Talk:Orthopedic surgery

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Contents 1 Ambiguity 2 Question 3 Templates 4 Spelling (requested move) 5 Spelling again - need more people's views 6 Linkspam 7 Dr. Goodley's comments

[edit] Ambiguity

"Particularly important for injured athletes was the use of arthroscopic tools by Dr. Watanabe of Japan"

Watanabe is a very common name in Japan. Replace "Watanabe" with "Brown" or "Smith" and read that sentence again. Sounds ambiguous, no?

Dr. Kirschner did wires as in K or Kirschner wires. IM rodding was pioneered by Dr. Kutchner (? SP) of Germany and Dr. Rush of Meridian Mississippi.

Correct spelling of the IM rod pioneer is Kunschner. He started using IM rods before world war II but German soldiers injured during that war recovered much quicker than Allied soldiers. As a result treatment with "K nails" became more popular in North America. However, traction treatment for fractured femurs was still the standard until 1970's when locked intramedullary rods inserted without opening up the fracture was popularised by Dr Winquist in Seattle. A great orthopaedic pioneer not mentioned in this account is Dr Ilizarov whose work with external fixators revolutionized the treatment of non-union and malunion of fractures. Myles Clough MD (user Mylesclough)Sept 20th 2005

Myles, could you update this article accordingly? This is of major historical interest and definitly worthy of inclusion. A historical overview of the orthopedic field, e.g. the AO rules, K wires, Pauwels and Garden... JFW | T@lk 17:22, 21 September 2005 (UTC)

I think that Pauwels and Garden should be discussed with reference to hip fracture and AO contributions, K wires etc in bone fracture --Mylesclough 00:24, 22 September 2005 (UTC)

OK JFW | T@lk 17:04, 22 September 2005 (UTC)

I noticed that there was no wikipedia entry for Hipocrates (?spelling) or for medical indications, both of which deserve an entry IMHO Reconstructive surgery bounces to Plastic surgery. Orthopods think of Reconstructive Surgery as joint replacement and other bone reconstruction. It is a separate subject. --Mylesclough 05:15, 23 September 2005 (UTC)

Hippocrates is a good page. Medical indication indeed has not been written; you are free to change indication from a redirect into a disambig.

As for reconstructive surgery, this is indeed a good point. Again, you may wish to change the redirect into a stub (or even a full page) to emphasise that reconstructive surgery is germane to all branches of surgery. JFW | T@lk 07:16, 23 September 2005 (UTC)

I have either got into or created a muddle over reconstructive surgery. I wrote a short article describing orthopaedic reconstructive surgery then created a reconstructive surgery (disambiguation) page. I had thought that the creation of a disambiguation page would automatically mean that all links would land on it. At the moment the page is held up on the database somewhere so I cannot test that. After I had done all that I thought it would bave been much simpler to create a new page Reconstructive Surgery (Orthopedics) and leave Reconstructive surgery to the Plastic surgery guys. Please advise --Mylesclough 06:36, 25 September 2005 (UTC)

It's okay now, although in the future the page may develop seperate sections for the plastic and orthopedic forms of reconstruction. If you think the principles of reconstructive orthopedics are radically different, you may choose to start reconstructive surgery (orthopedics), but now it's still okay. JFW | T@lk 17:30, 26 September 2005 (UTC)

It's not totally OK because reconstructive surgery lands on my new page not on the disambiguation page - which I cannot now find. I suspect that I didn't know how to establish a disambiguation page correctly. The result is that all the links from Plastic surgery subjects which were originally redirected from reconstructive surgery to plastics now land on the new page. They can get through to Plastics so this page is in a sense a disambiguation page but not in official form. Sorry --Mylesclough 21:55, 26 September 2005 (UTC)

I have collected some images from the Orthopaedic Trauma Association site and am planning to put them on the page about hip fractures. They have a statement on their site "To encourage the use of this compendium of fractures, reproduction of the figures and use of the classification is possible without the need to request permission from the OTA or publisher." I explored the Wikipedia Help page about uploading images and was bemused by all the different copyright options etc. Can you give me a quick run down about this specific situation and one in which I personally get permission from the copyright holder to post an image on Wikipedia. --Mylesclough 23:41, 26 September 2005 (UTC)

[edit] Question

--> SPELLING QUESTION: WHY IS THIS WORD SPELLED Orthopaedic AND Orthopedic AT SEEMINGLY RANDOM TIMES, BOTH IN THE ARTICLE, AND IN THE DISCUSSION OF THE ARTICLE??? —The preceding unsigned comment was added by Testing123abc (talk • contribs) 24 December 2005.

