Should be obliged to the doctor of the traumatologist of the trauma center. Doctor traumatologist orthopedist

Job description
traumatologist-orthopedist

1. This job description defines the duties, rights and responsibilities of a traumatologist-orthopedist.

2. A person who has a higher professional education in the specialty "General Medicine" or "Pediatrics", postgraduate professional education (internship and (or) residency) in the specialty "Traumatology and Orthopedics", a certificate of a specialist in the specialty "Traumatology and Orthopedics" without presenting requirements for work experience.

3. Traumatologist-orthopedist must know: Constitution Russian Federation; laws and other regulations legal acts Russian Federation in the field of healthcare; the basics of organizing medical and sanitary care, emergency medical care, specialized, including high-tech; theoretical foundations, principles and methods of clinical examination; organizational and economic foundations of the activity of a traumatologist-orthopedist and medical workers in the conditions of budgetary insurance medicine; fundamentals of occupational health, organization and economics of healthcare, medical ethics and deontology; legal aspects of medical activity; general principles and basic methods of clinical, instrumental and laboratory diagnostics of the functional state of organs and systems human body; etiology, pathogenesis, clinical symptoms, course features, principles of complex treatment of major diseases; rules for the provision of emergency medical care; bases of examination of temporary incapacity for work and medico-social examination; modern methods prevention, diagnosis, treatment and rehabilitation; content and sections of traumatology and orthopedics as an independent clinical discipline; tasks, organization, structure, staffing and equipment of the traumatology and orthopedics service; rules for issuing medical documentation; the procedure for conducting an examination of temporary disability and medical and social examination; principles of activity planning and reporting of the traumatology and orthopedics service; on the territorial program of state guarantees for the provision of free medical care to citizens in a constituent entity of the Russian Federation; issues of connection of diseases of the musculoskeletal system with the profession; rules of the sanitary and epidemiological regime; fundamentals of labor legislation; internal labor regulations; rules on labor protection and fire safety.

4. A traumatologist-orthopedist is appointed to the position and dismissed by order of the head medical organization in accordance with the current legislation of the Russian Federation.

5. A traumatologist-orthopedist reports directly to the head of the department, and in his absence to the head of the medical organization or his deputy.

2. Job responsibilities

Performs a list of works and services for diagnosing a disease, assessing the patient's condition and the clinical situation in accordance with the standard of medical care. Performs a list of works and services for the treatment of a disease, condition, clinical situation in accordance with the standard of medical care. Provides consultative assistance to medical specialists in their specialty. Controls the correctness of carrying out diagnostic and therapeutic procedures, the operation of instruments, apparatus and equipment, the rational use of reagents and drugs, compliance with safety and labor protection rules by middle and junior medical personnel. Plans its work and analyzes the performance of its activities. Ensures timely and high-quality execution of medical and other documentation in accordance with established rules. Carries out sanitary-educational work. Complies with the rules and principles of medical ethics and deontology. Participates in the examination of temporary disability and prepares Required documents for medical and social expertise.

A traumatologist-orthopedist has the right to:

1. independently establish a diagnosis in the specialty on the basis of clinical observations and examinations, anamnesis, data from clinical, laboratory and instrumental studies; determine the tactics of patient management in accordance with established rules and standards; prescribe the methods of instrumental, functional and laboratory diagnostics necessary for a comprehensive examination of the patient; carry out diagnostic, therapeutic, rehabilitation and preventive procedures using approved diagnostic and treatment methods; if necessary, involve in the prescribed manner doctors of other specialties for consultations, examination and treatment of patients;

2. to make proposals to the management on improving the diagnostic and treatment process, improving the work of administrative and economic and paraclinical services, the organization and conditions of their work;

3. control, within its competence, the work of middle and junior medical personnel, give them orders and demand their precise execution, make proposals to the management for their encouragement or imposition of penalties;

4. request, receive and use information materials and legal documents necessary for the performance of their duties;

5. take part in scientific and practical conferences and meetings dealing with issues related to its work;

6. pass certification in accordance with the established procedure with the right to obtain the appropriate qualification category;

A traumatologist-orthopedist enjoys all labor rights in accordance with the Labor Code of the Russian Federation.

4. Responsibility

The traumatologist-orthopedist is responsible for:

1. timely and high-quality implementation of the duties assigned to him;

2. timely and qualified execution of orders, instructions and instructions of the management, regulatory legal acts in their activities;

3. compliance with internal regulations, fire safety and safety;

4. timely and high-quality execution of medical and other service documentation provided for by the current legal documents;

5. providing, in accordance with the established procedure, statistical and other information on their activities;

6. observance of executive discipline and performance of official duties by employees subordinate to him (if any);

7. prompt action, including timely informing management, to eliminate violations of safety, fire and sanitary rules that pose a threat to the activities of a medical organization, its employees, patients and visitors.

For violation of labor discipline, legislative and regulatory legal acts, a traumatologist-orthopedist can be brought to disciplinary, material, administrative and criminal liability in accordance with the current legislation, depending on the severity of the misconduct.

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Job responsibilities of a traumatologist-orthopedist.

I approve

________________________________ (Surname, initials)

(name of the institution, its ________________________

organizational and legal form) (director; other person

authorized to approve

job description)

JOB DESCRIPTION

DOCTOR-TRAUMATOLOGIST-ORTOPEDIST

______________________________________________

(name of institution)

00.00.201_ #00

I. General provisions

1.1. This job description defines the duties, rights and responsibilities of a traumatologist-orthopedist _____________________ (hereinafter referred to as the "enterprise").

1.2. A person with a higher medical education and trained in the specialty "Traumatology and Orthopedics".

1.3. Appointment to the position of a traumatologist-orthopedist and dismissal from it is carried out in accordance with the procedure established by the current labor legislation by order of the head of the healthcare institution.

1.4. Traumatologist-orthopedist reports directly to _____________________

(Head of Department, Deputy Chief Physician)

1.5. The traumatologist-orthopedist should know:

Laws of the Russian Federation and other regulatory legal acts regulating the activities of healthcare institutions;

Current regulatory and methodological documents regulating the activities of medical institutions;

Methods and rules for the provision of medicinal and emergency medical care;

The content of traumatology and orthopedics as a separate clinical discipline;

Organization, structure, tasks, staffing and equipment of the traumatology and orthopedics service;

All legal and regulatory documents in their specialty;

Methods for prevention, diagnosis, treatment and rehabilitation of the patient;

Planning of activities and all reporting of the traumatology and orthopedics service;

The methodology and procedure for monitoring your service;

Rules and norms of labor protection, industrial sanitation, safety and fire protection;

Basics of the labor legislation of the Russian Federation

Internal labor regulations;

1.6. During the absence of a traumatologist-orthopedist (business trip, vacation, illness, etc.), his duties are performed in the prescribed manner by an appointed person who is fully responsible for their proper performance.

II. Job Responsibilities

Traumatologist-orthopedist:

2.1. In his specialty, he provides qualified medical care, using modern methods of diagnosis, prevention, treatment and subsequent rehabilitation of the patient.

2.2. In accordance with the established rules and standards, he chooses the tactics of managing the patient, develops a plan for his examination, and also specifies the scope and methods of examining the patient to receive it in the most short time reliable and complete diagnosis of the disease.

2.4. Based on the collected data, he makes an analysis, as well as prescribes and conducts the necessary treatment and procedures.

2.5. Performs daily check-ups in the hospital.

2.6. Modifies treatment plan as needed

2.7. Advises doctors of departments of healthcare facilities in their specialty

2.8. Manages junior medical staff

2.9. Monitors the correctness of diagnostic and therapeutic procedures, as well as the operation of equipment and apparatus, tools, drugs, reagents

2.10. Supervises compliance with the rules of safety and labor protection by lower-level medical personnel.

2.11. Timely and competently executes orders, instructions and instructions of the management of the institution

2.12. Complies with internal regulations.

2.13. Complies with the requirements of labor protection, industrial sanitation and safety

2.14. Timely and competently executes orders, instructions and instructions of the management of the institution

2.15. Complies with internal regulations.

2.16. Complies with the requirements of labor protection, industrial sanitation and safety

III. Rights

A traumatologist-orthopedist has the right to:

3.1. Make proposals to the management of the enterprise on the optimization and improvement of medical and social assistance, including on issues of their work activities.

3.2. Require the management of the institution to assist in the performance of their duties and rights.

3.3. Receive information from the company's specialists necessary for the effective performance of their duties.

3.4. Pass certification in accordance with the established procedure with the right to obtain the appropriate qualification category.

3.5. Take part in the work of meetings, scientific and practical conferences and sections on issues related to their professional activity.

3.6. Enjoy labor rights in accordance with the Labor Code of the Russian Federation

I V . Responsibility

The traumatologist-orthopedist is responsible for:

4.1. For the proper and timely performance of the duties assigned to him, provided for in this job description

4.2. For the organization of their work and the qualified execution of orders, orders and instructions from the management of the enterprise.

4.3. To ensure that subordinate employees comply with their duties.

4.4. For not following the rules internal order and safety regulations.

For offenses or omissions committed in the course of therapeutic measures; for errors in the process of carrying out their activities, which entailed serious consequences for the health and life of the patient; as well as for violation of labor discipline, legislative and regulatory legal acts, a traumatologist-orthopedist can be brought to disciplinary, material, administrative and criminal liability in accordance with the current legislation, depending on the severity of the misconduct.

The main issues of military field surgery: - gunshot injuries to the head and neck; - gunshot injuries to the chest and abdomen; - gunshot injuries to the pelvis and pelvic organs; - gunshot injuries to the upper and lower extremities;-combined radiation damage. 4.1.11. Traumatology childhood: -characteristics, course and treatment of injuries in different age groups. 4.2. In the field of orthopedics: 4.2.1. Congenital diseases of the musculoskeletal system: - torticollis, pterygoid neck, cervical ribs; - congenital deformity of the sternum, chest. 4.2.2. Congenital diseases and deformities of the spine and pelvis: - violation of posture; - fusion of the vertebral bodies; - scoliotic disease; - spinal hernia; - spondylolysis, spondylolisthesis. 4.2.3.

Job description of a traumatologist-orthopedist

Controls the correctness of carrying out diagnostic and therapeutic procedures, the operation of instruments, apparatus and equipment, the rational use of reagents and drugs, compliance with safety and labor protection rules by middle and junior medical personnel. Participates in training sessions to improve the skills of medical personnel.
Plans its work and analyzes the performance of its activities. Ensures timely and high-quality execution of medical and other documentation in accordance with established rules.
Carries out sanitary-educational work. Complies with the rules and principles of medical ethics and deontology. Participates in the examination of temporary disability and prepares the necessary documents for medical and social examination.

Determines the tactics of managing the patient in accordance with established rules and standards. Develops a plan for examining the patient, specifies the volume and rational methods of examining the patient in order to obtain complete and reliable diagnostic information in the shortest possible time.

Based on clinical observations and examinations, anamnesis, data from clinical, laboratory and instrumental studies, establishes (or confirms) the diagnosis.

Job Descriptions

Attention

Supervises the work of middle and junior medical staff. 2.13. Complies with the principles of medical ethics and deontology. 2.14.

Qualified and timely executes orders, orders and instructions of the management of the institution, as well as legal acts on his professional activities. 2.15. Complies with the internal labor regulations, rules on labor protection and fire safety, sanitary and epidemiological regime, promptly takes measures, including timely informing the management, to eliminate safety violations, fire and sanitary rules that pose a threat to the activities of the healthcare institution, its employees, patients and visitors.
2.16. Systematically improves his skills. 2.17. [Other Job Responsibilities]. 3. Rights A traumatologist-orthopedist has the right to: 3.1.

