformities, orthopedic surgery has become one of the most quickly-changing branches of

medicine (“Orthopedic Surgery”). Orthopedic surgeons devote their careers to the treatment of

arthritis, bone fractures, dislocations, joint and ligament disturbances, and inflammation of

muscles and tissue (“Orthopedics”). Though most orthopedic surgeons work in hospitals, they

can also work in other areas, including specialized clinics or the United States military (Daniels

et al. e162). The annual salary of an orthopedic surgeon ranges between $250,000 and $500,000,

depending on the specialization and the location of the practice (​Million Dollar Careers​ 108).

Prospective orthopedic surgeons have a very specific education path to follow in order to set

themselves up for a successful career.

An undergraduate college student wishing to pursue a career as an orthopedic surgeon

must first obtain a bachelor’s degree at a college or university. Generally, a major pertaining to

health science, such as biology, chemistry, or pre-medicine, will provide a student with the

strongest foundation in order to continue on his or her education path. While obtaining an

undergraduate degree, a student who desires a competitive edge when applying to postgraduate
 Krehnbrink 9

programs should gain exposure to orthopedics by volunteering in a hospital or performing

research (​Occupational Outlook Handbook 3​ 70). Once the student obtains a degree, he or she

must apply to medical school. A very competitive process, admission into most medical schools

requires undergraduate transcripts, letters of recommendation, an interview, and scores from the

Medical College Admission Test (MCAT) (370). Upon admission, a student spends the first two

years taking courses in general medical knowledge, including anatomy, microbiology, and

biochemistry (370). A student also studies the practice of healthcare, learning how to properly

interact with patients. In the final two years of medical school, a student will complete a series of

rotations in different areas of internal medicine, working directly with patients under the

administration of a physician in a hospital or clinical setting. During medical school, students

should perform research and even complete sub-internships to prepare for residency, the next

step in the education process (Jazrawi et al. 18). After medical school, a student must apply to a

residency program specific to orthopedic surgery, where he or she will gain practical experience

and complete intensive research (96). This lasts a minimum of five years, but may run longer

depending on the location (138). Upon completion, a student has the option of completing a

fellowship if he or she wants to specialize further in areas such as spinal or knee surgery (118).

However, orthopedic surgery, as a general practice, does not require any training beyond

residency (138). Once a student has completed the five required years of residency, he or she

must pass the United States Medical Licensing Examination (​Occupational Outlook Handbook

370). After successfully completing the exam, a student has all of the credentials to officially

begin practicing as a medical doctor.

 Krehnbrink 10

The University of North Carolina at Chapel Hill (UNC-Chapel Hill) and Duke University

both offer great undergraduate and graduate programs for North Carolina students wishing to

pursue orthopedic surgery. UNC-Chapel Hill, offering degrees in biology, chemistry, and

pre-medicine, provides students with a great foundation of knowledge when advancing to

medical school (“Studies: University”). Duke University, offering the same majors, will also

equip a student with the right assets to continue his or her medical path (“Studies: Duke”).

Though they have similar programs, these universities differ greatly in terms of affordability.

Duke University, a private institution and thus the most expensive option, has an annual

undergraduate tuition totalling $47,243, with an additional $13,290 for room and board

(“Colleges: College Search"). A student who decides to pursue medical school at Duke

University will pay an annual $43,134, without additional fees (“Tuition”). With an acceptance

rate of 10 percent, a Duke student will have a competitive edge when applying to medical

schools (“Admission: Duke”). Similarly, UNC-Chapel Hill has a fairly low acceptance rate of 27

percent (“Admission: University”). However, a public university, UNC-Chapel Hill has a

significantly lower annual tuition for in-state students than Duke, at $8,336 plus an additional

$10,592 for room and board (“Colleges”). An in-state student who pursues medical school at the

UNC-Chapel Hill will pay an annual $65,524, all fees included (“Cost of Education”).

Though orthopedic surgeons can practice once they pass their license exam, the education

does not stop. An orthopedic surgeon in practice must participate in continuing medical

education (CME) for the purpose of retaining all knowledge gained in medical school and

postgraduate programs, as well as staying up-to-date on the newest breakthroughs and

technologies (Leong 3). In order to meet the Maintenance of Certification (MOC) requirements
 Krehnbrink 11

of the American Board of Orthopedic Surgery (ABOS), surgeons must obtain and submit CME

credits by completing self-assessments exams through the American Academy of Orthopedic

Surgeons (AAOS), along with programs geared toward orthopedics. Depending on a specialty or

interest, he or she has a wide variety of educational courses to choose from to fulfill these credits

("Getting Your CME Credits” 12). Though most medical professions must undergo CME, it has

proven particularly important within orthopedics due to the rapidly-changing uses of technology

within the field.

