An orthopedic surgeon who

A good orthopedic surgeon is an intelligent, well-informed, and physically strong person. It is believed that this profession is more suitable for the stronger sex, since the orthopedist's tools are chisels, hammers and other heavy medical equipment. This is not true, however, because girls are excellent prosthodontists who can position joints perfectly and perform complex surgeries and do it just as well as men.

How does such an intervention work?

Orthopedic surgeons work in trauma centers and emergency rooms. Their work is intertwined with that of the anesthesiologist, the plastic surgeon and the surgical nurse. After an initial examination, diagnosis and further tests, the doctor goes to work. He implants foreign objects such as pins, screws, rods, and prostheses into the body when the injured limb needs to be fixed in position or replaced.

methods of investigation

Main surgical interventions

In addition to the listed operations, the orthopedist performs the following procedures:

Before the operation, the patient undergoes a comprehensive examination: tests (blood clotting and hemoglobin levels are particularly important), an MRI or X-ray, and a cardiogram. The rehabilitation period is almost always long and difficult. Physiotherapy and massages are recommended to restore mobility in the operated area.

Pediatric Orthopedist

Orthopedic problems in children are not uncommon, and the earlier they are identified, the easier they are to treat. Therefore, children are regularly examined up to the age of 6: at birth, at 1 month, then at 3 months, at 6 months and at 1 year. The following examinations until school enrollment should be carried out annually. What diseases are diagnosed in young children? Let's look at the most important of them:

When should your child be examined?

It is important to see an orthopedist if:

What is the visit like?

The pediatric orthopedist checks the body proportions, looks at the structure of the chest, arms and legs and the position of the head. He assesses the gait. The child lies on his back, bends his legs in his knees and straightens them. It is good if the knees can touch the table on which the child is lying. Nothing is done with violence. The infant's muscle tone is checked.

Orthopedic dentist: who treats whom and what

Dental orthopedics is one of the most sought-after medical specialties. It deals with the treatment of jawbone defects and the replacement of missing or partially missing teeth. The main goal of orthopedics is the reconstruction of the jawbone apparatus through prosthetics.

An orthopedic dentist is a doctor who deals with the restoration of canines, molars, premolars, and incisors. This specialist diagnoses and rebuilds lost teeth. His main duties include taking row casts, fabricating prosthetic restorations and attaching them under anesthesia. A qualified dentist consistently carries out the prosthetic procedure according to all the rules of the art and using advanced techniques. So we took a look at who a dentist is and what they do.

When should a dentist be consulted?

• Loss of one or more tooth segments.
• Damage to a molar, canine, or incisor.
• Mobility of elements of the jaw system.
• Pathology of the tissues and bones of the jaw.
• Cosmetic imperfections.
• Unattractive appearance of the row of teeth.
• Replacement of previously used orthopedic constructions.

There are many reasons to see a specialist. Timely treatment will prevent the complete destruction of the tooth unit.

What does an orthopedic surgeon do?

Don't assume that a referral to an orthopedist always means surgical treatment is required. This specialist also masters conservative techniques for correcting diseases of the musculoskeletal system. Sometimes up to 50 % of his work consists in non-surgical treatment of the disease.

What does an orthopedic surgeon do? This is his arsenal:

surgeries on long bones (which form the basis of the skeleton of the limbs), including the use of pins, external fixation devices, and more;

Various orthopedic aids (ortheses, corsets, special shoes, splints);

The doctor decides on the individual management of the patient and on the surgical and conservative treatment methods used. Every surgical intervention is always supplemented by a series of conservative rehabilitation measures. This not only shortens the recovery time, but also improves the outcome of the operation.

What the counseling process looks like

If you see an orthopedic surgeon, don't expect immediate treatment. The doctor will first determine what changes have occurred in the patient and how severe they are. It is also important to assess the degree of motor impairment and the persistence of symptoms.

It is advisable that the patient brings his previous medical records:

If X-rays, MRI or CT examinations have already been carried out, you should bring not only the report (description) but also the images. In this way, the orthopedist can assess the dynamics of the disease.

The doctor will conduct an external examination in combination with specific tests. The symmetry of the body and limbs, the extent of active and passive movement in all joints and any visible deformities are checked. The back examination assesses the position of the shoulder blades and upper arms, the degree of curvature of the various parts of the spine, the position of the pelvis, and the presence of muscle wasting or tightness.