Rokita Taras Grigorievich, traumatologist, orthopedist

Important

Consequences of bone injury: - pseudoarthrosis; - dangling joint; - bone defects. 4.2.7. Diseases of muscles, tendons and articular bags: - myositis, myositis ossificans, ischemic contracture; - stenosing ligamentitis; - bursitis, tendovaginitis, synovitis, ganglia.

4.2.8.

Info

Paralytic deformities: - poliomyelitis; - obstetric paralysis. 4.2.9. Diseases of the neck, chest and spine: - torticollis; - rachitic deformity of the chest; - scoliosis, kyphosis, lordosis; - osteochondrosis of the spine.

4.2.10. Diseases of the upper and lower extremities: - habitual dislocation of the shoulder: - contracture and ankylosis of the joints of the upper extremities, - Dupuytren's contracture; - diseases of the menisci knee joint;-coxa vara and coxa valga;-deformation of the feet and hands. 4.2.11. Dysplastic processes in the bones: - chondrodysplasia; - epiphyseal and diaphyseal dysplasia; - osteodysplasia; - hyperstosis; - bone eosinophilia. 4.2.12.
Based on the collected data, he makes an analysis, as well as prescribes and conducts the necessary treatment and procedures. 2.5. Performs daily check-ups in the hospital. 2.6.

Changes the treatment plan as needed 2.7. Advises doctors of departments of health care facilities in their specialty 2.8. Supervises subordinate medical personnel 2.9. Carries out control over the correctness of diagnostic and therapeutic procedures, as well as the operation of equipment and apparatus, tools, medicines, reagents 2.10.

Supervises compliance with the rules of safety and labor protection by lower-level medical personnel. 2.11. Timely and competently executes orders, orders and instructions of the management of the institution 2.12. Complies with internal regulations. 2.13. Complies with the requirements of labor protection, industrial sanitation and safety 2.14.

Job description of a traumatologist-orthopedist

Russian Federation; – questions of the relationship of diseases of the musculoskeletal system with the profession; - rules of the sanitary and epidemiological regime; — basics of labor legislation; - internal labor regulations; — rules on labor protection and fire safety. 2. Job responsibilities Doctor-traumatologist-orthopedist: 2.1.

Performs a list of works and services for diagnosing a disease, assessing the patient's condition and the clinical situation in accordance with the standard of medical care. 2.2. Performs a list of works and services for the treatment of a disease, condition, clinical situation in accordance with the standard of medical care. 2.3. Provides consultative assistance to medical specialists in their specialty. 2.4.

403 forbidden

I approve [position, signature, full name of the head or other official authorized to approve the job description] [day, month, year] M.P. [name of organization, enterprise, etc.] This job description was developed and approved in in accordance with the provisions of the Labor Code of the Russian Federation, the Unified Qualification Directory for the Positions of Managers, Specialists and Employees, the section "Qualification Characteristics of the Positions of Employees in the Sphere of Health", approved by Order of the Ministry of Health and social development of the Russian Federation of July 23, 2010 N 541n, and other regulatory legal acts regulating labor relations. 1. General provisions 1.1. The traumatologist-orthopedist belongs to the category of specialists and reports directly to [position title of the immediate supervisor]. 1.2.

Job description of a traumatologist-orthopedist

2.6. Ensures timely and high-quality execution of medical and other documentation in accordance with established rules. 2.7. Carries out sanitary-educational work. 2.8. Complies with the rules and principles of medical ethics and deontology. 2.9. Participates in the examination of temporary disability and prepares the necessary documents for medical and social examination. 2.10. Maintains proper medical records. 2.11. Plans, analyzes and prepares reports on the results of its work. 2.12.

Job description of a nurse doctor traumatologist-orthopedist

Performs a list of works and services for the treatment of a disease, condition, clinical situation in accordance with the standard of medical care. Provides consultative assistance to medical specialists in their specialty.

Ensures timely and high-quality execution of medical and other documentation in accordance with established rules. Carries out sanitary-educational work. Complies with the rules and principles of medical ethics and deontology.

Job description of an orthopedic traumatologist

Injuries of the spine: - fractures of the bodies, arches of the articular, transverse and spinous processes of the cervical, thoracic, lumbar and sacral departments spine; - fractures and dislocations of the vertebrae without damage and with damage to the spinal cord and its roots; - dislocations and subluxations of the lumbar vertebrae; - spondylolisthesis. 4.1.8. Pelvic injuries: - pelvic bruises, open and closed fractures of the pelvic bones; - pelvic fractures complicated by damage to the pelvic organs; - multiple and combined injuries; - compression of soft tissues. 4.1.9. Thermal, chemical, radiation damage, as well as electric shock damage: - burns and frostbite; - electrothermal and chemothermal injury; - radiation damage; - burn toxemia and septicotoxemia. 4.1.10.

Job description doctor traumatologist orthopedist

The traumatologist-orthopedist reports directly to the head of the department, and in his absence to the head of the medical facility or his deputy. 2. Responsibilities Provides qualified medical care in his specialty, using modern methods of prevention, diagnosis, treatment and rehabilitation, permitted for use in medical practice. Determines the tactics of managing the patient in accordance with established rules and standards. Develops a plan for examining the patient, specifies the volume and rational methods of examining the patient in order to obtain complete and reliable diagnostic information in the shortest possible time. Based on clinical observations and examinations, anamnesis, data from clinical, laboratory and instrumental studies, establishes (or confirms) the diagnosis.

General characteristics of the direction

So, the orthopedist deals with diseases related to the skeletal system. The specialization owned by one or another orthopedic doctor determines the specific directions of the features of his activity. Here are the existing options for this kind of directions:

Outpatient or, as it is called in another way, conservative orthopedics. In this situation, the implementation of preventive measures for diseases of the musculoskeletal system in a clinical setting where an orthopedist takes is considered. In addition, this direction is concentrated within the framework of the implementation of non-surgical therapeutic measures for the impact on diseases of the joints and bones.
Endoprosthesis technique. This direction focuses on the implementation of measures related to the surgical prosthetics of bones and joints, which is especially important in those situations in which it is no longer possible to save them using other methods of treatment.
Surgical field of activity. What is an orthopedic surgeon? As part of this area of orthopedics, the spine, feet, teeth and hands are treated. This direction is considered radical in treatment, as it affects the ligaments, joints and bones of a person.
What diseases does an orthopedist treat in traumatology? As methods of treatment, conservative and surgical therapy is used, which is focused on the impact on injuries that are in one way or another connected with the skeletal system. This includes, in addition, the timely fixation of fractures, along with measures that are aimed at correcting joint defects. In the field of traumatology, they also deal with the correction of chronic forms of defects. Sports orthopedics are also included in this area. Its purpose lies in the treatment of specific injuries acquired by athletes in the course of their activities.
Pediatric orthopedics, or, as it is also called, adolescent orthopedics. This direction of orthopedics focuses on the prevention and required treatment of defects that are relevant to the skeletal system. What kind of doctor is a pediatric orthopedist? This is a specialist to whom small children under the age of one year come for an appointment. Quite often, older guys along with teenagers become patients.

Directions in the medical field of dental orthopedics:

Maintaining dental health.
Diagnosis and treatment of pathologies of the maxillofacial apparatus: periodontitis, periostitis, osteomyelitis of the jaws, phlegmon.
With the help of the installation of dentures, crowns, bridges, the functions of chewing food, swallowing and speech are restored, the aesthetic appearance of the teeth is restored.

Orthopedic traumatology combines surgical and non-surgical methods of treatment of diseases of bones, joints, muscles, ligaments. Includes treatment of chronic fractures, dislocations, sprains, inflammation of the fascia, cartilage degeneration.
Children's orthopedics. The tasks of pediatric orthopedists include the treatment of scoliosis, flat feet, torticollis, clubfoot, hip dysplasia, and congenital dislocations in children and adolescents.
Endoprosthetics. This area specializes in the treatment of pathologies of the musculoskeletal system that require the replacement of joints with artificial implants. Thanks to the improvement of methods, patients have the opportunity to lead a full life and maintain efficiency. A striking example is the operation to replace the hip, knee, shoulder joints, prostheses for amputated limbs.
Surgical orthopedics. The direction is engaged in the surgical correction of defects in the feet, hands, spinal column, large bone and joint formations, muscles, ligaments.

Depending on the tasks performed by the orthopedist and the specifics of the work, the following areas of orthopedics are distinguished:

Ambulatory. This method of conservative treatment of various diseases of the musculoskeletal system in an orthopedic or trauma department, day hospital or at home. Also, within the framework of outpatient orthopedics, preventive and dispensary examinations of citizens are carried out.

Surgery. Surgical orthopedics involves the treatment of developmental pathologies and diseases of the musculoskeletal system in an operative way. Most often, ligaments and joints (arthroscopic surgery) are subjected to surgical intervention, and operations are performed on the hands, feet and spine.

Traumatology. This direction includes, in addition to working with domestic injuries (bone fractures, torn ligaments) and sports orthopedics, which deals with the treatment of specific conditions. Also, traumatological orthopedics allows for the correction of soft tissue and chronic defects.

Endoprosthetics. This direction implies the replacement of the affected joint or bone with a prosthesis. Most often, endoprosthetics are hip and knee joints, elbow joints.

Pediatric and adolescent orthopedics. The peculiarity of such orthopedics lies in the age characteristics of the musculoskeletal system of children and adolescents: increased muscle tone and imperfection of the ligamentous apparatus in infants, active growth of the musculoskeletal system in adolescents and lack of muscle strength to keep the spine straight, which leads to posture disorders.

Orthopedics traditionally acts in conjunction with traumatology. Traumatology is a branch of clinical medicine that studies injuries to the musculoskeletal system (joints, ligaments, bones, tendons). An integral part of orthopedics and traumatology is prosthetics.

The discipline is based on the development and use of prostheses/orthoses. A prosthesis is an artificial substitute for damaged body parts of a living organism. An orthosis is an external medical device that is used to change the functional or structural characteristics of the skeleton/neuromuscular system. Orthoses include corsets, bandage, special insoles or orthopedic shoes that support devices.

Orthopedics is also considered an important part of sports medicine. This is a science that studies changes in the human body during / after active physical activity. Both positive and negative results are evaluated. Why does an orthopedist need knowledge about physical education and sports? The practitioner conducts and prescribes exercise therapy, massage or physiotherapy. It is considered unacceptable to use medical manipulations without having full knowledge about them.

In conjunction with traumatology and orthopedics, there are other narrow-profile areas - spine surgery, biomechanics of the musculoskeletal system, joint replacement, arthroscopic surgery and others. In some countries (for example, in the post-Soviet space), the combination of traumatology and orthopedics constitutes an independent clinical discipline.

In a separate category, children's orthopedists are distinguished. The direction itself is focused on the prevention and treatment of skeletal defects. Orthopedic consultation is necessary not only for schoolchildren, but also for children preschool age. The doctor will diagnose the baby's musculoskeletal system, identify its strengths / weaknesses, determine the child's readiness for future stress (school / university) and tell parents how to avoid many ailments.