Over the last 50 years, a broad series of technological developments has led to massive

advancements within orthopedics. Artificial intelligence (AI), a recent phenomenon, has already

had a substantial impact on the way doctors approach orthopedic treatment. Current studies

surrounding AI’s potential use in analyzing skeletal radiographs provide compelling evidence in

support of its importance in the future of orthopedics (Olczak et al. 581). In a recent studying

seeking to determine the accuracy of AI in this radiograph analysis, a group from Karolinska

Institute of Technology in Stockholm, Sweden concluded that several deep learning programs,

including the Visual Geometry Group Convolutional Neural Networks (VGG CNN), matched

the performance of 2 orthopedic senior surgeons, reporting over 90 percent accuracy in

identifying central properties in radiographs (581). In fact, some programs exceeded human

performance in image analysis. The implementation of AI in hospitals and clinics comes with

many advantages, as doctors will have the ability to analyze radiographs quickly and in

unlimited quantities, opening the door to new studies with much clearer image viewing

(McLaughlin). AI also has extremely high potential in an emergency room setting where

screening must occur immediately. Moreover, the programs identify new patterns of bone
 Krehnbrink 12

injuries in tracing limitless amounts of fractures. Ultimately, using AI will eliminate the risk of

assumptions and human error (Olczak et al. 585).

Though AI has great potential within orthopedics, using technology to perform

historically-human tasks raises a few fundamental and ethical questions. The few programs

available for this purpose do not analyze any image with the slightest mark or scratch, presenting

a major setback (Olczak et al. 585). Additionally, the programs can not analyze multiple images

at once, so if a particular injury diagnosis requires multiple views, an AI program will not derive

it from a single image (585). Lastly, a radiograph report generated from a computer will not

answer a patient’s questions about his or her injury as a doctor could. Consequently, the thought

of technological devices performing doctors’ duties creates apprehension among patients (585).

Despite these limitations however, the rapid development of AI will undoubtedly influence the

field of orthopedics in the years to come.

In the last decade, orthopedic research and diagnosis evolved faster than ever. Optimal

understanding of orthopedic injuries requires high quality 3-D imaging that did not exist half a

century ago (Chen et al. 131). The heavy application of digital technology in identifying a

problem, coming up with the best operative plan, and mapping out recovery proves its great

importance in orthopedic surgery (131). In fact, the continued application of computational

biomechanics has led to the creation of “digital orthopedics,” a broad integrative field of study

that combines image processing, medical technology, and orthopedic simulation (132). One of

the most notable breakthroughs in digital orthopedics involves the application of virtual reality

(VR) in orthopedic surgeon training. In the past, inexperienced surgeons trained by studying

x-ray screenings and manually modifying them in preparation for an operation. However, VR
 Krehnbrink 13

allows doctors to program surgical scenarios on a screen and create a preoperative plan,

eliminating any sources of error at the time of surgery (132). Though most full VR systems

remain in developmental stages, the programs have vast potential in the future of orthopedic

surgery (132).

Another area of digital orthopedics, called rapid prototyping (RP), has proven paramount

in orthopedic medical development. An anatomical modeling technique involving the digital

control of lasers, RP encompasses the creation of body parts, such as bone and tissue, using

synthetic materials and computer aided design (CAD) software (Chen et al. 132). Through

extremely meticulous layering processes, RP quickly creates these parts with high precision

(133). Thus far, RP has advanced many orthopedic treatments, including jaw deformity repairs,

cranioplasties, and bone tissue engineering (133). Specifically, it aided in the design of new

materials for specific procedures, such as titanium plates for cranial reparation and

polycaprolactone scaffolds for skeletal tissue replacement. Aside from the benefit of more

durable tissue and bone replacements, RP models have great use in planning complex surgical

procedures (133).