The alignment of the feet, the condition of the arches of the feet, signs of changes in muscle tone, the symmetry of the large skin folds and the length of the limbs are checked. The strength of the main muscle groups is checked.

After collecting the medical history and a thorough examination, the podiatrist will often recommend additional examinations.

Preventive and unscheduled check-ups

During the visit, the doctor examines the child and interviews the parents to take a medical history. Palpation of the joints and bones is used to assess the condition. The orthopedist determines muscle tone, motor activity and the general condition of the musculoskeletal system. In children of the first year of life, special attention is paid to detecting signs of rickets and metabolic disorders, as well as indicators of motor development.

The following measures are taken to secure the diagnosis:

• ultrasound examination;
• ROENTGEN;
• computed tomography and magnetic resonance imaging;
• Examination of bone tissue;
• Endoscopic examination of the joints.

To make an appointment with a pediatric orthopedist, please fill out the feedback form or call the number provided.

Implantology and orthopedics – inseparable sisters

Dental implantation is a procedure that requires long and thorough preparation to ensure successful placement of the implants. You can't just make an appointment and have your implants placed the same day. First, the implant surgeon will perform diagnostic tests—X-rays and CT scans—to obtain data that will help them plan the implant procedure.

The implant surgeon is an expert in the surgical part of the implantation: he takes into account the specifics of each clinical case in relation to the difficulties or risks of implantation in a specific patient. The prosthodontist, on the other hand, plans the placement of the implants to ensure they provide a quality and secure fit for future prostheses. The opinion of both specialists is essential for the successful restoration of chewing function and the beauty of the smile.

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Many clinics, especially those working with premium implant systems, use 3D modelling, CAD/CAM technology and surgical templates. A template is a custom-made mouthguard that is needed for precise implantation. It allows for quick placement of the implants with minimal surgical intervention.

The templates are made in the dental laboratory and this is where the orthopedist comes in. He takes impressions of the patient's jaws (yes, two, even if only one implant is needed!), scans them and transfers them to the simulation software. Everything is taken into account, from the implant models to the insertion sites. The template is then made of a stiff and durable material so that it fits securely in the mouth, hugs the gums or teeth as best as possible, and does not fly out with careless movements in the heat of the procedure. In addition, the template must accurately depict the oral anatomy, so no two templates are exactly alike - they are custom made.

The implant is placed, but the tooth is still missing.

As soon as the surgeon has inserted the implant using the template, it's time to wait. Even if you have a one-stage implant surgery, the implant and dentures are placed on the same day. However, each implant takes time to take root, so even with a one-stage implantation, the prosthesis is only temporary.

Who is responsible for the production of the temporary dentures made of plastic? Of course he or she again – the orthopedic dentist. Temporary dentures can help prevent problems with diction, restore a beautiful smile, and prevent teeth from shifting toward their missing neighbor. As a temporary prosthesis, the dentist can make a plastic crown that is attached to the implant, or a butterfly prosthesis that is attached to two adjacent teeth. It takes a long time before the prosthesis can be worn because the healing time of implants varies between three and six months depending on the insertion site and other factors. At this stage, the prosthodontist should have created a beautiful, strong, and secure structure.

Assessment by Russian doctors

We begin our rating of the leading Russian specialists in the field of orthopedics with the personalities who recently became winners of the All-Russian Doctors' Competition sponsored by the Ministry of Health of the Russian Federation. And these great doctors just can't be missed. In 2018 and 2017, the prizes in the category 'Best Orthopaedist of the Year' were awarded to:

• Ivan Andreyevich Yendovichi – orthopedist of the 1st qualification category, works in the orthopedic-traumatological department No. 2 of the Interdistrict Clinical Hospital No. 5 of the Leningrad region named after him (Vsevolozhsk city, Koltuska street/20);
• Pavel V. Iskusov – is a specialist in orthopedics and traumatology of the highest qualification level and works in the Department of Traumatology and Orthopedics of the Arkhangelsk Regional Hospital (Arkhangelsk, Lomonosov Avenue/192);
• Aleksey Sergeevich Shvarov – High-ranking orthopedist-traumatologist, head of the Trauma Center, which is part of the Bashkir State Medical Institution 'Kumertau City Hospital' (Kumertau, Sovetskaya Street/39);
• Pollyak Leonid Naumovich – Doctor of Medical Sciences in Orthopedics, Head of Department of Orthopedics and Traumatology No. 1 of Chelyabinsk Regional Hospital. 'Chelyabinsk regional hospital' (Chelyabinsk, Vorovskogo street/70).
• Anatoly Vasilyevich Bondarenko – High-ranking specialist in orthopedics, professor and doctor of medical sciences, works in Barnaul, Altai Krai 'KKB Ambulance Service' (Barnaul City, Komsomolsky Ave, 73).

Evaluation of foreign specialists

Doctors specializing in orthopedics from selected foreign countries deserve special respect. We have selected doctors from countries with the best development of orthopedic traumatology and the highest level of patient care. Therefore, the rankings are compiled by country and the best specialists are listed.

Czech Republic

The Czech Republic tops the list because the field of 'orthopaedics and traumatology' is the most developed and highly valued in this country. The Czech Republic strictly adheres to an individual and multidisciplinary approach, so that a person can forget about his pain and return to an active and fulfilling life as soon as possible. Clinics and orthopedic traumatologists in the Czech Republic have received many enthusiastic, positive reports from patients, including those from Russia, who were lucky enough to be treated here. We present the most important orthopedic surgeons in the Czech Republic.

• Jan Deniger is an orthopedic doctor of the highest specialization, a legend of Czech orthopedics with more than 35 years of medical experience. The high level of professionalism of Dr. Deniger is known throughout Europe, which is why he deservedly takes first place in the ranking of foreign orthopedic surgeons. Jan worked productively in Austria and Germany (Cologne). Since 2005, his second home, where he spends most of his time rescuing patients, has been the Kłodzko District Hospital. He is the chief physician in the orthopedics and traumatology department. In his practice, he extensively and skilfully uses the innovative tactics of the most gentle method of joint replacement - the MIS method through a compact incision (6-8 cm), without traumatic severing of muscles and soft tissues. Jan Deniger has successfully used more than 8,000 artificial hip prostheses and more than 2,000 knee endoprostheses. That's an amazing statistic for one doctor! Of course dr. Deniger not only strong in endoprosthetics, but also very competent in other areas of modern surgery.

The activities of a specialist in dental orthopedics

In order to reconstruct partially or completely destroyed teeth, it is important for the orthopedist to choose the most suitable prosthetic treatment technique. There are three main areas of restorations: microprosthetics, removable prosthetics and the use of fixed prostheses.

microprosthetics

This type of restoration is performed in the case of severe caries due to damage in the upper area or cosmetic imperfections. Veneers, lumineers and inlays are used for microprosthetic restorations. Let's take a closer look at each type of construction.

veneers. They are bonded to the front teeth to correct the appearance of the teeth. They help hide chips, cracks and other damage to the enamel, conceal a slight curvature or even out the color. It is a thin sheet of ceramic or porcelain that is glued to the cutting surface with cement. With careful treatment, veneers can last up to ten years.

• Before veneers are used, the enamel must be ground down;
• There is no possibility of using another type of veneer at the end of its life.

Lumineers have a similar structure to veneers; however, they differ in that they do not require the enamel to be abraded since the thickness of the plate is less than 0.3 mm. The thinness of veneers is both an advantage and a disadvantage as it results in a shorter lifespan.

Also read: Bormachine: What is it, what are the variants, how are the teeth treated with it?

• inability to conceal irregularities on the edges of teeth;
• Difficulty gluing to panels;
• Increased fragility of structures.

Inlays are similar to conventional fillings, but are made of ceramic and are therefore more durable and attractive. They are used when the tooth is almost completely destroyed. Inlays are most commonly used to restore damaged chewing teeth.

Most popular services and prices

Dental filling prices vary depending on the scope of the work, the materials used, the dentist's qualifications, and the region. Dentures are not cheap, but the high cost is offset by its reliability and durability. Which service is best? For example, here are the prices in Moscow in 2017.