An emergency visit to a specialist is indicated in such cases:

incorrect position of the hip of the newborn (congenital dislocation);
heaviness of gait, rapid fatigue of the baby after a few steps or minutes of walking;
slouch;
constant tilt of the head to the shoulder;
complaints of the child himself about episodic pain in the legs/back/neck/arms;
clubfoot.

What diseases does an orthopedist treat?

Orthopedists treat.

Pathologies accompanied by inflammation: damage to the joints and periarticular bags (arthritis, bursitis).

The main reasons for urgently seeking the advice of an orthopedist are:

Severe swelling of the periarticular region, accompanied by discomfort, pain with minimal motor activity.
Intense pain syndrome in one of the sections of the spinal column.
Cracking and stiffness of movements in the joints.
Rapid fatigue and visible violation of posture.

There is a list of conditions that do not require an urgent appeal to an orthopedist, but are a good reason for registration and further observation by this specialist. These states are referred to.

Previous injuries, dislocations, fractures, sprains.
Curvature of the spine.
Degeneration of discs and joints.

In addition, people professionally involved in sports and leading an active lifestyle need regular consultations with an orthopedic specialist.

Based on all of the above features that determine the specifics of the activities of an orthopedist in the role of a particular specialist, one should summarize and indicate what this doctor treats:

Muscle diseases.
Joint problems.
Tendon stretch.
Ligament damage.
Bone injury.
Nerve endings.

All this is done by an orthopedist. What organs does this doctor treat? With regard to this issue, it should be noted that this specialist deals with the back, feet, shoulder blades, knee and hip joints, humerus, teeth, and so on.

This specialist eliminates a variety of disorders in the oral cavity and maxillofacial region:

Restores the integrity of individual teeth. Manufacture of microprostheses.
Restores the integrity of the dentition.
Produces prostheses that replace soft tissue defects of the maxillofacial region after injuries, including after surgical interventions.
Treats diseases of the temporomandibular joint.
Carries out the correction and repair of prostheses already existing in the patient.

This is what a doctor is - an orthopedist in dentistry.

An orthopedic traumatologist treats those pathologies that have damaged the musculoskeletal system and caused a violation of the function of movement in any of its departments. Damage can be the result of injury or illness. A traumatologist helps with acute conditions that can be life threatening. An orthopedist in his practice rarely encounters pathologies that can be life-threatening.

An orthopedic traumatologist uses both surgical and non-surgical methods of treating pathology. After the cause of the violation is eliminated, the rehabilitation period begins, that is, the restoration of the function of the affected department of the musculoskeletal system. At this stage, other specialists are involved in the treatment - rehabilitation specialists, physiotherapists, chiropractors and massage therapists.

