Introduction to

Orthopedics
 Congenital disorders
 Development disorders
Prof. Jao Mulimba
 Genetic disorders e.g. blood e.g.
sickle cell anemia, storage
Study of locomotor system. disorders

Historically derived from Greek  Inflammatory - infective e.g.

meaning straight child. Osteomyelitis

Termed by Andre in 1741 - non-infective e.g.

Scope of locomotor system
 Bones
 Joints
 Muscles and tendons
 Ligaments
 Bursae
 Nerves
 Blood vessels
Orthopedics: Derangements of the
locomotor system
Orthopedic Trauma: injury of
locomotor system
Rheumatoid arthritis
 Degenerative disorders e.g.
Osteoarthritis
 Tumours e.g. Osteosarcoma,
Osteoclastoma
 Misc. - Osteoporosis
Scope of Orthopedic Trauma
 Fractures - excluding chest and
skull
 Dislocations
 Sub-laxations
 Muscle and tendon injuries
 Ligamentous injuries
 Nerve injuries
 Blood vessels
 Cartilage
  Accompanying person may have
something to fill in
 Discourage complete take-over
In the time of Andre ortho was
by accompanying person
primitive and now has become very
sophisticated as a result of:
 Development of anaesthesia
 Development of aseptic
techniques
Examination
 Development of imaging
 Adequately expose patient -
 Metallurgy and other implants most important factor.
 Plasters  Look carefully
 Labs  Ask patient to move the part
 Passively move the part, always
look at the patients face.
 Document tenderness or
otherwise.
Management is methodical:
 Further examination will
 History depend on the region and the
condition
 Examination
 If patient has to turn, see how
 Investigation
he/she does it.
 Treatment
 Rehabilitation

Investigations
 Decide on the investigations to
History be done.
 Patient should give own story  Remember they are expensive
 Ask a few leading questions to  E.g. of investigations:
fill in the gaps -Blood
-Special Fluids
 -X-rays
-Scans: CT, MRI, Isotopic, PET

Orthopedic Technologists
 Arthroscopy - any joint
Prepare all sorts of appliances
 Biopsy - FNA, Core Biopsy, Open
biopsy, X-ray guided  Crutches
 Prostheses
 Etc

Treatment is broadly divided into 2;

 Conservative - non-operative
 Operative Operative
 Muscles - usually not amenable
to repair
Requires technical know-how,
instruments, implants appropriate  Tenetomy - division of a tendon
theatres.
 Elongation e.g. Elongation of
TendoAchilles (ETA) done in
club foot
 Transposition - Transfer
 Release - Tenolysis e.g. De
Occupational Therapy
Quervains syndrome - usually
 Rehabilitation with methods during pregnancy
relevant to work and profession
 Tenodesis -
 Includes kitchen, bath and
lavatory
 Printing/typing
 Woodworking
Bones

Chiropractors  Osteotomy - breakage of bones

 Not many in this country  Osteosynthesis - fixing fractures

Joints
 Arthroscopy - opening a joint
 Aspiration
 Synovectomy
 Arthrodesis - fusion of joint
 Arthoplasty - construct joint
 Excision
 Hemi arthroplasty
 Total arthroplasty