In addition to RP, other new technologies have fostered great advancements in the

creation and testing of prosthetic devices. Programs within computational biomechanics, a new

and advanced field surrounding technological research of musculoskeletal behavior, allow for the

quick testing of relative strengths of fracture repair appliances (Chen et al. 134). Moreover, the

creation of “bio-inspired dexterous robotic hands” out of a variety of materials marks one of the

many ways these technologies impact prosthetic treatment (Saikia et al. 256). The Zurich-Tokyo

hand, a newer bionic device, has pressure sensors allowing the user to explore surfaces and grasp
 Krehnbrink 14

objects on his or her own (257). The iLimb hand, arguably the most advanced bionic hand to

date, combines all of the newest breakthroughs in material and computer science. Aside from its

extremely versatile design, each finger on the iLimb runs on its own motor, giving the hand

extremely precise articulation (258). Its newest feature involves the placement of electrodes on

the skin of the amputee, allowing the transfer of myoelectric signals between the skin and a

software program that interprets the signals and controls the hand (258). This technology makes

the iLimb’s freedom of movement much more accessible to amputees. This accessibility,

coupled with the advanced skin technology, proves just how much of a reliance orthopedics will

have on technology in the future.

In a world of constant technological evolution, orthopedics will remain an ever-changing

and vital component of medicine for its application to a growing number of lives. From the

wooden plates used at the foundation of mankind, to the creation and design of bionic limbs, the

extensive education requirements of orthopedists have led to hundreds of life-saving discoveries

by pioneers who define the long-lasting importance of a career in orthopedics.

 Krehnbrink 15

Works Cited

“Admission: Duke University.” ​Naviance Family Connection,​ N.p., n.d. Web. 10 Feb. 2018.

https://static.naviance.com/family-connection/colleges/#/hubs/4c5420a3-c9c1-4a8b-8a5f-

d47d428f5af3/Admissions

“Admission: University of North Carolina at Chapel Hill.” ​Naviance Family Connection,​ N.p.,

n.d. Web. 10 Feb. 2018.

https://static.naviance.com/family-connection/colleges/#/hubs/4c62d94b-2fcc-4430-957f-

c829856c7974/Admissions

Ashwood, Neil and Sarah Wren. "The Life and Times of Hugh Owen Thomas." Trauma, vol. 12,

no. 4, Oct. 2010, pp. 197-201. ​EBSCOhost,​ 22 Jan. 2018.

http://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,custuid&custid=s8455

861&db=a9h&AN=54278842&site=ehost-live&scope=site​.

Blomstedt, Patric. "Orthopedic Surgery in Ancient Egypt." ​Acta Orthopaedica,​ vol. 85, no. 6,

Dec. 2014, pp. 670-676. ​EBSCOhost,​ 29 Jan. 2018.

http://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,custuid&custid=s8455

861&db=a9h&AN=100094422&site=ehost-live&scope=site​.

Chen, Yan-xi, et al. "Research Status and Application Prospects of Digital Technology in

Orthopaedics." ​Orthopaedic Surgery,​ vol. 4, no. 3, Aug. 2012, pp. 131-138. ​EBSCOhost​,

11 Feb. 2018.

http://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,custuid&custid=s8455

861&db=a9h&AN=79356522&site=ehost-live&scope=site​.
 Krehnbrink 16

“Colleges: College Search." ​Naviance: Family Connection​. N.p., n.d. Web. 10 Feb. 2018.

https://connection.naviance.com/family-connection/colleges/supermatch

“Cost of Education.” ​UNC School of Medicine,​ 19 Feb. 2018.

www.med.unc.edu/ome/finaid/cost/cost-of-education​.

Daniels, Christopher M., et al. "Gender Disparities within US Army Orthopedic Surgery: A

Preliminary Report." ​Military Medicine​, vol. 183, no. 1/2, Jan/Feb2018, pp. e162-e166.

EBSCOhost​, 8 Feb. 2018.

http://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,custuid&custid=s8455

861&db=a9h&AN=127867079&site=ehost-live&scope=site​.

De Araujo, Silvia Teresa Carvaiho and Lys Eiras Cameron. “Undergraduate Students in

Orthopedic Nursing Care.” ​Revista Latino-Americana De Enfermagem (RLAE),​ vol. 19,

no. 6, Nov. 2011, pp. 1391–1397. ​Academic Search Complete​, ​EBSCOhost​,​ ​22 Dec.

2017.

http://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,custuid&custid=s8455

861&db=a9h&AN=71422035&site=ehost-live&scope=site​.

Emeagwali, N. Susan. "The World of Sports Medicine." ​Techniques: Connecting Education and

Careers,​ vol. 83, no. 5, 01 May 2008, pp. 16-19. ​EBSCOhost,​ 10 Feb. 2018.

http://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,custuid&custid=s8455

861&db=eric&AN=EJ793854&site=ehost-live&scope=site​.

"Getting Your CME Credits from ‘Point A’ to ‘Point B.’” ​AAOS Now​, vol. 8, no. 8, Aug. 2014,

pp. 12-13. ​EBSCOhost​, 10 Feb. 2018.