Treatment methods used by an orthopedic traumatologist

Pathology	Methods of surgical and non-surgical treatment	Approximate recovery time after surgery	Forecast
Treatment methods for injuries
Injury	non-surgical treatment- an ice pack on the first day and a pressure bandage ( reduction of edema and hemorrhage), thermal procedures for 2-3 days ( absorption acceleration); puncture of the joint - a minor surgical intervention is performed in the same way as a diagnostic puncture to remove the outflow of blood from the soft tissues or the joint; immobilization (immobilization)- carried out with the help of bandages or splints for hemarthrosis.	The duration depends on the severity of the injury. With hemarthrosis, 1 to 2 weeks are required for immobilization. In mild cases, the bruise resolves within a week.	The prognosis is favorable. With absence proper treatment there is a risk of infection of damaged tissues.
compression	local treatment - local cold, pressure bandage; anesthesia - circular novocaine blockade ( the introduction of novocaine around above the compression site); immobilization - carried out with the help of transport tires ( latches); general treatment - the introduction of intravenous solutions for the purpose of detoxification ( removing toxins from the body) and restoration of disturbed metabolism; prosthetics - prostheses are installed if the limb had to be amputated.	Patients are treated in the intensive care unit. The duration of treatment depends on the duration of tissue compression and the severity of intoxication of the body.	The prognosis depends on the correct treatment. The syndrome of intoxication can lead to insufficiency of vital organs, primarily the kidneys.
Sprain	anesthesia - the introduction of a solution of lidocaine or novocaine into the area of \u200b\u200bdamage, as well as taking painkillers; immobilization - the imposition of a plaster bandage.	The bandage must be worn for 10 to 12 days. With sprains of the lower extremities, immobilization lasts up to 2 months.	The prognosis is favorable, provided that the rest mode for the limb is observed.
Torn ligaments, muscles and tendons	surgery- stitching of a tendon or muscle; arthroscopic operations– stitching during arthroscopy; immobilization - the imposition of a plaster cast ( longuet).	It is necessary to wear a plaster splint from 2 weeks to 2 months. The duration of the rehabilitation period depends on the type of muscle.	The prognosis is favorable. With sports injuries, the ability to restore the function of movement is possible after 2 months.
Peripheral nerve damage	immobilization - a plaster splint is applied so that the damaged part does not sag and is not fixed in the wrong position ( due to loss of muscle tone), as well as to bring together the ends of the nerves; drug treatment- stimulation of the neuromuscular apparatus with drugs; surgery- Stitching of the nerve (neurorrhaphy).	Drug treatment is carried out within 10 days. Immobilization is carried out before and after the suturing of the nerve for a period of 3 weeks.	The nerve recovery process takes a very long time ( the nerve grows at a rate of 1 mm per day).
Dislocation	anesthesia - local or general anesthesia is performed to relax the muscles and proceed with the reduction; reduction - return of the displaced articular surface to its place; immobilization - fixation of the joint after reduction; surgery– plastic correction of joint components (capsule, ligaments) using arthroscopy or open surgery with pin fixation.	Immobilization is carried out for several weeks, the specific period depends on the joint and the presence of complications.	The prognosis is generally favorable. With repeated dislocations, only surgery is effective.
fracture	closed reduction– comparison of bone fragments and immobilization ( under radiographic control); skeletal traction- bone fragments are gradually reduced by suspending the load to the limb and maintaining it in a natural position; external osteosynthesis- reposition is carried out under the control of X-ray examination, after which the bones are fixed with knitting needles in the apparatus ( Ilizarov apparatus); internal osteosynthesis– reposition of fragments and fixation with metal structures ( screws, screws, spokes, plates and others) is performed during open surgery; joint and limb prosthetics- is carried out with a low probability of self-healing of intra-articular or peri-articular fractures, as well as if an amputation of the limb was performed.	The healing time for fractures depends on the specific bone and ranges from 2.5 to 10 months, depending on the complexity of the injury.	The prognosis largely depends on age and the presence of concomitant diseases that affect the rate of callus formation.
Spinal injury	closed methods- reduction and skeletal traction; Spinal fusion is a strong fixation of the vertebrae using various structures that are implanted during open or endoscopic surgery.
Meniscus injury	anesthesia - a solution of novocaine is injected into the joint; reduction - elimination of blockade of the joint, that is, pinching of the meniscus; immobilization - using a plaster splint ( special clamp in the form of a sleeve); surgery– removal of the damaged meniscus using arthroscopy or open knee surgery (arthrotomy), followed by a meniscus transplantation ( replacement with another cartilage or synthetic implant).	For the operation, the patient is hospitalized in the hospital, where he must stay for 3 days. Immobilization lasts 3 weeks, after which they begin to restore function.	The prognosis depends on age, as well as on the timing of the detection of injury. If left untreated, osteoarthritis develops.
Pseudarthrosis and slowing down of fracture union	surgery- includes excision of the edges of bone fragments ("refreshment"), correct reposition of bone fragments, fixation of the limb in the correct position using metal structures or replacement of the missing bone tissue (bone grafting).	The structures are left until the bone is completely fused.	The prognosis depends on the early diagnosis of the false joint and the correct treatment of diseases that slow down the healing of the fracture.
Polytrauma and traumatic shock	stop bleeding and replenish blood loss; anesthesia in the area of the fracture; antibiotics; surgical treatment of the wound.	Treatment is carried out in the intensive care unit ( resuscitation). The duration of treatment depends on the severity of the condition.	The prognosis depends on the degree of blood loss, the presence of trauma to the brain and spinal cord, and the condition of the internal organs.
Traumatic brain injury	surgery- reposition of depressed fragments or plastic closure of a bone defect.	Patients with TBI in most cases are treated in the neurology department, where they are observed for at least 3 to 5 days in mild cases.	The prognosis is relatively good if there is no severe brain damage. Among the long-term complications, mental illness is possible.
Methods of treatment for orthopedic diseases
Limb length inequality	surgery - osteosynthesis using the Ilizarov apparatus, reconstructive operations on the lower leg and joints, amputation of underdeveloped segments and prosthetics.	The terms of "stay" in the Ilizarov apparatus range from 4 to 10 months.	The prognosis is favorable if muscle function is preserved. If the cause is muscle weakness, bone lengthening is not performed.
Congenital dislocation of the hip	non-surgical methods- physiotherapy exercises, massage, wide swaddling, diverting splints, adhesive plaster traction and plaster cast; surgery– arthroplasty ( correction of elements of the hip joint), osteotomy ( artificial fracture to restore correct anatomy) or hip arthroplasty.	The duration of treatment with traction and plaster casts is 5-6 months.	The prognosis is better, the earlier hip dysplasia is detected.
Clubfoot	non-surgical treatment- plaster bandages, massage, physiotherapy exercises, wearing individual orthoses; surgery – Plastic surgery on the tendons or calcaneus of the foot and fixing the "new" position with a pin, arthrodesis.	Plaster bandages and orthoses are changed in stages to new ones, as the child grows until complete correction.	The prognosis is favorable. If orthopedic non-surgical correction was started in infancy, then surgery can be avoided.
Club hand	surgery– arthrodesis of the wrist joint in the correct position, the use of the Ilizarov apparatus, prosthetics.	"Growing" of the bone with the help of the Ilizarov apparatus lasts at least 3-4 months.	The treatment of patients has its own difficulties, so the operation is performed on children under 10 years old.
flat feet	non-surgical treatment- Wearing comfortable shoes orthopedic insoles, therapeutic exercises, massage, load limitation, fixation with a plaster bandage; surgery- form the arch of the foot with the help of osteotomy, arthrodesis with fixation of the bones with screws.	A bandage for Morton's neuroma is applied for a period of 1.5 months, and after surgery ( osteotomy) - for 2 months.	The prognosis is favorable if you start using orthopedic insoles and shoes in time. Otherwise, the load is transferred to the spine and causes deformation.
hollow foot	non-surgical treatment- wearing comfortable (with lifting) shoes or orthopedic insoles, physiotherapy; surgery– formation of the foot by dissection of the plantar fascia, arthrodesis and osteotomy, transplantation of muscles and tendons.	After the operation, a plaster cast is worn for 6-7 weeks.	The prognosis is favorable when wearing comfortable shoes and not overloading the foot. If the load on the foot increases, then it deforms even more, which impairs the ability to walk.
Valgus deformity of the foot	non-surgical treatment– wearing comfortable (wide) or orthopedic shoes and orthoses ( clamps and tires); surgery– osteotomy, arthrodesis or tenodesis ( tendon fixation).	Orthoses should be worn for about a month if the deformity is “fresh”, with chronic deformity it has to be worn constantly.	The prognosis is favorable if the deformity is corrected in time. Otherwise, there is an overload of the foot, which is transmitted to the overlying joints and back.
hammer fingers	non-surgical treatment– wearing loose shoes, orthopedic insoles, or using an adhesive bandage ( fixes the finger in the correct position); surgery- tendon plasty or metatarsal osteotomy.	Adhesive bandage should be worn every time you walk. With severe deformity, surgical treatment is performed.	The prognosis depends on timely detection and correction.
Finger Morton	non-surgical treatment- wearing special shoes or orthoses; surgery– shortening of the fingers with bone or joint surgery ( osteotomy, arthrodesis).	It is necessary to wear special shoes or orthopedic devices at all times.	The prognosis is favorable. If the length of the second toe is significantly longer than the length of the first, then it may be difficult to wear shoes.
Anomalies in the development of the fingers	surgery– removal of constrictions between the fingers and plastic skin, removal of an additional finger, restoration of the anatomy of the hand and its function.	The number of stages for correction depends on the pathology.	The prognosis is generally favorable. With ectrodactyly, the operation is performed only for adults.
Tunnel Syndromes	non-surgical treatment- reducing the load on the limb, immobilization of the joint, wearing insoles, anti-inflammatory treatment, the introduction of hydrocortisone, physiotherapy, exercise therapy; surgery- open or arthroscopic surgery with dissection of the ligaments, elimination of the mechanical cause of compression of the nerve plexus ( tumor, bone formation).	Non-surgical treatment is prescribed for several months, if it is ineffective, surgery is performed.	The prognosis is favorable. If the tension of the ligaments decreases ( habitual movements are not carried out), then the pain goes away.
Torticollis	non-surgical treatment– physiotherapy exercises, massage, physiotherapy; surgery– the operation is performed on the modified neck muscle, its legs are cut off and lengthened.	Non-surgical methods of treatment are carried out in courses. Their duration is on average 10-15 sessions.	The prognosis is favorable with timely and proper treatment.
Chest defects	non-surgical treatment wearing orthoses, physiotherapy exercises, massage, swimming, physiotherapy; surgery– fixation of the ribs and sternum with a metal plate in the correct position.	Orthoses are worn for no more than 2 years. Surgical fixation lasts 2-3 years.	Complications of chest defects include pneumonia, pneumothorax ( accumulation of air in the pleural cavity).
Osteoarthritis		Drug treatment is carried out in courses that last several months. Stretching is carried out for 20 minutes for 7-10 sessions.	The prognosis is generally favorable, if you start treatment on time, you can maintain your ability to work. If it is impossible drug treatment (severe deformity of the joint) arthroplasty allows you to return a person to work.
Arthritis	non-surgical treatment- antibiotics, anti-inflammatory drugs, pain relief; joint puncture - the accumulated purulent or non-purulent ( serous) fluid is removed from the joint cavity, which has a therapeutic effect; surgery- carried out outside the period of exacerbation, most often with the help of arthroscopic surgery, the synovial membrane of the joint is removed or partially excised ( it produces liquid).	The duration of treatment depends on the form and cause of arthritis ( infection, rheumatic disease, tuberculosis, brucellosis and others). On average, the duration of non-surgical treatment is several months.	The prognosis for infectious arthritis is good, and non-infectious arthritis can lead to arthrosis over time if left untreated.
Osteomyelitis	non-surgical treatment- antibiotics, intravenous fluids, limb immobilization, physiotherapy; surgery- removal of a purulent focus and replacement of an empty place with a muscle flap on a feeding leg ( with supply vessel), removal of metal structures ( postoperative osteomyelitis) and a plaster cast.	Treatment is carried out until the purulent process stops and the fracture heals.	The prognosis depends on the state of the body's resistance and early detection of osteomyelitis. If left untreated, blood poisoning ( sepsis) can develop.
Anomalies in the development of the spine	non-surgical treatment- elimination of symptoms pain relief, anti-inflammatory drugs, physiotherapy); surgery- removal of the transverse process of the transitional vertebra ( with sacralization and lumbarization), spinal fusion and fixation of the spine.	The duration of physiotherapy courses and the regimen of prescribing drugs is set individually.	The prognosis is favorable in many cases, the need for surgery does not always arise ( if the patient's ability to work is impaired).
Rachiocampsis (kyphosis, lordosis)	non-surgical treatment- immobilization with a corset, wearing a backboard, massage, therapeutic exercises; surgery– spinal fusion and other methods of spinal fixation.	Wearing corsets and back supports is carried out for a long time or only during the load period. Therapeutic gymnastics and massage are prescribed according to an individual program.	The prognosis depends on early detection and treatment, as the curve progresses if left uncorrected.
Posture disorder	formation of correct posture- sports, gymnastics, a hard bed, proper carrying of a bag, a comfortable workplace.	The formation of correct posture is a matter of habit, the main factor in fixing which is the constant observance of the rules for several months.	The prognosis is favorable. If there are no serious deformations of the spine, then the posture can be easily corrected.
Scoliotic disease	non-surgical treatment- orthopedic corsets, strengthening of the back muscles; surgery- epiphyseodesis ( removal of part of the intervertebral disc and part of the growth plate on the convex side), spinal fusion ( fixation of the spine with bone grafts) and other types of operations.	Spinal fusion grafts can be removed 3 to 5 years after they are placed, but in some cases they are left. Orthopedic corsets are worn with mild forms of scoliosis, along the way strengthening the back muscles. The duration of their wearing is set individually.	The prognosis is favorable if the operation or orthopedic correction was performed in childhood.
Osteochondropathy	non-surgical treatment- rest the affected joint, orthopedic shoes, short-term or long-term immobilization with simultaneous physiotherapy, chondroprotectors and anti-inflammatory drugs; surgery- reconstruction of the joint, arthroscopic removal of the "articular mouse", arthrodesis.	The disease is chronic, so long-term or permanent treatment is required.	If the disease is detected in the early stages, it is possible to avoid deformation of the bones.
Osteoporosis	non-surgical treatment- drugs that reduce bone destruction ( bisphosphonates), calcium and vitamin D supplements.	Treatment of osteoporosis is carried out in courses.	The prognosis is not very favorable, since osteoporosis is often detected already at the stage when the bone has become so fragile that it breaks from careless movement. Prevention of osteoporosis is a means of preventing pathological fractures.
Osteodystrophy	non-surgical treatment– carried out similarly to the treatment of osteoporosis; surgery- remove lesions of bone tissue or tumors of the parathyroid gland ( the surgeon performs the operation).	Osteodystrophy requires constant monitoring of the state of the bone tissue.	The prognosis depends on the form of osteodystrophy. In Recklinghausen's disease, after the removal of a hormonal tumor, the condition of the bone tissue is restored within a few years. Paget's disease is considered a precancerous disease.
Spondylosis	non-surgical treatment- immobilization of the spine with corsets, bed rest, anti-inflammatory treatment, novocaine blockades, physiotherapy, spinal traction, exercise therapy; surgery– restoration of the anatomical relationships of the elements of the spine, fixation of the vertebrae with a metal structure ( bone grafting, spinal fusion).	Constant monitoring of the condition of the spine is required, treatment is carried out in courses.	The prognosis depends on the degree of compression of the nerve roots ( pain syndrome) and on an early visit to the doctor.
Spondylitis
Spondylarthrosis
Spondylopathy
Osteochondrosis
Myositis	non-surgical treatment- antibiotics ( with infectious myositis), hydrocortisone ( with myositis ossificans); surgery- removal of dead tissue, pus, calcifications, drainage.	Non-surgical treatment is advisable at the very beginning of myositis and is more prophylactic. In most cases in orthopedic practice, myositis is treated surgically.	The prognosis depends on the type of pathogen, timely and correct treatment.
Tendinitis	non-surgical treatment- immobilization with a plaster bandage, the appointment of anti-inflammatory treatment; surgery– excision of the thickened tendon and its plasty, bone resection ( Achilles tendonitis).	If non-surgical treatment does not help within 3 to 6 months, then surgery is performed.	Treatment of tendonitis especially Achilles tendon) is a long process, but with a favorable outcome.
Ligamentite	non-surgical treatment- local administration of novocaine and hydrocortisone ( hormonal anti-inflammatory drug), massage, thermal treatments; surgery- excision of the thickened section of the ligament.	Non-surgical treatment is carried out for 3-4 weeks, and if there is no effect, they are treated surgically. After the operation, it is necessary to immobilize the limb for a week.	If left untreated, the disease progresses and the ligaments thicken. Timely treatment is the key to a favorable outcome.
tendovaginitis	non-surgical treatment- the introduction of hydrocortisone into the tendon sheath and immobilization of the limb with a plaster cast; surgery- puncture of the synovial bag or excision of the tendon sheath ( excision on the fingers of the hand is not carried out).	After the introduction of hydrocortisone, the immobilization of the limb lasts 1-2 weeks.	In most cases, the prognosis is favorable. If left untreated, there is a risk of fusion of the tendon sheath with the tendon.
plantar fasciitis	non-surgical treatment- restriction of physical activity and immobilization, anti-inflammatory drugs, wearing orthopedic insoles, physiotherapy; surgery- dissection of the plantar fascia in the area of the calcaneus, which reduces the tension of the plantar nerve.	Non-surgical methods apply for 5-6 months ( immobilization - 3 - 4 weeks), and in case of inefficiency, an operation is performed.	The prognosis is favorable with timely and adequate treatment.
bone tumors	surgery- removal of the tumor within healthy bone tissue or wide excision of the affected area.	The length of stay in the hospital depends on the volume of planned activities. Histological confirmation is required to exclude or confirm a malignant tumor (3 - 7 days).	Forecast at benign tumors favorable, with malignant tumors there is a high risk of pathological fractures.

With what complaints should I go to the orthopedist?

An orthopedist and an orthopedist-traumatologist treat torticollis, hip dysplasia, flat feet, clubfoot, valgus and varus deformities of the feet and lower legs, arthrosis and arthritis of all joints (including intervertebral joints), osteochondrosis and spondylolisthesis, joint dislocations, bone fractures, tears and ruptures of ligaments, tendons and muscles, contractures, deforming osteosis and osteoarthritis, various kinds sarcoma (chondromyxosarcoma, Ewing's tumor) and so on.

You should consult an orthopedist if you have the following symptoms:

posture disorders,

different lengths of the limbs (especially the lower ones),

injuries with suspected fracture or fracture of the bone,

joint pain ,

swelling, redness or fever in the joint area,

limited mobility of the limbs or spine,

pain in the spine (especially in the lower back and cervical region),

crunch in the spine or joint when moving,

pain in the muscles of the limbs,

sensation of muscle hypertonicity,

bone pain,

"ache" in the joints when the weather changes,

deformity of a joint or limb,

contractures.

Even if these symptoms are not regular, it is necessary to find out their cause, because in most cases they speak of already begun degenerative processes in the joints and bones, whose development in the early stages can still be contained. For athletes and people who lead an active lifestyle, as well as those who are overweight, it is advisable to regularly visit a doctor for the timely detection of microtraumas or beginning, but still asymptomatic, diseases.

Particular attention should be paid to orthopedic consultations in pediatric and adolescence. It is the timely diagnosis and professional treatment of disorders of the musculoskeletal system in infants that in most cases guarantee the normal physical (and sometimes mental) development of the child, and the absence of physical and, resulting from them, psychological problems.

What does an orthopedist do?

