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Orthopedic services

 

Orthopedics, or orthopedic services, aim at the treatment of the musculoskeletal system. This includes your bones, joints, ligaments, tendons, and muscles.

Information

There can be many medical problems that can affect the bones, joints, ligaments, tendons, and muscles.

Bone problems may include:

  • Bone deformities
  • Bone infections
  • Bone tumors
  • Fractures
  • Need for amputation
  • Nonunions: failure of fractures to heal
  • Malunions: fractures healing in a wrong position
  • Spinal deformities

Joint problems may include:

  • Arthritis
  • Bursitis
  • Dislocation
  • Joint pain
  • Joint swelling or inflammation
  • Ligament tears

Common orthopedic-related diagnoses based on body part include:

ANKLE AND FOOT:

  • Bunions
  • Fasciitis
  • Foot and ankle deformities
  • Fractures
  • Hammer toe
  • Heel pain
  • Heel spurs
  • Joint pain and arthritis
  • Sprains
  • Tarsal tunnel syndrome
  • Sesamoiditis

HAND AND WRIST:

  • Fractures
  • Joint pain
  • Arthritis
  • Tendon or ligament injury
  • Carpal tunnel syndrome
  • Ganglion cyst
  • Tendinitis
  • Tendon tears
  • Infection

SHOULDER:

  • Arthritis
  • Bursitis
  • Dislocation
  • Frozen shoulder ( adhesive capsulitis )
  • Impingement syndrome
  • Loose or foreign bodies
  • Rotator cuff tear
  • Rotator cuff tendinitis
  • Separation
  • Torn labrum
  • SLAP tears
  • Fractures

KNEE:

  • Cartilage and meniscus injuries
  • Dislocation of the kneecap (patella)
  • Ligament sprains or tears (anterior cruciate, posterior cruciate, medial collateral, and lateral collateral ligament tears)
  • Loose or foreign bodies
  • Osgood-Schlatter disease
  • Pain
  • Tendinitis
  • Fractures

ELBOW:

  • Arthritis
  • Bursitis
  • Dislocation or separation
  • Ligament sprains or tears
  • Loose or foreign bodies
  • Pain
  • Tennis or golfers elbow ( epicondylitis or tendinitis)
  • Elbow stiffness or contractures
  • Fractures

SPINE:

  • Herniated (slipped) disk
  • Infection of the spine
  • Injury to the spine
  • Scoliosis
  • Spinal stenosis
  • Spinal tumor
  • Fractures
  • Spinal cord injuries

SERVICES AND TREATMENTS

Imaging procedures can help diagnose or even treat many orthopedic conditions. Your health care provider may order:

  • Arthrogram (joint x-ray)
  • Bone scans
  • Computed tomography (CT) scan
  • Discography
  • Magnetic resonance imaging (MRI) scan
  • X-rays

Sometimes, treatment involves injections of medicine into the painful area. This may involve:

  • Corticosteroid injections into joints, tendons, and ligaments, and around the spine
  • Hyaluronic acid injection to help relieve arthritis pain

Surgical procedures used in the treatment of orthopedics include:

  • Amputation
  • Arthroscopic surgeries
  • Bunionectomy and hammer toe repair
  • Cartilage repair or resurfacing procedures
  • Cartilage surgery to knee
  • Fracture care
  • Arthroplasty
  • Ligament reconstructions
  • Repair of torn ligaments and tendons
  • Spine surgery, including diskectomy, foraminotomy, laminectomy, and spinal fusion

Newer orthopedic services procedures include:

  • Minimally invasive surgery
  • Advanced external fixation
  • Use of bone graft substitutes and bone-fusing protein

WHO IS INVOLVED

Orthopedic care often involves a team approach. Your team may include a doctor, a non-doctor specialist as well as others. Non-doctor specialists are professionals such as a physical therapist.

  • Orthopedic surgeons receive 5 or more extra years of training after school. They specialize in the care of disorders of the bones, muscles, tendons, and ligaments. They are trained to manage joint problems with both operative and non-operative techniques.
  • Physical medicine and rehabilitation doctors have 4 or more extra years of training after medical school. They specialize in this type of care. They are also referred to as physiatrists. They do not perform surgery, although they can give joint injections.
  • Sports medicine physicians are doctors with experience in sports medicine. They have a primary specialty in family practice, internal medicine, emergency medicine, pediatrics, or physical medicine and rehabilitation. Most have 1 to 2 years of additional training in sports medicine through subspecialty programs in sports medicine. Sports medicine is a special branch of orthopedics. This provides complete medical care to active people of all ages.

Other doctors that may be a part of the orthopedics team include:

  • Neurologists
  • Pain specialists
  • Primary care doctors
  • Psychiatrists
  • Chiropractors

Non-doctor health professionals that may be a part of the orthopedics team include:

  • Athletic trainers
  • Counselors
  • Nurse practitioners
  • Physical therapists
  • Physician assistants
  • Psychologists
  • Social workers
  • Vocational workers

 

Open References

References

Ball JW, Dains JE, Flynn JA, Solomon BS, Stewart RW. Musculoskeletal system. In: Ball JW, Dains JE, Flynn JA, Solomon BS, Stewart RW, eds. Seidel's Guide to Physical Examination . 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 21.

Crenshaw AH. Surgical techniques and approaches. In: Canale ST, Beaty JH, eds. Campbell's Operative Orthopaedics . 12th ed. Philadelphia, PA: Elsevier Mosby; 2013.chap 1.

Epicondylitis. First Consult. 2011. www.clinicalkey.com/#!/content/medical_topic/21-s2.0-1014923 . Accessed: April 26, 2016.

Swartz MH. The musculoskeletal system. In: Swartz MH, ed. Textbook of Physical Diagnosis . 7th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 17.

Williams DT, Kim HT. Wrist and forearm. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts And Clinical Practice . 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 51.

 

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                Review Date: 3/10/2016

                Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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