[edit] Templates

Orthopaedics and most other surgical subjects have at least two aspects which would benefit from a standardized approach. One subject is the conditions that may be treated surgically and the other is an account of the operation (procedure) that a surgeon might perform. To help us get organized I propose the following template for orthopaedic procedures viz
Name of Procedure;
Description;
Synonyms;
Technique;
Variations;
Indications;
Contra-Indications;
Pre-Operative Work-up;
Post-Operative Rehabilitation;
Timecourse of recovery;
Risks and Complications;
Controversies;
Prognosis;
History.
I have used this template for Knee replacement and would appreciate comments.

A template for conditions might be one that is common to all medical conditions not just orthopaedic ones. However, because the key issue in potentially surgical conditions is the question of operative indications I think that a specifically surgical template for conditions is justifiable and might be
Name
Definition
Synonyms
Incidence
Pathogenesis and predisposing factors
Pathology
Stages
Classification
Natural History/Untreated Prognosis
Clinical Features
Investigation
Non-Operative Treatment
Risks of Non-Operative Treatment
Prognosis following Non-Operative Treatment
Operative Treatment (Note that each operations should have its own wiki entry)
Risks of Operative Treatment
Prognosis Post Operation
Complications
Management
Prevention
History
n

Comments? Provisionally I have copied the template to the talk page of all the orthopaedic stub pages I could find.--Mylesclough 05:18, 8 October 2005 (UTC)

When I have a moment (probably tomorrow), I'll fix any double redirects and similar issues relating to the move (specifically, the related category name), unless anyone gets there first. Arbitrary username 11:01, 31 May 2006 (UTC)

 ?! I count two opinions expressed in favor, two against. This move needs to be undone, and more time given to the matter. Please don't make any other changes until the move is reverted. BrianinStockholm 11:08, 31 May 2006 (UTC)

Most administrators are anti-Americans of one stripe or another. The policy on spelling is, in practice, make it British/Commonwealth whenever possible. This Night Stallion person is just adhering to the de facto policy. Outrageous, yes, but no one here seems to care. Too bad.

Please assume good faith. I suspect Nightstallion will realize his error -- what I in any event believe is an error -- and revert it. That's not to say there's not a lot of anti-American bias in Wikipedia. There is; and there's also a bit of anti-British bias. To be expected. Best, BrianinStockholm 11:33, 31 May 2006 (UTC)

Fine, I won't make any other changes until this discussion has run its course. Though I think that to say "until the move is reverted" does rather seem to be prejudging the result. Arbitrary username 11:58, 31 May 2006 (UTC)

I agree. :) Sorry. But it seemed so obvious to me that the move was made incorrectly that I assumed it would immediately be reverted. BrianinStockholm 12:18, 31 May 2006 (UTC)

[edit] Spelling again - need more people's views

What seems to have happened regarding the spelling is now unfortunately messy. There is contention about whether Nightstallion made the right decision or not. I agree that simply based on the math Nightstallion's decision was questionable, but then again Knowledge Seeker is (or has been) a physician in the US (see earlier versions of user page e.g. [1]) so ought to have more idea than most about what it's actually called in US English, and Nightstallion could legitimately have given weight to this. But whichever way one might interpret the discussion so far, hopefully we all agree that it has only involved a small number of people, and I think that if there is disagreement it would be beneficial to attract more people to the discussion so as to result in a decision which will be more readily accepted as consensus. This is particularly important as the spelling appears in a number of places, and editing without consensus is liable to lead to inconsistencies, which I really think we ought to strive to avoid. These places are:

• the text within the article
• the name of the article
• the name of the category
• (maybe others?)

What is the best way to involve more people? I see that there is the RfC process, but it gives me the impression of being generally used for issues which have become rather heated, and I think it would be a great shame to categorize this essentially amicable disagreement in that way, so it would be nice to use something rather more informal to invite people to visit this talk page. I am going to post a note on Wikipedia talk:WikiProject Medicine. Other suggestions very welcome.