What diseases do orthopedic doctors treat? If we talk about specific ailments, then we should highlight following list their main types:

The presence of curvature of the feet along with flat feet, clubfoot.
Congenital diseases in the form of joint dysplasia and torticollis. Often the help of an orthopedic infant is needed. What doctor is this? More on that below.
The presence of bursitis, arthrosis in patients, that is, diseases that are accompanied by inflammation of the periarticular bags and joints, including.
The development of osteochondrosis, that is, a chronic disease, which is accompanied by damage to the spine in the region of its specific segments.
Joint dislocations along with bone fractures and Ewing's tumor.
The development of rheumatoid arthritis, that is, a systemic chronic disease, the course of which suggests damage to the skeletal system, which in turn can lead to severe forms of joint deformity. Such a pathology in some situations may be a prerequisite for subsequent disability in the patient.
The presence of osteogenic sarcoma.
The development of deforming osteosis along with chondromyxosarcoma.

An orthopedist deals with the treatment of flat feet, scoliosis, the consequences of injuries, congenital malformations with the help of exercise therapy, manual therapy or surgery. He treats clubfoot, torticollis, pathology of the joints, corrects their vicious position. An orthopedist treats injuries: sprains, bruises, dislocations, fractures, burns.

The spine pays for our ability to walk upright from the moment we take our first steps. Throughout his life, he experiences enormous stress. An orthopedist also deals with the problems of the pathology of the spine. The most common problem since childhood is scoliosis.

For children and adults with diseases of the musculoskeletal system, the orthopedist can prescribe the manufacture of individual orthopedic insoles. He can also set a course physiotherapy exercises, to carry out therapeutic measures for household and sports injuries.

In advanced cases, the patient is transferred to the hands of orthopedic surgeons specializing in arthroplasty (artificial replacement of the joint). It may be needed for a disease such as arthrosis, when the cartilage in the joint wears out or for fractures, for example, of the femoral neck. Also in the competence of an orthopedist is the treatment of deformities of the neck and chest.

A pediatric orthopedist helps children with complications after cerebral palsy and poliomyelitis to get back on their feet together with a neurologist. Orthopedic examination plays an important role in the prevention and treatment of hip dysplasia and congenital hip dislocation. The orthopedist also treats rheumatoid arthritis, arthrosis, bursitis - inflammatory and degenerative diseases of the joints.

If you have people in your family neurological diseases, or if you have been injured in the past, had an accident, do not forget to see an orthopedist once a year. This will save you from complications.

The orthopedist conducts an examination on the couch, assesses the range of motion in the joint and prescribes ultrasound of the joints, X-ray, MRI or CT.

Wounds and fractures were treated by the ancient Incas, they knew how to perform operations on the skull, set dislocations and splice bones.

With the development of orthopedics, the orthopedic profession has become high-tech. An orthopedist must have an engineering mindset, have golden hands, be able to put into practice knowledge about the biomechanics of the body. The pioneer in the pace of development of orthopedics today is Germany. A good orthopedist is responsible, has the skills of an engineer and a sculptor, he has an excellent fine motor skills and a pronounced propensity to work with his hands. The ability to empathize must be combined with determination. The orthopedist must be able to correctly decipher X-rays, MRI sections.

A traumatologist deals with the restoration of health if it has suffered as a result of an injury, and an orthopedist deals with those cases when the musculoskeletal system is under load or deformed. In order not to get confused in the terminology, all the pathologies that the orthopedist deals with are called orthopedic diseases, and the pathologies that the traumatologist treats are called trauma.

Injury (damage) is anatomical and physiological changes in tissues or in the whole organism, arising from a sudden and strong impact of factors that exceed the strength of tissues or their maximum allowable range of motion. It is the surprise factor that leads to injury. Any dysfunction of movement or deformity that has occurred over a longer or shorter period of time is classified as a non-traumatic injury and falls within the competence of the orthopedist.

Pathologies dealt with by an orthopedic traumatologist

The responsibilities of a traumatologist include:

diagnosis of damage to the musculoskeletal system;
providing first aid for injuries;
specialized trauma care;
treatment of patients with injuries until full recovery after discharge from the hospital;
dispensary observation of patients after trauma;
examination of temporary disability due to injuries;
referral of patients for medical examination and disability;
injury prevention.

The duties of an orthopedist include:

examination of patients with pathology of the musculoskeletal system;
the appointment of the necessary tests and studies to diagnose the cause of the pathology and the general condition of the patient;
specialized treatment of patients with diseases of the musculoskeletal system;
periodic dispensary observation of patients who have undergone surgery or use orthopedic devices (orthoses) and prostheses;
examination of the ability to work of patients and referral for disability;
educational work with doctors of other specialties who discover pathologies that require consultation and treatment by an orthopedist.

A bruise is a closed injury to soft tissues or organs. Closed are those injuries in which the skin remains intact (there is no wound channel). The cause of bruises is a direct mechanical impact on an open part of the body, for example, a blow against a hard object. Bruising of the joint causes the formation of hemarthrosis - the accumulation of blood in the joint cavity. Most often, hemarthrosis occurs in the knee joint, manifesting itself as balloting of the patella.

Compression is also a closed injury and occurs with strong and relatively prolonged pressure on soft tissues. Compression violates the nutrition of tissues, they are destroyed, and the decay products of tissues enter the bloodstream and cause intoxication syndrome. All this condition is called "syndrome of prolonged squeezing." With the syndrome of prolonged squeezing, not only traumatologists, but also general surgeons and resuscitators are involved in the victims.

Wounds - a violation of the integrity of the skin, mucous membranes, as well as tissues that are located under them (subcutaneous tissue, muscles, tendons, ligaments and nerves). Injuries are considered a surgical problem if there are no associated fractures. If, along with the wound, there are tissue ruptures, bone fractures, then they are treated by traumatologists.

Tears and sprains are called injuries of those tissues that have the property of elasticity and contractility - muscles, tendons, ligaments (soft tissues). Tendons are the part of a muscle that attaches it to bones. Ligaments fix two bones, providing joint stability during movement, but do not contract themselves. The reserve of ligaments in terms of elasticity is greater than the reserve of tendons, so the tendons are more likely to tear and the ligaments are stretched.

Injuries to muscles, tendons and ligaments have the following three degrees of damage:

1 degree or stretch- observed if the tissue is stretched more than is possible, provided that its continuity is maintained;
Grade 2 or incomplete rupture- there is a violation of the continuity of the tissue in a certain area;
Grade 3 or complete rupture- the integrity of the tissue is completely broken, while two or more torn pieces are determined.

Sprains and ruptures have the following features:

ligament and tendon injury occurs when sudden and sudden movement, which is outside the range of motion in this joint;
damage to the tendon impairs flexion or extension of the joint;
when injured, the muscle ruptures, as it has quite a large opportunity to stretch ( stretching the muscle "to the limit" causes it to relax, not injury, stretching beyond its capabilities - a gap);
muscle rupture occurs in the place where it passes into the tendon - this is the “weakest” point, which is devoid of both muscle elasticity and tendon strength;
rupture of the muscle occurs at the moment when it is overstretched or when struck at the moment of maximum tension.

Peripheral nerves are the nerves of the limbs, which, unlike the central nerves (in the brain and spinal cord), are subordinate structures. Nerves can be motor (motor neurons) and sensory (sensory), but it is important to know that nerve bundles (plexuses) are composed of motor and motor fibers. sensory nerve. Nerve damage can be due to a bruise or rupture.

Most often, the nerves of the upper extremities (ulnar, radial and median), lower extremities (femoral, ischial, tibial and peroneal) and the brachial plexus are damaged.

dislocations

A dislocation is a change in the normal arrangement of the articular surfaces of two bones, their separation or displacement. If the dislocation is combined with a fracture, then in this case they speak of fracture-dislocation. If, due to dislocation, the integrity of the skin is violated, that is, destruction of all tissues of the joint, as well as the skin, is observed, then this condition is referred to as an open dislocation.

There are the following types of dislocations:

traumatic dislocation- occurs due to violent movement in the joint, impact or fall;
pathological dislocation- is a consequence of various pathological processes that destroy bone formations and the ligamentous apparatus of the joint, cause inflammation of the articular bags or paralysis of the muscles that strengthen the joint ( paralytic dislocations);
habitual dislocation - repeated more than 2 times and is a consequence of instability in the joint;
congenital dislocation- occurs due to underdevelopment of the joint.

How is an appointment with an orthopedist

Primary counseling includes the main stages.

Getting to know the patient, studying his outpatient card, assessing complaints and general condition.
Visual examination and assessment of the movements of large and small joints, as well as the spinal column throughout its entire length.
Identification of anomalies and deformities of the musculoskeletal system.
Drawing up a plan for further examination, as well as making a preliminary diagnosis.

Patients come to the doctor for a second appointment with the results of an instrumental examination (images, laboratory tests). Based on the diagnostic data, as well as on the information obtained as a result of the re-examination, the doctor makes the final diagnosis and forms a comprehensive treatment plan.

A doctor examines a patient who has previously undergone surgery on the structures of the musculoskeletal system. Evaluates the effectiveness of the operation, the presence of contractures, instability and draws up an individual rehabilitation plan. There is a separate schedule of visits to the orthopedist in the postoperative period, which allows you to monitor the general condition of the patient in dynamics.

An orthopedic examination can be called "superficial", which does not require special preparation. Inspection is always performed on a naked body, i.e. in the doctor's office, it will be necessary to expose the disturbing limb or undress to underwear if the spine and the entire musculoskeletal system are disturbed. An orthopedic doctor will conduct a visual examination, thanks to which it is possible to ascertain the presence of deformities of the bones (joints) or curvature of the limbs (spine), determine the functional ability of the joints and muscles, and so on. For accurate diagnosis and determination of the causes of the condition, it is usually prescribed:

X-ray of the affected area

ultrasound of the joints,

CT or MRI in severe pathologies and to exclude cancer,

laboratory blood tests for ESR, prothrombin index, fibrinogen, etc.

Further, based on the results of the tests, a suitable treatment in a particular case will be prescribed. But regardless of whether any orthopedic disease is diagnosed, the doctor will definitely recommend adhering to proper nutrition and lead healthy lifestyle from a life with sufficient physical activity.

Swimming is highly recommended, especially in modern conditions when most of the time people spend sitting at the computer, which leads to compression of the spine and congestion in the pelvic organs. Constant care for your musculoskeletal system will ensure active old age, not complicated by pain and movement-restricting conditions.

Very often, patients are interested in how the first appointment with an orthopedist takes place. In order to get an approximate idea of this, we will tell you about the main nuances of visiting this specialist:

The orthopedist visually assesses the anatomical structure relevant to the skeletal system. In this situation, the correctness is analyzed along with the irregularity of the structure. This stage is especially important when examining newborns.
The specialist determines the range of motion that is relevant for the affected joints.
The doctor prescribes fluoroscopy, within which, as a rule, the alleged diagnosis is clarified or refuted.
The presence of complex forms of diseases may require the need for such research methods as computed tomography along with magnetic resonance imaging.

We examined who this orthopedist is and what this specialist treats.

To get the most efficient and informative

You need to prepare for the reception. To do this, you should remember exactly when and in connection with what the problem arose, about which a person turns to an orthopedist. It is also very important to remember how the disease developed - when it started, how fast it progressed, which led to an increase in the severity of deformities and other nuances.

In addition, it is very important to tell the doctor the whole range of sensations (pain, stretching, shooting, etc.) that occur when making movements or at rest in the deformed area of the musculoskeletal apparatus. It is best to write down all this information in a concise form on paper, and at the doctor’s appointment, either just read it or tell it, referring to the summary, so as not to miss or forget anything.

Since the orthopedist will necessarily perform a physical examination, the deformed area should be washed, bandages and other devices used to improve the condition on their own should be removed from it. You also need to dress in such a way that you do not feel shame or embarrassment in the process of undressing in front of the doctor.

