1 Introduction: The past

and the Present

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The bones of prehistoric humans provide
mute testimony of disorders and injuries
of the musculoskeletal system, and from
the beginning caring persons sought
ways to alleviate the crippling conditions
of others. As early as 9000BC, in the
Paleolithic age, superstitions were being
replaced by rational thinking and
caregivers were beginning to use splints
for weak limbs and broken bones.In
Neolithic (5000BC), crude amputations
of disease or damaged limbs were
already being performed. The
Egyptians had develop the concept of
the crutch by 2000BC. reece replaced
!gypt as the centre of culture by the
fifth century BC and Hiposocrates,
through his teaching and through his
student, had become the "father of
medicine". I# the second century A!
alen, a reek physician who move to
$ome, became the founder of
e%perimental investigation.
Throughout the first eighteen
centuries A! knowledge in medicine
and surgery advanced slowly,
culminating in significant contributions
of !ngland&s "ohn Hunter '()*+,()-.),
"father of surgical research".
/nderstandbly, however, the
development and performance of major
surgical operations had to await the
revolutionary nineteenth century
discoveries of general anesthesia by
0ong and 1orton'/2A), the #acterial
#asis of disease by 3asteur '4rance),
antisepsis by 0ister'2cotland) and $%ray
by $oentgen'erman)
In the t&entieth century, the of
patient with disorder and injuries of the
musculoskeletal system has evolved
through three phases. 'irst was
the"strap and buckle" phase in which
various orthopaedic splints! #races,
andd other types of appliances
constituted the predominant form of
management. (econd phase of
e%cessive orthopaedic operations, many
of which were based on clinical
e)pirics) than on scientific
investigation. In the third and current
phase, science is rapidly replacing
empiricsm, as evidenced by the
combination of increased e%perimental
laboratory investigation '#asic research)
The care of patient remains an art, but
the art must be based on science
THE SCOPE OF
ORTHOPAEDICS
In ()5(, #icolas Andry, then 3rofesor of
1edicine in 3aris, published a book, the
!nglish translation of which is
6rthopaedia, or the art of 3reventing and
7orrecting 8eformities in 7hildren. 9e
coined the term"6rthopaedia" from
orthos 'straight or free from deformity)
and pais 'child) and e%pressed the view
that most deformities in adults have their
origin in childhood.
The present scope of 6rthopaedics
has come to include all ages and is
considered to consist of the art and
science of pre*ention! in*estigation!
diagnosis! and treat)ent of disorders
and in+uries of the )usculos,eletal
syste) #y )edical! surgical! and
physical )eans%including
physiotherapy% as &ell as the study of
)usculos,eletal physiology! pathology!
and other related #asic science
Thurman.H.Silalahi/Residen Orthopaedic/FKUI