Arbitrary username 13:26, 2 June 2006 (UTC)

You (Arb. username) and I are both fairly new here, so this might be the blind leading the blind, but my impression is that it's policy to be very careful about involving other people. "Getting out the vote," for example, is against policy, I'm pretty sure (can't find a link to that part of policy right now). I agree it would help to have more people involved, but I lean more strongly than before towards thinking the article (and spelling in category name) should be left as is (after my revert of Nightstallion's move, that is). This represents a big change. One thing, though: you refer to a notion of what it's "actually called in US English." We don't need experts for that. We know that both are acceptable. And, speaking as a linguist, I'd be willing to bet that, if anything, the -ped- spelling is gaining the upper hand, since English (all dialects) are moving in the direction of reducing ae to e. Regardless, the orthopedics is definitely a correct spelling. That's not at issue. BrianinStockholm 14:27, 2 June 2006 (UTC)

Just a comment that I assume there is a difference between "getting out the vote" (i.e. inviting specific groups of people who are likely to support a particular POV), and widening the readership in a neutral way. At least, I sure hope there is! Anyway, you'll obviously realize that I disagree with your reversion of the move, but pending wider discussion I'll merely state it here because I don't think it would help anyone for us to get into a cycle of reversions. Regards, Arbitrary username 14:47, 2 June 2006 (UTC)

Yes, widening the readership in a neutral way would probably be fine. For the record: I believe in ruthless adherence to principle, so I'll revert my own revert of NS's revert if sentiment moves in that direction! Although, technically, I'm not sure what the operative principle is here, with the vote "officially" being closed, and the person who "took the pulse" having admitted he might have been wrong (to the extent that he suggested it would be OK for me to revert his change....) Complicated! Is the situation precisely as it would have been if no change had been made at all? If so, you'd need to call a new vote, but that itself, might be against policy, for obvious reasons (John Kerry can't call for a new election next week).... :-/ BrianinStockholm 15:07, 2 June 2006 (UTC)

Hello. Yes, I am (still) a resident physician (I still have the category listed on my user page). I don't have a strong preference to either spelling, but overall, as I mentioned above, I prefer orthopaedic in this case, though I am American and normally use American spellings. While American and British spellings should not be lightly switched, I don't think this is a simple American vs. British issue. Orthopedic is certainly less common in American English than orthopaedic, but see for instance its Merriam-Webster entry, compared to the one, say, for gynaecology, which is listed as a British variant. Undoubtedly both spellings are "correct". My personal philosophy in naming and spelling, both on Wikipedia and in real life, tends to give more credence to respected authorities or professional societies than to overall surveys of usage. Since my perception is many orthopaedic surgeons in the United States tend to use the ae spelling and professional societies like the AAOS use it, my preference is for that spelling. That said, there are many who use the e spelling and perhaps it will become more well-established with time (I am not a linguist and cannot pass judgment on this). Which spelling is ultimately used is not very important to me. I think it would be very appropriate to seek feedback (I'd recommend the clinical medicine WikiProject. — Knowledge Seeker দ 03:39, 3 June 2006 (UTC)

Hi. Just thought I'd pop my head up. A long time ago I read something about spelling with respect to english dialect variations - I'm not sure if it was a Wikipaedia policy or simply a suggestion, but it seemed quite sensible at the time - so here it is: Go with the spelling you use regionally, as long as it's correct (ie in a dictionary). Most people are aware that different english dialects have differing use of dipthongs and tend to allow for that in online searching. I'm training in orthopaedic surgery and so I routinely use both spellings , for example, in Medline searches etc. As long as there is consistency in the article it shouldn't really matter which spelling is used. And if you create an article who's name has recognised alternate spellings, create redirects in consideration of others who may want the information. That's it! Happy wiki-ing Mattopaedia 05:12, 3 June 2006 (UTC)

Hi. I work in the field, though not in the US, and my general preference is Orthopaedics. BrianinStockholm's points are well taken - as a liguist you would probably know better than I about the general trends for language going from "-paed-" to "-ped-". However, like Knowledge Seeker, I find that even many US Orthopaedics experts prefer the -paed- spelling, and my feeling for the field is that this spelling is still prefered overall.