In order for the orthopedist to be able to make a diagnosis and prescribe treatment literally in one visit, before consulting a doctor, you can take an x-ray or tomography of the deformed area of the musculoskeletal system. In this case, you need to take pictures and conclusions of studies with you to the appointment.

In addition, it is imperative to take all available x-rays, tomograms, ultrasound records and other studies that were previously performed on the deformed area of the musculoskeletal system (if any, of course, if any) to an orthopedic appointment.

Orthopedic recommendations: how to identify flat-valgus deformity of the feet in a child, treatment, choice of shoes, massage - video

It should be noted that some of the types of diseases that have been listed are only a small part of their existing options. Among other things, the variety of such discrepancies is noted not only in pathologies, but also in methods of treatment, which relates to injuries and diseases of the skeletal system.

Diseases of the joints, bones, ligaments, spine and tissues that are located in the immediate environment of the affected area may be congenital or acquired during life, and, in addition, may have an infectious nature of occurrence. Acquired pathologies are always associated with any injuries or occupational injuries along with metabolic disorders. Infectious diseases occur due to concomitant inflammation as a result of the transfer of a particular disease.

In this situation, as is already clear from the specified area of the doctor's specialization, we are talking about his connection with various injuries, as well as the elimination of their consequences. In this regard, a number of reasons are determined, within the framework of which a visit to the office of an orthopedist-traumatologist is required:

Fractures resulting in dysfunction of the bones.
Re-transfer of fractures by the patient.
Residual signs of human transmission of polio.
Not stopping, but, in addition, persistent pain in the region of the spine, limbs and joints.
The presence of sprains, bruises, frostbite, insect or animal bites.
Deformation of the limbs or other injuries inflicted on the spine, chest.
Damage to the functions of small and large joints.

A certain group of symptoms is distinguished, on the basis of which an urgent appeal to an orthopedist is required, since such a pathological condition can act as a kind of signal that will indicate the development of a serious pathogenic process, and, in fact, the disease itself. A similar need for medical care should be discussed in the case of the following symptoms:

The presence of a crunch in the joints.
Poor joint mobility.
Feeling of numbness in hands.
The appearance of swelling of the joints.
Soreness in the joints during any, even the most insignificant movements.
The appearance of pain in the back.
Violation of posture along with a quickly emerging feeling of fatigue.
The presence of aching pains and aching muscles, which are caused by changes in the weather.

There is, in addition, a number of diseases, the development of which determines the need for a particular patient in a regular visit to the orthopedist. Among them are the following types of diseases:

Presence of rheumatoid arthritis.
The transfer of the patient any injuries of the spine.
The presence of arthrosis of the joints.
Shoulder or knee dislocations.
The development of osteochondrosis.
Fracture of the femoral neck.

Moreover, orthopedic traumatologists can advise preventive actions with regular sports loads, and, in addition, when choosing extreme types of recreation as a way of spending time. In this case, it will be possible to timely eliminate certain injuries, which, in turn, will make it possible to eliminate the problems that accompany them in the future.

There are a number of different circumstances in which you should visit this specialist with your child. Due to the timely appeal to the orthopedist, it is possible to achieve effective results regarding the elimination of developing pathologies. Plus, it becomes possible to correct the congenital forms of any diseases associated with the motor system, if any. So, such circumstances include the presence of the following defects:

Defective position of the hip, which can be noted in a newborn baby. This usually happens with congenital dislocations.
Rapid fatigue of children while walking. Noticeable visual heaviness of the gait. In this situation, we are usually talking about flat feet.
A noticeable stoop along with a constant inclination of the head to the same shoulder. In this case, most likely, we have to talk about torticollis.
Complaints of the child about the periodic appearance of pain in the arms and legs, and, in addition, in the neck or back.
The presence of clubfoot, in which it visually seems that the child is raking with his foot during his walk.

The difficulties of pediatric orthopedics lie in the fact that it is not always possible to determine the pathology at birth by eye. Therefore, a timely appeal to a specialist when parents or a pediatrician detects congenital or acquired anomalies in a child helps to avoid serious complications. And with age, the loss of performance. The main indications for contacting a pediatric orthopedist include:

Noticeable curvature of posture (kyphosis, lordosis, scoliosis).
Signs of congenital dislocation of the hip in newborns.
Heaviness of gait and fatigue during walking.
Foot deformity - varus or valgus.
Complaints of discomfort, stiffness and aching pain in the lumbar region, neck, upper and lower extremities.
Incorrect position of the head with an inclination to the right or left shoulder (signs of torticollis).

A pediatric orthopedist is a doctor who specializes in the diagnosis, prevention and treatment of deformities of the musculoskeletal system in children of any age (from birth to 18 years of age). A pediatric orthopedist is no different from an adult, except that his patients are children, not adults.

The selection of a pediatric orthopedist as a separate specialty was made because the doctor needs to know the characteristics of bones, joints and muscles in children of different ages, as well as their growth rate, and take this into account when choosing therapy. Due to the peculiarities of the structure and growth of bones, joints and muscles inherent in children, pediatric orthopedists are a separate medical specialty.

An orthopedist should be contacted in cases where a person of any age or gender has either visible deformities of the musculoskeletal system, or periodically occurs

Evidence of the presence of such deformations. This means that an orthopedist should be consulted if a person is concerned about any of the following conditions or symptoms:

Torticollis (neck tilt to the side and down with the inability to straighten the head);
Any deformities in the joints (for example, crookedness, inability to bend or straighten the joint, etc.);
Any bone deformities (for example, a skewed pelvis, curvature of the bones of the chest, legs, arms, etc.);
Any violation of posture;
flat feet;
Clubfoot;
Habitual dislocation of the hip or shoulder;
Osteochondrosis;
Residual effects after poliomyelitis;
Difficulty, pain or limited movement in any joint;
Persistent, persistent pain in the joints, arms, legs, or spine;
The need for rehabilitation after injuries;
The need for the selection of prostheses or orthoses.

A visit to the orthopedist should become a regular procedure. Go through a general medical examination 1-2 times a year to control your own body and prevent illnesses in time. Bone disorders can develop for years without causing much discomfort or pain to the patient. That is why frequent diagnosis- the guarantee of the health of the musculoskeletal system.

An unscheduled consultation with an orthopedist may be needed unexpectedly. Have you or a child been injured while playing sports, experiencing discomfort in the limbs, for no apparent reason, or just being out in the cold a little longer than expected? Go to a consultation with an orthopedist to rule out serious diseases or immediately treat them.

Sprains, bruises, animal bites, deformation of the limbs / spine / chest / functionality of small or large joints should also prompt a person for urgent diagnosis.

The main rule is not to endure pain. Cracking in the joints, numbness or swelling of the hands, pain in movement, episodic aching pains throughout the body, rapid fatigue or poor posture significantly affect the quality of human life. Protect your own comfort, do not wait until the pain goes away on its own or develops into a chronic one - visit an orthopedist.

People who are engaged active species sports, like extreme recreation or work in exhausting conditions (for example, in production), should visit an orthopedist more often, as they are at risk.

Situations that lead a person to a traumatologist and those that make him turn to an orthopedist are fundamentally different. One criterion is important here - the connection of complaints and symptoms with a recent injury or the absence of this connection. If the patient's complaints arose after an injury, a blow, a fall, an awkward movement, then he needs to go straight to the traumatologist's office.

If a person cannot move any part of his body due to an injury, then an orthopedist sees him. It is possible to get to a traumatologist right away, while people can go to an orthopedist after consulting a general practitioner, pediatrician or doctors of other specialties. That is why the orthopedist in most cases accepts people with an already known diagnosis.

Symptoms that should be addressed to a traumatologist

Symptom	Development mechanism	What studies are needed to diagnose the cause?	What diseases are symptomatic?
Sharp pain after a blow, movement, fall, which increases with the slightest movement or pressure	Pain occurs due to irritation of pain receptors in the tissues of the damaged area. The most sensitive are the pain receptors of the periosteum ( Therefore, when fractures pain is the most severe).		bruises; compression ( long-term squeezing syndrome); nerve damage; dislocation; fracture; spinal injury; false joint.
Swelling and bruising in the area of injury	When tissues are damaged, blood vessels rupture, blood flows into soft tissues ( into the skin, under the skin, under the fascia) or into the cavity of the joints, which outwardly looks like swelling ( puffiness). Bruising occurs when blood soaks into soft tissues.	inspection and palpation; measurement of limb length; joint movement testing; radiography; arthroscopy; general analysis of blood and urine; coagulogram.	bruises; compression ( long-term squeezing syndrome); rupture and sprain of ligaments, tendons and muscles; dislocation; fracture; spinal injury;
Limb shortening after injury	In a fracture, bone fragments are displaced in different directions due to the tension of the muscles that are attached to different parts bones. With a dislocation, one of the heads of the bone is located above the level at which it should be.	inspection and palpation; goniometry; radiography;
Abnormal bone mobility	In the area of the fracture, when probing, it is possible to displace the fragments in relation to each other, to determine the edges of the fragments (usually sharp). A crunch is a sound manifestation of the displacement of fragments or damaged cartilage.	inspection and palpation; radiography; arthroscopy; general analysis of blood and urine; coagulogram.
Feeling of sharp edges or the appearance of a crunch when pressed			fracture; trauma to the menisci of the knee joint; traumatic brain injury.
Open wound with protruding bone fragments	The edges of bone fragments protrude from an open wound if the skin is damaged from the inside by a sharp edge of a fragment.	inspection and palpation; radiography; general analysis of blood and urine; coagulogram.	fracture; open dislocation; fracture-dislocation; traumatic brain injury.
Deformity in the area of the joint and soft tissues	Deformation and defects occur when the anatomical location of various parts of the joint or soft tissues is disturbed, as well as with edema ( traumatic or inflammatory) articular and extra-articular tissues.	inspection and palpation; testing the range of motion in the joint; radiography; scintigraphy; arthroscopy; general analysis of blood and urine; coagulogram.	injury; compression ( long-term squeezing syndrome); stretching and rupture of muscles, ligaments, tendons; dislocation; fracture; spinal injury; trauma to the menisci of the knee joint; traumatic brain injury.
Soft tissue defects (retraction, dense formation)	In the form of a dense formation, a piece of the torn muscle can be felt, and the retraction is the place where the tissue should normally have been.	inspection and palpation; testing the range of motion in the joint; measuring the length and volume of the limb; radiography; arthroscopy; general analysis of blood and urine; coagulogram.	rupture and sprain of ligaments, tendons and muscles; spinal injury; injury to the menisci of the knee joint.
Unnatural or forced position of the limb or torso	A forced position occurs when the components of the joint become disengaged, which fixes the joint in one position, without the possibility of changing it. An unnatural position acquires a part of the body if the bone is broken somewhere.	inspection and palpation; radiography; arthroscopy; general analysis of blood and urine; coagulogram.	dislocation; fracture; spinal injury; injury to the menisci of the knee joint.
Dysfunction of movement in the joint	The function of the joint is disturbed when there is a rupture or severe swelling of its tissues, a violation of the integrity of the bones that make up the joint, or damage to the motor nerves.	inspection and palpation; testing the range of motion in the joint; measuring the length and circumference of a limb; radiography; arthroscopy; joint puncture; general analysis of blood and urine; coagulogram.	injury; compression ( long-term squeezing syndrome); rupture and sprain of ligaments, tendons and muscles; dislocation; fracture; injury to the menisci of the knee joint.
Violation of skin sensitivity	Weakening ( numbness) or loss of skin sensitivity is observed when sensory nerves are compressed or ruptured.	inspection and palpation; testing the range of motion in the joint; radiography; general analysis of blood and urine; coagulogram.	compression ( long-term squeezing syndrome); nerve damage; spinal injury; traumatic brain injury.