 Krehnbrink 17

http://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,custuid&custid=s8455

861&db=a9h&AN=97755228&site=ehost-live&scope=site​.

Goggins, Sophie, et al. "Prosthetic Limbs on Display: From Maker to User." ​Science Museum

Group Journal,​ no. 8, Sept. 2017, pp. 213-232. ​EBSCOhost​, 15 Feb. 2018.

http://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,custuid&custid=s8455

861&db=a9h&AN=126279135&site=ehost-live&scope=site​.

Jazrawi, Laith M., et al. ​Orthopedic Residency & Fellowship: A Guide to Success.​ SLACK,

Incorporated, 2010, 10 Feb. 2018.

https://books.google.com/books?id=CXMQ7A69Ij8C&printsec=frontcover#v=onepage&

q&f=false

Leong, John C. Y. “Orthopaedic Surgeons Worldwide Must Overcome Hurdles in Their Career

Path.” ​Orthopaedics Today/International Edition​, vol. 11, no. 3, May 2008, pp. 3–4.

Academic Search Complete​, ​EBSCOhost​,​ ​28 Dec. 2017.

http://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,custuid&custid=s8455

861&db=a9h&AN=31949858&site=ehost-live&scope=sit​e.

Markatos, Konstantinos, et al. "Hallmarks in the History of Orthopaedic Implants for Trauma

and Joint Replacement." ["glavna obilježja povijesti ortopedskih implantanata kod trauma

i zamjene zglobova"]. ​Acta Medico-Historica Adriatica​, vol. 14, no. 1, Aug. 2016, pp.

161-176. ​EBSCOhost​,​ ​24 Jan. 2018.

http://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,custuid&custid=s8455

861&db=a9h&AN=117921376&site=ehost-live&scope=site​.
 Krehnbrink 18

Mazloom, Sean E, et al. ​Orthopedic Residency Guide.​ 1st ed., Jaypee Brothers Medical

Publishers, 2014, 20 Feb. 2018.

books.google.com/books?id=irGHAwAAQBAJ&pg=PA114&dq=ruth+jackson+orthope

dics&hl=en&sa=X&ved=0ahUKEwiW4K_DmLjZAhVCzFMKHf23C_YQ6AEIKzAB#

v=onepage&q=ruth%20jackson%20orthopedics&f=false.

McLaughlin, Todd. “Pride Project Interview.” email interview. 13 Feb. 2018.

Million Dollar Careers​. WetFeet, Inc., 2005, 10 Feb. 2018.

books.google.com/books?id=IfIGDIg3EW8C&pg=PA108&dq=careers+in+surgery&hl=

en&sa=X&ved=0ahUKEwjZnLD1rqHZAhUO0FMKHWwxCM0Q6AEIQTAF#v=onepa

ge&q=careers%20in%20surgery&f=false.

Occupational Outlook Handbook.​ Skyhorse Publishing, 2008, 10 Feb. 2018.

books.google.com/books?id=twhrCgAAQBAJ&printsec=frontcover&dq=surgeon+career

&hl=en&sa=X&ved=0ahUKEwjiwsX2xJ7ZAhUR1lMKHT3DBoQQ6AEIRTAG#v=one

page&q=orthopedic&f=false

Olczak, Jakub, et al. “Artificial Intelligence for Analyzing Orthopedic Trauma Radiographs:

Deep Learning Algorithms--Are They on Par with Humans for Diagnosing Fractures?”

Acta Orthopaedica​, vol. 88, no. 6, Dec. 2017, pp. 581–586. ​Academic Search Complete,​

EBSCOhost​,​ ​28 Dec. 2017.

http://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,custuid&custid=s8455

861&db=a9h&AN=126129120&site=ehost-live&scope=site​.

"Orthopedics." ​Funk & Wagnalls New World Encyclopedia,​ 2017, p. 1p. 1. ​EBSCOhost,​ 26 Dec.

2018.
 Krehnbrink 19

http://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,custuid&custid=s8455

861&db=funk&AN=OR032200&site=ehost-live&scope=site

“Orthopedic Surgery (Orthopedics).” ​Oxford Illustrated Companion to Medicine​, Oxford

University Press, 2001, Jan. 2001, p. 599. ​Health Source: Consumer Edition.​ ​Academic

Search Complete​, ​EBSCOhost​,​ ​22 Dec. 2017.

http://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,custuid&custid=s8455

861&db=hxh&AN=7371692&site=ehost-live&scope=site​.

