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Unformatted text preview: PT 425 – Clinical Medicine I Winter 2002
Course Syllabus & Requirements & Introduction to Orthopaedic Medicine Introduction to Orthopaedic Medicine What is orthopaedic medicine? … the branch of medicine concerned with the diagnoses (dx), treatment (rx), and prevention of diagnoses ), dysfunctions & diseases of the musculoskeletal system (MS) system …includes muscles, tendons, ligaments, joints, includes and bones of the trunk & extremities and …by medical, surgical, and physical methods Related Terms
ICIDH : ICIDH Disease, Impairment, Disability, Disease, Handicap Handicap Nagi: Disease, Impairment. Functional Disease, limitations, Disability limitations, ICIDH Definitions
Impairment -- any loss/abnormality of psychological, physiologic, or anatomic structure/function structure/function can be temporary or permanent occur at organ level Example: loss of proprioception in a leg Example: resulting in decreased sensory input to CNS resulting ICIDH Definitions Disability -- any restriction/lack of ability to perform activity in a normal way (WNL) perform disability status or activity restriction describes disability how impairment affects activities at work/home how e.g., lack of proprioception may cause e.g., excessive weight shift, > risk of falling excessive Not all disease leads to impairment; not all Not impairment leads to a disability impairment ICIDH Definitions
Handicap : any disadvantage for an impaired/disabled person that limits/prevents fulfillment of normal life roles roles Example: lack of independent mobility in Example: the community the International Symbol Nicholas Andry’s Nicholas “Orthopaedic Tree” from his 18th Century from book book Captures the idea that Captures the young can be straightened with right application of forces application Brief History of Orthopaedics 9000 BC (Paleolithic Age) Use of splints for broken & weak bones 5000 BC (Neolithic Age) Crude amputations for diseased/damaged limbs 2000 BC (Egyptian Period) Developed concept of the crutch Greek culture Hippocrates, the ‘Father of Medicine’ Significant Discoveries
General anesthesia (Long & Morton, USA) Bacterial basis of disease (Pasteur, FRA) Antisepsis (Lister, Scotland) X-rays (Roentgen, Germany) X-rays ‘Father of Modern Orthopaedics’
Nicolas Andry published Orthopaedia, or Nicolas the Art of Preventing and Correcting Deformities in Children in 1741 Deformities Orthos (straight or free of deformity) Pais (child) 20th Century Developments
1rst Phase “strap & buckle” phase that featured strap splints, braces, and other appliances; the predominant form of management predominant 2nd Phase Excessive surgical operations based on Excessive clinical empiricism, not scientific investigation investigation Current Phase
Science replaced empiricism Experimental laboratory investigations Retrospective clinical investigations Evidenced-based practice Prospective clinical trials Study the natural course of disorders and Study critically evaluate the results of various forms of treatment forms Development of Sub-specialties
Pediatric orthopaedics Hand surgery Sports Medicine Spinal surgery Joint replacement surgery More can be found on AAOS website… www.aaos.org Complementary Medical Specialists
Rheumatologist Radiologist Physiatrist (Physical medicine) Neurosurgeons Internal medicine specialists Podiatrists Oncologists Prevalence
MS disorders & injuries are fairly common Prevalence is high; 2nd to CVD in frequency Most common cause of disability In North America, > 15 % of the total # of In pts seen by a primary care, or family, physician suffer from a disorder/injury of the MS system, either with or without a cothe existing condition Diversity of Patients & Sites Examples? 1 2 3 4 5 6 Present Scope of Practice
Consists of the art & science of prevention, Consists investigation, diagnosis, and treatment of disorders and injuries of the MS system by medical, surgical, and physical means medical, Desired outcome of orthopaedic treatment? Recent Advances
Total prosthetic joint replacements Limb salvage operations to reduce the Limb number of amputations (microsurgery) number ‘Distraction osteogenesis’ technique Distraction (Ilizarov technique) (Ilizarov More effective nonoperative treatments Bracing, e-stim, CPM, steroid injections ...
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This note was uploaded on 04/22/2011 for the course ERG 101 taught by Professor Hawthorne during the Fall '10 term at Grand Valley State.
- Fall '10