Erased symptoms

The development of various bone disorders occurs, as a rule, in a very slow manner, because the first symptomatology, which might require an orthopedic consultation, may be mild. But a serious and pronounced manifestation of symptoms will be noted at the stage of large-scale lesions that occur against the background of pathological processes. Given this feature, visiting the orthopedist's office should become regular, and this must be done from childhood.

Traumatologist-orthopedist - what kind of doctor is this? Let's take a closer look at this issue.

Who is an orthopedist, orthopedic traumatologist and orthopedic surgeon?

is a doctor specializing in orthopedics, which is a medical field that deals with prevention,

treatment and

people suffering from various deformities of bones, muscles, joints or ligaments. That is, if for any reason a person has any deformation of the bones, joints, ligaments or muscles, then it is the orthopedist who corrects such defects.

Various deformations of the musculoskeletal system can appear due to various reasons, such as trauma, congenital malformations, long-term inflammatory diseases, etc. However, regardless of the cause of the deformity of the musculoskeletal system, an orthopedist is engaged in their correction.

Orthopedics is closely related to another medical field - traumatology, which deals with the diagnosis and treatment of various injuries of muscles, bones, joints and ligaments. However, traumatologists identify and treat "fresh", recent injuries of the musculoskeletal system, such as fractures, sprains, ruptures of muscles and tendons, etc.

Due to the close links between traumatology and orthopedics, these medical disciplines are combined into one specialty. This means that after graduating from the institute, a doctor who has completed an internship or residency in the specialty “orthopedics and traumatology” is qualified as a “traumatologist-orthopedist”.

After completing an internship or residency, a physician may work in the field of orthopedics or traumatology. It is impossible to complete an internship or residency in the specialty only orthopedics or only traumatology and, accordingly, it is impossible to qualify as an “orthopedist” or “traumatologist”. These disciplines are one specialty, like “obstetrics and gynecology”.

Accordingly, the term "orthopedist-traumatologist" is the correct and full name of the specialty of a doctor involved in the identification and treatment of injuries and deformities of the musculoskeletal system. But, besides this, the term “orthopedist-traumatologist” in everyday life has another meaning - that a doctor can simultaneously repair injuries as a traumatologist, and treat deformities of the musculoskeletal system as an orthopedist.

Based on such terminology features, if a person has any complex damage to bones, joints, muscles or ligaments, which will subsequently give a deformation of the musculoskeletal system, then he needs to contact an orthopedist-traumatologist, who can simultaneously eliminate the damage, and then carry out the correction of the resulting deformations.

The term "orthopedic surgeon" means a specialist who can perform not only conservative, but also surgical treatment (operations) of various deformities of bones, joints, muscles and ligaments. In principle, traumatology and orthopedics is a surgical specialty, the possession of which implies the performance of operations.

But in practice, not all orthopedic traumatologists perform surgical interventions, some doctors specialize only in conservative therapy. Therefore, when they say “orthopedic surgeon”, they mean that the doctor treats deformities of bones, joints and muscles not only with conservative methods, but also with the help of surgical operations.

An orthopedic doctor can apply both conservative and surgical methods for the treatment of deformities of the musculoskeletal system. So, for example, contractures, clubfoot, congenital dislocation of the hip are treated with conservative methods using plaster casts, scoliosis - with the help of corsets and a specially designed complex exercise, etc.

But the curvature of bones, paralysis, tendon ruptures are treated with surgical methods, performing operations to restore the normal position of the bones, tendon transplantation, etc. Regardless of whether surgical or conservative treatment of deformities of the joints, bones or muscles is performed, orthopedic doctors widely use various orthopedic devices, such as shoe insoles, corsets, prostheses, and splint sleeve devices.

It should be remembered that orthopedics is a very extensive medical field, as a result of which there are separate narrow areas in it: spine surgery, intra-articular operations, joint prosthetics, etc. Accordingly, different orthopedic traumatologists can specialize in one or another area of orthopedics or traumatology, and therefore not all doctors will undertake the treatment of any orthopedic or traumatological pathology.

An orthopedic traumatologist is a specialist who diagnoses and treats traumatic and non-traumatic pathologies of the musculoskeletal system (bones, joints, muscles, ligaments, cartilage). Traumatologist-orthopedist graduated medical university, and after that for 2 years he studied the specialty "Traumatology and Orthopedics".

Traumatology is the study of violent or accidental injuries.

Orthopedics (ortos - direct, correct and paideia - education) is the doctrine of the correct development of different parts of the musculoskeletal system and deformities that occur with various diseases. Due to the fact that both sections of medicine are related to the musculoskeletal system, and the methods of treating injuries and diseases are basically the same, it was decided to combine traumatology and orthopedics into one specialty.

An examination by a traumatologist takes place in the same order as an examination by an orthopedist. The difference between the studies conducted by these two specialists is what exactly they find. A traumatologist is a “quick response” specialist, his task is to determine the type, severity and location of damage, the general condition of the patient.

After that, the question of his treatment is decided, and also as quickly as possible. As for the orthopedist, the problems that this doctor faces are mostly old, one might say, familiar to the patient. Orthopedic diseases develop slowly, so the specialist needs more time to diagnose and choose a treatment method.

Studies prescribed by an orthopedic traumatologist

Study	How is it carried out?	What injuries does it reveal?	What orthopedic pathologies does it reveal?
Inspection, feeling	Inspection allows you to assess the state of the skeleton, its deformation, the forced position of the patient, posture and symmetry of the body. If an injury is suspected, examination and palpation of tissues are carried out very carefully, since this, firstly, can cause increased pain, and secondly, aggravate the injury.	injury; compression; wounds; breaks, stretching; fractures; dislocations; damage to peripheral nerves; meniscus damage; false joint ( pseudoarthrosis); traumatic brain injury.	congenital dislocation of the hip; tunnel syndromes; clubfoot; clubhand; flat feet; hollow foot; valgus deformity of the first toe; Morton's finger; hammer fingers; torticollis; chest deformities; syndactyly; polydactyly; ectrodactyly; amniotic bands; osteoarthritis; arthritis; bone deformity in rickets; violation of posture; rachiocampsis ( pathological lordosis, kyphosis); scoliotic disease; myositis; tendinitis; tendovaginitis; plantar fasciitis; bone tumors; osteodystrophy.
Testing the range of motion in the joints	Movements in the joint can be active ( the patient makes them himself) and passive ( made by a doctor). The volume of passive movements is greater than the volume of active ones. The range of motion depends on the state of the joints and the musculoskeletal system. With the help of flexion and extension of the joint, the doctor determines how much range of motion is preserved. In addition, various tests for each joint and muscle group) allow to carry out differential diagnosis pain syndromes. Tests can be performed in a sitting, standing and lying position.	joint injury; meniscus damage; dislocations; stretching of the musculoskeletal system.	congenital dislocation of the hip; osteoarthritis; arthritis; osteochondropathy; osteochondrosis; spondylosis; myositis; tendinitis; tendovaginitis; scoliotic disease; violation of posture; rachiocampsis ( pathological lordosis, kyphosis); lumbarization; sacralization; bone tumors.
Measurement of range of motion in the joints of the limbs and spine (goniometry)	The amplitude of movements is measured using an orthopedic goniometer with two levers. On one of them there is a scale with degrees, and on the second - an arrow. The levers are set parallel to the segments that make up the joint, and the center of the instrument (scale) is placed on the joint itself. The measurement is made in the state of flexion and extension.	In trauma, measuring the range of motion in a joint can be dangerous, so range of motion testing is limited.
Measuring the length and circumference of limbs	Change in limb length ( shortening or lengthening) is often carried out "by eye". To do this, the doctor asks the patient to bend his arms at the elbow joints or legs at the hip and knee joints (sitting or lying down). A more objective method of measuring limbs is measuring with a centimeter tape. The doctor measures the limb between the bony protrusions, which are, as it were, identification points. The circumference of individual limb segments is measured to assess the condition of the soft tissues, and the circumference of the joint is measured to identify its deformation. The thigh must be measured in three different places - in the upper, middle and lower part of it.	bruised joint with hemorrhage in its cavity ( hemarthrosis); bone fractures; intra-articular fractures; fracture; trauma to the menisci of the knee joint; traumatic brain injury; rupture and sprain of ligaments, tendons and muscles; dislocation.	hip dysplasia ( congenital dislocation of the hip); osteochondropathy; osteodystrophy; osteoporosis; osteomyelitis; tumor of bone and cartilage; osteoarthritis; arthritis; limb length discrepancy.
X-ray examination	Radiography of the skull, limbs, chest, spine and pelvis is carried out in two projections - front and side. The chest and spine are usually examined in a standing position ( if condition allows). To study a specific part of the limb, it is placed on the x-ray cassette directly or at an angle. In some cases, it may be necessary to stand on the cassette with both feet ( foot examination).	dislocation; fracture; spinal injury; meniscus injury ( contrast x-ray); traumatic brain injury; polytrauma; epiphysiolysis in children.	congenital dislocation of the hip; osteoarthritis; arthritis; clubfoot; osteodystrophy; osteochondrosis; osteoporosis; spondylolisthesis; lumbarization; sacralization; chest deformity; flat feet; hollow foot; plantar fasciitis; bone tumors; congenital and acquired)
Ultrasonography	Ultrasound examination can detect changes in tendons, joints, bones, muscles. The sensor sends echo signals and registers the signals reflected from tissues. The degree of reflection depends on the properties of tissues, which change with pathological conditions (the absorption of ultrasound also changes accordingly).	meniscus injury; injury ( hematoma, hemarthrosis); breaks, stretching; intra-articular damage (capsule rupture); trauma to the menisci of the knee joint; spinal injuries; false joint; epiphysiolysis in children.	congenital dislocation of the hip; chronic meniscitis; bone tumors; tendovaginitis; plantar fasciitis; myositis; osteoarthritis; arthritis; osteomyelitis; osteochondropathy; tunnel syndromes.
Arthroscopy	Arthroscopy is an endoscopic examination of the joints using a special device called an arthroscope. An arthroscope is a thin metal tube with a camera that allows you to broadcast the image on the monitor screen in an enlarged form. The procedure is performed under general anesthesia or under spinal anesthesia. For a better examination of the joints, fluid is injected into their cavity through the arthroscope. Arthroscopy also allows tissue sampling (biopsy) and therapeutic manipulations.	trauma to the menisci of the knee joint; bruised joint with hemorrhage ( hemarthrosis); torn ligaments and muscles associated with the joint); fractures ( patella, shoulder neck); dislocations ( especially familiar).	chronic meniscitis; osteoarthritis; osteochondropathy; arthritis (chronic); tendinitis.
Magnetic resonance imaging (MRI)	During an MRI, the patient lies down on a platform that moves inside the tomograph tunnel, which creates a magnetic field around the patient. This field temporarily sets the protons in motion, which become the sources of the signal picked up by the sensors. If you need to examine a specific joint, then instead of a tunnel, a “coil” is used that wraps around the joint and produces a “local MRI” ( such devices are called open). In an MRI, contrast agents can be injected intravenously to amplify signals from tissues or make blood vessels visible.	breaks, stretching; trauma to the menisci of the knee joint; broken bones ( especially pathological); intra-articular fractures; traumatic brain injury; dislocations; epiphysiolysis in children.	osteoarthritis; arthritis; osteochondropathy; osteodystrophy; osteochondrosis; malignant bone tumors; spondylosis; spondylitis; spondylopathy; spondylarthrosis; lumbarization; sacralization; spondylolisthesis.
CT scan (CT)	CT is an analogue of X-ray examination, it allows you to make very thin X-ray sections of the organ under study and, after computer processing, to obtain a three-dimensional pattern. The study is carried out in the same way as with MRI - on the diagnostic table. Difference in the presence of irradiation in CT.	fractures ( pelvic bones, spine, intra-articular fractures); pathological fractures ( can only be detected by CT); traumatic brain injury; ruptures of muscles, tendons and ligaments; epiphysiolysis in children.	congenital dislocation of the hip; limb length inequality ( congenital and acquired); osteochondrosis; osteoarthritis; chronic meniscitis (meniscopathy); spondylopathy; spondylarthrosis; spondylitis; osteoporosis; lumbarization; sacralization; osteodystrophy.
Scintigraphy	Scintigraphy is a scanning of the body or its individual sections after the introduction of radionuclides, which, accumulating in the tissues, begin to emit rays. The radiation is captured by a gamma camera, which is installed over the desired area. In pathology, the accumulation of the drug may decrease or increase.		arthritis; osteochondropathy; bone tumors; osteomyelitis.
podometry (podography)	Podometry is a method that allows you to obtain information about the state of the supporting points of the feet and the violation of the even distribution of the load. Currently, computerized submetry is used. The subject steps with one foot onto a platform connected to a computer. This platform has elements that register the pressure of each section of the foot on the surface. The received data on the computer are displayed as a color image of the foot ( color depends on the degree of stress experienced).	condition after a fracture of the bones of the lower extremities.	flat feet; hollow foot.
plantometry (plantography)	Another method for diagnosing the condition of the foot. With computer plantometry, the patient stands with both legs on a transparent platform, which has special lighting from below. Transparency provides the ability to photograph or scan and transfer to a computer an image of sole prints (footprint).		flat feet; hollow foot.
Joint puncture	A puncture is the insertion of a needle or instrument into an organ. An orthopedic traumatologist performs a puncture of the joint, soft tissues ( if suspects the presence of an abscess, hematoma or tumor), bones. The material that the doctor receives during the puncture is called punctate. The punctate is sent to the laboratory for analysis. In some cases, the diagnosis is clarified at one glance at the punctate (color and composition).	joint bruise ( hemarthrosis); intraarticular fracture.	arthritis; osteoarthritis; chronic meniscitis (meniscopathy).
Bone biopsy	A biopsy is the removal of tissue in this case bone) by puncturing the bone with a needle (puncture) or during a surgical operation ( open biopsy). The purpose of the procedure is to assess the state of the bone tissue.	in traumatology, a biopsy is performed if there is a suspicion that the injury is accompanied by gangrene of the limb ( necrosis) and amputation is necessary.	osteoporosis; osteochondropathy; bone tumors.
Densitometry	Densitometry, or evaluation of bone density, may be done with x-rays or ultrasound ( carried out in the same way as a conventional ultrasound). X-ray densitometers have an L-shaped sleeve and a platform on which the patient lies. The sleeve is an X-ray emitter, it is installed over the desired area. Bone density on x-rays is assessed "by eye" or using computer programs.	pathological fractures ( with suspected osteoporosis).