"Orthotic and Prosthetic Technician." ​Techniques: Connecting Education & Careers,​ vol. 83, no.

1, Jan. 2008, p. 58. ​EBSCOhost​, 30 Dec. 2017.

http://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,custuid&custid=s8455

861&db=f6h&AN=28407334&site=ehost-live&scope=site

Park, Michelle. "Who to Watch in Healthcare." ​Crain's Cleveland Business​, vol. 33, no. 27, 16

July 2012, p. 0013. ​Academic Search Complete​, ​EBSCOhost​,​ ​22 Dec. 2017.

http://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,custuid&custid=s8455

861&db=b9h&AN=78172346&site=ehost-live&scope=site​.

Peltier, Leonard F. ​Orthopedics: A History and Iconography.​ Norman Publishing, 1993,​ ​29 Jan.

2018.

books.google.com/books?id=iYXel4RXuU8C&printsec=frontcover&dq=orthopedics+an

+iconography&hl=en&sa=X&ved=0ahUKEwj7vpyXkoXZAhUEwVkKHX5aDrkQ6AEI

KDAA#v=onepage&q=orthopedics%20an%20iconography&f=false.

Prioreschi, Plinio. ​A History of Medicine: Primitive and Ancient Medicine.​ 2nd ed., vol. 1,

Horatius Press, 1991, 29 Jan. 2018.

 Krehnbrink 20

books.google.com/books?id=MJUMhEYGOKsC&printsec=frontcover&dq=A+History+

of+Medicine:+Primitive+and+ancient+medicine&hl=en&sa=X&ved=0ahUKEwiEvfmm

rYbZAhWBuFMKHYINCS0Q6AEIJjAA#v=onepage&q=A%20History%20of%20Medi

cine%3A%20Primitive%20and%20ancient%20medicine&f=false.

“Prosthetics.” ​Funk & Wagnalls New World Encyclopedia​, World Book, Inc., 2017, pp. 1p. 1.

Funk & Wagnalls New World Encyclopedia.​ ​Academic Search Complete,​ ​EBSCOhost,​ 29

Dec. 2017.

http://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,custuid&custid=s8455

861&db=funk&AN=PR141200&site=ehost-live&scope=site​.

Romero, Melissa. "The Latest Treatments." ​Men's Health​, vol. 31, no. 6, Jul/Aug2016, p. 91.

EBSCOhost​, 15 Feb. 2018.

http://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,custuid&custid=s8455

861&db=f6h&AN=115874466&site=ehost-live&scope=site​.

Saikia, Angana, et al. "Recent Advancements in Prosthetic Hand Technology." ​Journal of

Medical Engineering & Technology,​ vol. 40, no. 5, July 2016, pp. 255-264. ​Academic

Search Complete​, ​EBSCOhost​, 28 Dec. 2017.

http://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,custuid&custid=s8455

861&db=a9h&AN=116265301&site=ehost-live&scope=site​.

Shier, David, et al. ​Hole's Essentials of Human Anatomy & Physiology.​ 12th ed., McGraw Hill,

2015, 13 Feb. 2018.

books.google.com/books?id=O3JzCgAAQBAJ&pg=PA9&dq=ancient+egypt+wooden+t
 Krehnbrink 21

oe&hl=en&sa=X&ved=0ahUKEwi39buuoLnZAhUK7lMKHZGlA7sQ6AEIJjAA#v=one

page&q=ancient%20egypt%20wooden%20toe&f=false.

“Stepping to the Front: Women in Orthopaedic Leadership.” ​AAOS Now​, vol. 7, no. 3, Mar.

2013, pp. 6–7. ​Academic Search Complete​, ​EBSCOhost​, 22 Dec. 2017.

http://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,custuid&custid=s8455

861&db=a9h&AN=86054361&site=ehost-live&scope=site​.

“Studies: Duke University.” ​Naviance Family Connection,​ N.p., n.d. Web. 10 Feb. 2018.

https://static.naviance.com/family-connection/colleges/#/hubs/4c5420a3-c9c1-4a8b-8a5f-

d47d428f5af3/Studies

“Studies: University of North Carolina at Chapel Hill.” ​Naviance Family Connection,​ N.p., n.d.

Web. 10 Feb. 2018.

https://static.naviance.com/family-connection/colleges/#/hubs/4c62d94b-2fcc-4430-957f-

c829856c7974/Studies

“Tuition & Financial Support.” ​Duke University,​ 19 Feb. 2018.

medschool.duke.edu/education/degree-programs-and-admissions/master-biomedical-scie

nces/tuition-financial-support