Orthopaedics literally means straight child, and began as advice for parents
In 1741 a Paris medical professor named Nicolas Andry wrote the first textbook on correcting children's deformities, coining a word from Greek for straight and child. It prescribed exercise, manipulation and splints, and also covered freckles and sweaty palms. Surgery joined the field only later, and many of its leaps came from war.
Early progress was institutional as much as technical. Jean-André Venel opened the first orthopaedic institute in 1780, a hospital for children's skeletal problems, where he designed a club-foot shoe. John Hunter studied how tendons heal, Percivall Pott investigated spinal deformity, and in 1851 the Dutch military surgeon Antonius Mathijsen invented the plaster of Paris cast. Until the 1890s the discipline still focused on correcting deformities in children, and there was real argument over whether it should involve operations at all.
The Welsh surgeon Hugh Owen Thomas widened it to fractures in general, lending his name to a neck collar for spinal tuberculosis and a hip test still in use. His nephew Robert Jones became surgeon-superintendent for the Manchester Ship Canal in 1888, caring for 20,000 workers and creating what is described as the world's first comprehensive accident service; he handled 3,000 cases himself. In the First World War he found fracture care badly lacking and pushed for military orthopaedic hospitals from 1916.
Twentieth-century hardware reshaped treatment. Gerhard Küntscher pioneered metal rods inside the thigh and shin bones, though traction remained standard for thigh fractures until the late 1970s. In the 1960s Sir John Charnley in England showed that worn joint surfaces could be replaced by implants fixed with acrylic bone cement; his low-friction hip, a steel stem with a polyethylene socket, underpins all modern hip replacements. Knee replacements followed in the 1970s, and Gavriil Ilizarov's frame made it possible to realign and even lengthen bones.
The spelling still splits the field: the American Academy of Orthopaedic Surgeons keeps the ae, while American hospitals mostly drop it. Around 700 surgeons finish residency in the United States each year, following a five-year programme that the Hospital for Special Surgery pioneered in 1887. The work is demanding, averaging 57 hours a week according to one 2021 estimate, and a survey of leading surgeons reported 70 or more.
Source: Orthopedic surgery