Operative and closed intervention

As part of the ongoing treatment, an orthopedic traumatologist can apply methods of surgical and closed intervention. This technique is called redressing. In this situation, a step-by-step correction by an orthopedic doctor of pathological disorders that are relevant to the patient, and, in addition, deformities in the area of individual joints that relate to the support and movement system, is implied.

This is what an orthopedist treats and does. What doctor is this? This question can be heard from patients quite often.

Where does the orthopedist take?

General information

An orthopedic doctor can work both on the basis of a department of a hospital, and in outpatient clinics. However, the orthopedist always conducts an appointment only on the basis of outpatient clinics. Currently, orthopedists can see patients in municipal polyclinics, rehabilitation centers,

orthopedic direction or in private medical clinics. Accordingly, in order to get an appointment with an orthopedist, you must either go to the clinic at the place of residence or work, or to a rehabilitation center for people with disorders of the musculoskeletal system, or to a private clinic, or to an orthopedic sanatorium.

In municipal polyclinics, the staff list includes the position of a traumatologist-orthopedist. Therefore, if the doctor's office is busy, then you can get to the orthopedist,

and having previously received a referral or coupon from the district police officer

If the place of an orthopedist is not actually occupied in the polyclinic, then you need to contact the head of the polyclinic and get a referral from him for a consultation with an orthopedist in another outpatient clinic in the city.

You can get an appointment with an orthopedist in a rehabilitation center without a referral from a local therapist. It is enough to find out the appointment schedule and sign up for a consultation in your free time.

Specialists conduct receptions on the basis of municipal polyclinics. Before you get an appointment with a doctor, you must first register at the reception, having received a ticket to the district police officer. The therapist refers to an orthopedist if a serious pathology is suspected.

In addition to state polyclinics, patients are consulted on a commercial (paid) basis. This information is equally relevant for adult and pediatric orthopedics.

Job description of a traumatologist-orthopedist

1. General Provisions

1. This job description defines the duties, rights and responsibilities of a traumatologist-orthopedist.

2. A person with a higher medical education who has completed postgraduate training or specialization in the specialty "Traumatology and Orthopedics" is appointed to the position of a traumatologist-orthopedist.

3. A traumatologist-orthopedist must know the basics of the legislation of the Russian Federation on health care; legal documents regulating the activities of healthcare institutions; the basics of organizing medical and preventive care in hospitals and outpatient clinics, emergency and emergency medical care, disaster medicine services, sanitary and epidemiological services, drug supply to the population and health care facilities; theoretical foundations, principles and methods of clinical examination; organizational and economic foundations for the activities of health care institutions and medical workers in the context of budgetary insurance medicine; fundamentals of social hygiene, organization and economics of healthcare, medical ethics and deontology; legal aspects of medical activity; general principles and basic methods of clinical, instrumental and laboratory diagnostics of the functional state of organs and systems of the human body; etiology, pathogenesis, clinical symptoms, course features, principles of complex treatment of major diseases; rules for the provision of emergency medical care; bases of examination of temporary incapacity for work and medico-social examination; fundamentals of health education; internal labor regulations; rules and norms of labor protection, safety measures, industrial sanitation and fire protection.

In his specialty, a traumatologist-orthopedist should know modern methods of prevention, diagnosis, treatment and rehabilitation; content and sections of traumatology and orthopedics as an independent clinical discipline; tasks, organization, structure, staffing and equipment of the traumatology and orthopedics service; current legal and instructive and methodological documents in the specialty; rules for issuing medical documentation; the procedure for conducting an examination of temporary disability and medical and social examination; principles of activity planning and reporting of the traumatology and orthopedics service; methods and procedures for monitoring its activities.

4. A traumatologist-orthopedist is appointed to the position and dismissed by order of the head physician of the medical facility in accordance with the current legislation of the Russian Federation.

5. A traumatologist-orthopedist reports directly to the head of the department, and in his absence, to the head of the medical facility or his deputy.

2. Job responsibilities

Provides qualified medical care in his specialty, using modern methods of prevention, diagnosis, treatment and rehabilitation, permitted for use in medical practice. Determines the tactics of managing the patient in accordance with established rules and standards. Develops a plan for examining the patient, specifies the volume and rational methods of examining the patient in order to obtain complete and reliable diagnostic information in the shortest possible time. Based on clinical observations and examinations, anamnesis, data from clinical, laboratory and instrumental studies, establishes (or confirms) the diagnosis. In accordance with the established rules and standards, prescribes and controls the necessary treatment, organizes or independently conducts the necessary diagnostic, therapeutic, rehabilitation and preventive procedures and measures. The patient is examined daily in the hospital. Makes changes to the treatment plan depending on the patient's condition and determines the need for additional examination methods. Provides consultative assistance to doctors of other departments of health care facilities in their specialty. Supervises the work of secondary and junior medical personnel subordinate to him (if any), facilitates the performance of his duties. Controls the correctness of carrying out diagnostic and therapeutic procedures, the operation of instruments, apparatus and equipment, the rational use of reagents and drugs, compliance with safety and labor protection rules by middle and junior medical personnel. Participates in training sessions to improve the skills of medical personnel. Plans its work and analyzes the performance of its activities. Ensures timely and high-quality execution of medical and other documentation in accordance with established rules. Carries out sanitary-educational work. Complies with the rules and principles of medical ethics and deontology. Participates in the examination of temporary disability and prepares the necessary documents for medical and social examination. Qualified and timely executes orders, orders and instructions of the management of the institution, as well as legal acts on his professional activities. Complies with the rules of internal regulations, fire safety and safety, sanitary and epidemiological regime. Promptly takes measures, including timely informing the management, to eliminate violations of safety, fire and sanitary rules that pose a threat to the activities of the healthcare institution, its employees, patients and visitors. Systematically improves his skills.

3. Rights

A traumatologist-orthopedist has the right to:

1. independently establish a diagnosis in the specialty on the basis of clinical observations and examinations, anamnesis, data from clinical, laboratory and instrumental studies; determine the tactics of patient management in accordance with established rules and standards; prescribe the methods of instrumental, functional and laboratory diagnostics necessary for a comprehensive examination of the patient; carry out diagnostic, therapeutic, rehabilitation and preventive procedures using approved diagnostic and treatment methods; to involve, in necessary cases, doctors of other specialties for consultations, examination and treatment of patients;

2. to make proposals to the management of the institution on improving the diagnostic and treatment process, improving the work of administrative, economic and paraclinical services, issues of organization and conditions of their work;

3. control the work of subordinate employees (if any), give them orders within the framework of their official duties and demand their precise execution, make proposals to the management of the institution on their encouragement or imposition of penalties;

4. request, receive and use information materials and legal documents necessary for the performance of their duties;

5. to take part in scientific-practical conferences and meetings, which discuss issues related to his work;

4. timely and high-quality execution of medical and other service documentation provided for by the current legal documents;

5. providing, in accordance with the established procedure, statistical and other information on their activities;

6. Ensuring compliance with executive discipline and performance of their duties by subordinate employees (if any);

7. prompt action, including timely informing the management, to eliminate violations of safety, fire and sanitary rules that pose a threat to the activities of the healthcare institution, its employees, patients and visitors.

Should be obliged to the doctor of the traumatologist of the trauma center. Doctor traumatologist orthopedist

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Erased symptoms

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Job description of a traumatologist-orthopedist

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Job description of a traumatologist-orthopedist

Job description of a nurse doctor traumatologist-orthopedist

Job description of an orthopedic traumatologist

Job description doctor traumatologist orthopedist

General characteristics of the direction

What diseases does an orthopedist treat?

With what complaints should I go to the orthopedist?

What does an orthopedist do?

dislocations

How is an appointment with an orthopedist

Orthopedic recommendations: how to identify flat-valgus deformity of the feet in a child, treatment, choice of shoes, massage - video

Erased symptoms

Who is an orthopedist, orthopedic traumatologist and orthopedic surgeon?

Operative and closed intervention

Where does the orthopedist take?

General information

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