Orthopedic Surgeon

Also referred to as orthopaedics, orthopaedic surgeons are doctors who focus on bone, joint and muscle surgery. Orthopaedic surgeons are specialists in treating disorders in the musculoskeletal system that comprises of bones, ligaments, joints, muscles, tendons and nerves. Corrective surgeries such as joint replacement and removal of torn cartilages are also performed by these surgeons. Orthopaedic surgeons can also specialize in certain areas of surgery such as shoulder surgery, hand surgery etc.

After completion of medical school, they have to complete another five years residency of which one year is concentrated in general surgery and the rest in the field of orthopaedic surgery. They can train for another one year in any kind of sub-specialization if they are interested. Orthopedic surgeons specialize in:

• Joint replacement surgeries.
  
• Treating injuries in athletes and in athletic surgeries.
  
• Hip replacement, hip surgery in adults.
  
• Sports medicine.
  
• Treating dislocations and lacerations.
  
• Set right broken bones.
  
• Perform reconstructive hip and knee surgery in adults.
  
• Spinal surgeries
  
• Arthroscopic surgery.
  
• Treat hand injuries and conduct hand surgeries.
  
• Treat conditions related to arthritis.

Latest techniques employed in orthopaedics

• Arthroscopic tools are used for re-constructing torn ligaments in a non-invasive method where in the patient recovers in a few days after the surgery rather than months as required to recover in open surgeries.
  
• Uni-compartment knee replacement facilitates replacement of one of the knees and is very popular.
  
• Joint replacement surgeries have become easier with the use of newer materials as replacement substitutes.
  

Femur fracture

The word 'femur' is taken from Latin meaning 'thigh'. The femur is the thigh bone and it is the largest and strongest bone in the human body. The femur bone extends from the hip to the knee joint. A femur fracture can be life threatening. Since the inside of the thigh is a place of major blood vessels, broken femur means break in the artery. Femur fracture is also called femoral shaft fracture, femur injury, femur stress fracture, fractured femur, femur trauma and femoral diaphyseal fracture. Femur is a tremendously strong bone. It usually requires a great deal of force to break the femur bone. The most common causes for femur fractures include:

• Falls from a great height
  
• Blows that are strong in force
  
• Car accidents and Collisions
  
• Severe twists
  
• Bones weakened by osteoporosis, tumor or infection leading to a condition called pathologic femur fracture.
  

Proximal femur fracture: This involves fracture in the uppermost portion of the thighbone adjacent to the hip joint. are further sub divided into different types.

Femoral shaft fracture: The femoral shaft fracture is a severe injury that occurs during high-speed motor vehicle collisions and significant falls. Injuries caused by femoral shaft fractures are usually severe. Treatment of femoral shaft fracture is always with surgery. The common procedure is to insert a metal rod bone, called 'intramedullary rod' down the center of the thigh. The two ends of the bone are connected by the rod. This intramedullary rod usually remains in the bone for the life of the patient but can be removed if it causes pain and other problems.

Supracondylar femur fracture: In this kind of fracture, the injury occurs just above the knee joint. Cartilage surface of the knee joint is usually involved in this fracture. Patients who sustain supracondylar femur fracture are at high risk of developing knee arthritis later. Supracondylar femur fracture is common in patients with severe osteoporosis. Patients who have undergone total knee replacement surgery also run the risk of this fracture. Treatment for supracondylar femur fracture is highly variable. A cast or brace, external fixator, plate, screws or intramedullary rod are used for treatment.

Symptoms of femur fracture include swelling, bruising and severe pain. There may be numbness or paralysis in the leg below the femur fracture. Femur fractures are apparent and visible in many cases. Apart from clinical examination by the orthopaedic, for non-apparent fractures, a bone scan is required. Treatment for fractures of femur depends upon various factors such as the patient's age, type of fracture, location of the break, bone stability in the injured, mechanism of injury, direction of the blow, factors of twisting, existence of internal bleeding and extent of soft tissue damage. Some of the methods of treatment are:

• Reduction or re-alignment
  
• Immobilization whereby the movement is restricted
  
• Insertion of an intramedullary fixation
  
• A cast
  
• External fixation such as a frame on the outside of the leg anchored into the bone using pins.
  

• Pain or arthritis
  
• Rotational deformity due to misalignment
  
• Infections in open fractures
  
• Uneven leg length
  
• Injury of blood vessels
  
• Nerve damage
  
• Compartment syndrome
  
• Amputation
  
• Failure to heal - 'non-union' is also a possibility
  

Intra articular sepsis, arthritis and knee stiffness are some of the permanent complications that can occur among persons who have undergone femur fracture and treatment. Sometimes femur fracture is bound to cause permanent disability in injured persons. This is due to the thigh muscle pull and incorrect reunion of fragments when they overlap. Femur fracture patients should be careful not to put weight on the leg as this can delay the healing process.