• Consultation – from 500 rubles;
• X-ray examination – from 250 rubles;
• Insertion of a temporary crown – from 2,500 rubles;
• Metal-ceramic crown on a chewing tooth – from 4,000 rubles;
• Ceramic crown on the front tooth – from 10,000 rubles
• ceramic facings – from 15,000 rubles
• Removable structure made of nylon - from 16,000 rubles
• Adaptation of a partial denture – from 40000 rubles
• Crown on an implant – from 30,000 rubles.

Surgical methods in orthopedics

Many people are unaware that traumatology and orthopedics are surgical specialties. Both injuries and most orthopedic pathologies require surgical treatment. Although new models are constantly appearing in the orthopedic market that claim to cure most musculoskeletal disorders without surgery, any orthopedic surgeon will refute most of these claims.

Orthopedic trauma surgeons today have a wealth of formal surgical techniques to treat most orthopedic pathologies. Research in this area and the discovery of new techniques and methods never stop. A large number of scientific papers are published every year proposing new surgical methods of treatment for one or another pathology. At the same time, the classic surgical techniques that have been used to treat people since the last century are also widely used. The right method of treatment can only be chosen by a qualified specialist who can contact specialized centers or departments of district hospitals.

Differences between orthopedic surgery in children and adults

Orthopedic surgeries can range from puncture wounds to large incisions. This depends on the type of condition and the technique used. For example, in the treatment of pediatric skeletal disorders, minimally invasive surgical techniques with low access and minimal surgical stress are used wherever possible. The pediatric orthopedist and traumatologist must be as careful as possible in the surgical treatment. Damage to bone growth zones and intraoperative cartilage damage in children can be critical and lead to musculoskeletal complications during continued growth.

One of the most common surgeries performed by pediatric orthopedic surgeons is the lengthening of a limb that has a congenital growth retardation. This is performed minimally invasively with the Illizarov apparatus. Other orthopedic diseases in children are treated conservatively, and surgical methods are used only if the prognosis is unfavorable. Surgical methods are also used by pediatric orthopaedists when treating the consequences of trauma (wrong joints, dislocated joints) and conservative treatment has no prospect of a favorable result.

While the pediatric orthopedic surgeon tries to avoid surgical methods at all costs so as not to traumatize the growing organism, the adult orthopedic surgeon uses more surgical tactics in the treatment. The reason for this is that the specifics of orthopedic diseases in adults preclude complete cure by conservative methods.

What tests can the doctor prescribe?

The orthopedist/traumatologist will refer the patient for further diagnostic evaluations before establishing a treatment plan:

X-rays

Every emergency hospital has an X-ray department.

• Once the patient has been referred, an X-ray should be taken.
• The doctor will identify fractures, dislocations and deviations of bone fragments. He will also rule out that the pathology was caused by a tumor or a destructive process.
• If signs of osteoarthritis or a tumor are detected, the trauma surgeon recommends a consultation with a rheumatologist, oncologist or other specialist.

MRI and CT scans

Modern, high-precision techniques that make it possible to visualize lesions that are inaccessible to classic X-rays.

• MRI can be used to detect injuries and tears in ligament structures such as the cruciate ligaments in the knee or the rotator cuff in the shoulder joint.
• A CT scan with three-dimensional reconstruction can provide a three-dimensional image of the fracture area.
• This information is of great help to the surgeon, as it gives him as complete a picture as possible of the relationship between the bone fragments before the operation.

Each technique has its limitations and contraindications, which are known to the orthopaedist/traumatologist. Pregnant women, no matter what trimester they are in, should not be sent for CT or classic X-rays. Ionizing radiation has a teratogenic effect on the fetus.

MRI is contraindicated if the patient wears cardiac pacemakers or neurostimulators, as they become inoperable under the influence of the constant magnetic field. Magnetic metals, with the exception of titanium and its alloys, are also a limitation of the procedure. On the other hand, magnetic resonance imaging can also be performed during pregnancy.

Tips for practitioners

Bone and joint pathologists advise against self-treatment. A prolonged untreated course is fraught with significant consequences and complications:

• Late osteoarthritis can only be corrected with an endoprosthesis;
• An abnormally healed fracture is repaired by surgery and subsequent traction;
• A partially torn ligament may be completely torn without timely dressing.

In the absence of a complete diagnostic picture and clinical experience, any treatment will not have the desired effect. It relieves the symptoms of the condition but does not address the underlying cause.

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