I would point out that majority of the orthopaedics journals (http://freeortho.com/journals.html) use the -paed- spelling. Thus I heartily endorse a switch back. Aaron 16:55, 8 July 2006 (UTC)

[edit] Linkspam

Is there anything that can be done to discourage linkspam (unnecessary external links) from this subject area? I find it mildly annoying that this page keeps needing to be reverted. Dr Aaron 22:50, 30 August 2006 (UTC)

I am currently exploring options. The spammer is using a dynamic IP, so it is difficult to block them that way. We could put partial protection on this page, but this particular spammer is hitting a number of other pages. Until my latest attempt goes through, the best we can do is keep an eye on the changes and keep thwarting him. --Mdwyer 00:01, 31 August 2006 (UTC)

[edit] Dr. Goodley's comments

An important brief digression is essential here: The hidden consternation implicit in the above description of orthopedics is that this vast area of medicine, most of which is non-surgical, is viewed herein through minds dominantly predisposed to surgical approaches. That reality expresses medicine's Fundamental Flaw, from which the Pain Pandemic - the countless who unnecessarily persist in pain and impairment – emanates. Future historians may well call this last century a time of unnecessarily perpetuated pain. In contrast, comparable specialties such as neurology and neurosurgery; internal medicine and general surgery conjointly emerged balanced, dynamic and mutually respectful. But for a number of reasons, this did not happen in orthopedics. This story began about a century and a half ago when during one of medicine's low intellectual ebbs clinical biomechanics of the musculoskeletal system through hands-on examination and treatment was repudiated, skills that require special palpatory training and manipulative reasoning. Thus, osteopathy reluctantly emerged and then chiropractic to which traditionalism reacted with reflexive antagonism instead of reflecting and performing a "systems analysis" to study what had gone wrong. The medical scene became a war zone of confusion that continues to confound (realized or not) everywhere that Westernized medicine is practiced. Eventually, Orthopaedic Medicine developed as a discipline within medicine. Its scope includes caring for the commonest of conditions, the “aches and pains” that orthopedic surgeons willingly admit disinterests them. Unquestionably, Orthopaedic Medicine’s "Father" is Dr. James Cyriax, deceased, a British physician, author of the Textbook of Orthopaedic Medicine I & II. Unfortunately, "Jimmie" fell victim to his greatness and eventually concluded that if he could conceive of assembling such an encyclopedia of knowledge - and develop extraordinarily powerful fundamental tools for clinical examination -then all of his reasoning must have been of the same stature. It wasn't true, and he became deservedly controversial. The story is long one and requires its own space. (This statement is initially necessary because, in some minds, this controversy colors the major issue. It should not. While Dr. Cyriax was the first to begin codifying the discipline, his work does not circumscribe it.) It will be highly desirable for the purposes of Wikipedia if an Orthopaedic Medicine section be established for the full elicitation of this critically important discipline whose guidelines fulfill the requirements of a specialty. In essence, the musculoskeletal system (it can be more accurately but more complexly, described) can also be viewed as a machine where the joints, the ligaments etc. have equivalents. While problems of alignment may be expressed as pain and dysfunction, or squeaks, the effective approaches are similar, and restorative rebalancing becomes first obligation. I phrase, 'the task of the musculoskeletal clinician is to restore appropriate motion. All the rest is commentary.' The necessity is to follow all clues that are evident and commensurate with the patient's complaint. The traditional orthopedic examination is too coarse to distinguish the subtle abnormalities that traditionalism did not historically accept because "they" were doing such things. The realization is essential that the final book on the orthopaedic clinical examination has not been written. As one example of a cause for self-perpetuating therapeutic failure: the spine came to be clinically examined as if it were like a spring, with a unitary motion. The fact, of course, is that the vertebral column is a complex, multi-articulated structure whose small individual movements are normally reflexively coordinated into movements that appear to be unitary. That stated, the primary purpose of this digression is completed at this time. With respect and gratitude for the reader's attention, you are now returned to the orthopedic surgical perspectives. Contributed by Paul H. Goodley, M.D.

Welcome to Wikipedia. Please get a user account. You will have more rights and be taken more seriously. Your comments above are interesting, but are not written in a style suitable for the article. They can be discussed here, and if anything usable is developed, it can be added to the article a little bit at a time. -- Fyslee 13:09, 30 November 2006 (UTC)