Orthopaedics Health Dictionary

More popularly called ‘keyhole surgery’, MIS is surgical intervention, whether diagnostic or curative, that causes patients the least possible physical trauma. It has revolutionised surgery, growing from a technique used by gynaecologists, urologists and innovative general surgeons to one regularly used in general surgery, GYNAECOLOGY, UROLOGY, thoracic surgery, orthopaedic surgery (see ORTHOPAEDICS) and OTORHINOLARYNGOLOGY.

MIS is commonly carried out by means of an operating laparoscope (a type of ENDOSCOPE) that is slipped through a small incision in the skin. MIS now accounts for around 50 per cent

of all operations carried out in the UK. A small attachment on the end of the laparoscope provides an image that can be magni?ed on a screen, leaving the surgeon’s hands free to operate while his assistant operates the laparoscope. Halogen bulbs, ?breoptic cables and rod lenses have all contributed to the technical advancement of laparoscopes. Operations done in this manner include extracorporeal shock-wave LITHOTRIPSY for stones in the gall-bladder, biliary ducts and urinary system; removal of the gall-bladder; appendicectomy; removal of the spleen and adrenal glands; and thoracic sympathectomy. MIS is also used to remove cartilage or loose pieces of bone in the knee-joint.

This method of surgery usually means that patients can be treated on a day or overnight basis, allowing them to resume normal activities more quickly than with conventional surgery. It is safer and lessens the trauma and shock for patients needing surgery. MIS is also more cost e?ective, allowing hospitals to treat more patients in a year. Surgeons undertake special training in the use of MIS, a highly skilled technique, before they are permitted to use the procedures on patients. The use of MIS for hernia repair, colon surgery and repairs of duodenal perforations is under evaluation and its advantages will be enhanced by the development of robotic surgical techniques.... minimally invasive surgery (mis)

That branch of medicine involved in the treatment of injuries, deformities or individual diseases by operation or manipulation. It incorporates: general surgery; specialised techniques such as CRYOSURGERY, MICROSURGERY, MINIMALLY INVASIVE SURGERY (MIS), or minimal access (keyhole) surgery, and stereotactic sugery (see STEREOTAXIS); and surgery associated with the main specialties, especially cardiothoracic surgery, gastroenterology, GYNAECOLOGY, NEUROLOGY, OBSTETRICS, ONCOLOGY, OPHTHALMOLOGY, ORTHOPAEDICS, TRANSPLANTATION surgery, RECONSTRUCTIVE (PLASTIC) SURGERY, and UROLOGY. Remotely controlled surgery using televisual and robotic techniques is also being developed.

It takes up to 15 years to train a surgeon from the time at which he or she enters medical school; after graduating as a doctor a surgeon has to pass a comprehensive two-stage examination to become a fellow of one of the ?ve recognised colleges of surgeons in the UK and Ireland.

Surgery is carried out in specially designed operating theatres. Whereas it used to necessitate days and sometimes weeks of inpatient hospital care, many patients are now treated as day patients, often under local anaesthesia, being admitted in the morning and discharged later in the day.

More complex surgery, such as transplantation and neurosurgery, usually necessitates patients being nursed post-operatively in high-dependency units (see INTENSIVE THERAPY UNIT (ITU)) before being transferred to ordinary recovery wards. Successful surgery requires close co-operation between surgeons, physicians and radiologists as well as anaesthetists (see ANAESTHESIA), whose sophisticated techniques enable surgeons to undertake long and complex operations that were unthinkable 30 or more years ago. Surgical treatment of cancers is usually done in collaboration with oncologists. Successful surgery is also dependent on the skills of supporting sta? comprising nurses and operating-theatre technicians and the availability of up-to-date facilities.... surgery

A therapeutic technique involving the skilful use of the hands to move a part of the body, joint, or muscle to treat certain disorders. Manipulation is important in orthopaedics, physiotherapy, osteopathy, and chiropractic.

Manipulation may be used to treat deformity and stiffness caused by bone and joint disorders, to realign bones in a displaced fracture, to reposition a joint after a dislocation, or to stretch a contracture.

Occasionally, manipulation is used to help treat frozen shoulder.... manipulation

n. (in orthopaedics) increasing the distance between two points. In *limb lengthening procedures callus can be stretched longitudinally by increasing the distance between pins attached to the bone (see callotasis).... distraction

n. 1. an instrument that is used to raise a depressed broken bone, for example in the skull or cheek. A specialized periosteal elevator is used in orthopaedics to strip the fibrous tissue (periosteum) covering bone. 2. a lever-like instrument used to ease a tooth or root out of its socket during dental extraction.... elevator

a preparation of gypsum (calcium sulphate) that sets hard when water is added. It is used in various modified forms in dentistry to make *plaster models. It is also used in orthopaedics for preparing plaster *casts.... plaster of paris

An abbreviation for oral rehydration therapy. (See also rehydration therapy.)

ortho- A prefix meaning normal, correct, or straight, as in orthopaedics, a branch of surgery concerned with correcting disorders of the bones and joints.

orthodontic appliances Fixed or removable devices, commonly known as braces, worn to correct malocclusion, or to reposition overcrowded or buck teeth. Usually fitted during childhood and adolescence, they move teeth using sustained gentle pressure. A fixed appliance has brackets attached to the teeth through which an arch wire is threaded and tightened to exert pressure. These are usually kept in place for about a year, after which time a retainer plate may be needed to hold the teeth in place until tooth and jaw growth has finished.

Removable appliances, consisting of a plastic plate with attachments that anchor over the back teeth, are used when only one or a few teeth need correcting. They apply force by means of springs, wire bows, screws, or rubber bands fitted to the plate.... ort