ORTHOPEDICS

also called orthopedic surgery medical specialty concerned with the preservation and restoration of function of the skeletal system and its associated structures, i.e., spinal and other bones, joints, and muscles. Orthopedics began in the 18th century with the pioneering efforts of Jean Andr Venel, who established an institute in Switzerland for the treatment of crippled children's skeletal deformities. A vastly increased knowledge of muscular functions and of the growth and development of bone was gained in the 19th century. Significant advances at this time were the new operation of tenotomy (the cutting of tendons, which made correcting deformities easier), the surgical correction of clubfoot, the invention of the Thomas splint (which provided better support for fractures of long bones in the limbs), and the introduction of quick-setting plaster of Paris for use in orthopedic bandages. The efforts of Sir Robert Jones and the massive casualties of World War I led to the founding of many orthopedic training centres in the early 20th century. Modern orthopedics has extended beyond the treatment of fractures, broken bones, strained muscles, torn ligaments and tendons, and other traumatic injuries to deal with a wide range of acquired and congenital skeletal deformities and with the effects of degenerative diseases such as osteoarthritis. A specialty that originally depended on the use of heavy braces and splints, orthopedics now utilizes bone grafts and artificial plastic joints for the hip and other bones damaged by disease, as well as artificial limbs, special footwear, and braces to return mobility to disabled patients. Orthopedics uses the techniques of physical medicine and rehabilitation and occupational therapy in addition to those of traditional medicine and surgery.