The Orthopaedic Surgeon Paradox

On the ward round today, I have a re-realisation about orthopaedic surgeons.

We were looking at the CXR of a child who had been treated under orthopaedics 11 months ago for a broken humerus (arm bone). The professor of paediatrics pointed out that at the time this child had his surgery there was a very obvious coin lesion in the upper zone of his chest. If this had been spotted then, the child could have been investigated thoroughly.We would have found out that the coin lesion visible on the CXR was cancer; as most coin lesions tend to be in this part of the world and he would have been treated according.

But instead the child was brought into the outpatients clinic nearly a year after this CXR was taken. He had, had an unexplained fit.

Today, he is dying. He has metastases in his brain and bone, his management is palliative.

Our professor pointed out to the team how typical this was for orthopaedics. 'They can't see beyond the bone they are fixing' he stated angrily shaking the CXR in the air. Same in the UK, I nodded knowingly, recalling the difficultly I had managing patients with medical problems on orthopaedic wards.

Most specialists have some kind of stereotype associated with them, perhaps none more so than orthopedic surgeons. One of the predominant stereotypes about them is that they’re into power tools and carpentry and things like that, and are less intelligent than other doctors.

The mistake described above I must say is extremely, extremely rare. Orthopaedic surgery is a competitive speciality that continues to attract the brightest young doctors and the coin lesion was small and poorly defined. It is very easy to crtisize other doctors when you have a retroscope. Hind sight is always 20/20. The orthopaedic surgeon was agast when he found out what had happened despite, reassurance from the radiologists about how difficult a call it was.

In the coffee room after the ward round I re-counted some of my favourites jokes about orthopaedic surgeons-in haphazard Japanese. Listed below:


3 orthopaedic surgeons took 55 days to do a jigsaw and were proud of their achievement.When asked why they were so proud they said because it said 2-3 years on the box.



At an orthopaedic meeting how can you spot the academic orthopaedic surgeon? He's the one who can just get his knuckles off the floor!


What's the difference between a carpenter and an orthopaedic surgeon?A carpenter knows more than one antibiotic!

How do you hide a twenty pound note from an orthopaedic surgeon? Put it in a text book!

How do you spot the orthopaedic surgeon's car in the car park? It's the Porsche with a comic on the back shelf!

What's the difference between a rhinoceros and an orthopaedic surgeon? One's thick-skinned, small-brained and charges a lot for no very good reason....the other's a rhinoceros.

What do you call two orthopaedic surgeons looking at a chest X-ray? A double blind study.


The definition of shifting dullness - an orthopaedic ward round.


Why do anaesthetists take an instant dislike to orthopaedic surgeons? Because it saves time

How do you get an Orthopaedic Surgeon to refer you to some one else? Ask him the time.

How many orthopaedic surgeons does it take to change a light bulb? Just one to write the ref feral to the medics saying 'darkness ?cause'

An elderly lady and an orthopaedic surgeon were travelling in an elevator together. The doors started to shut as the lady was trying to get out of the doors. The surgeon kindly put his head in between the doors so the lady could get out. 'Thank you very much' said the lady, 'but why did you use your head?'. 'I used my head because I need my hands for work' said the orthopod grinning proudly.

The list goes on...................................................


But despite the stereotype we owe some of the greatest scientific discoveries this decade to our orthopods. Have a look!


Sir Alexander Flemming

Trained in orthopaedics,named one of Time Magazines 100 Most Important People this Century for his discovery of penicillin, and stated; "It was a discovery that would change the course of history.


Sir Frederick Grant Banting, KBE, MC, FRSC

Orthopaedic surgeon and Nobel laureate noted as one of the co-discoverers of insulin.

In 1923, Banting and John James Rickard Macleod received the Nobel Prize in Medicine.


James K Styner, MD, FACS

An orthopaedic surgeon, practicing in Lawndale, California. He was instrumental in the development of the Advanced Trauma Life Support (ATLS) program which has consequentially changed the face of trauma care worldwide.


Shinya Yamanaka

A Japanese orthopaedic surgeon and stem cell researcher. He was recently awarded the Lasker award and was also named one of time magazines most influential scientists and well as my own personal demi-god when he changed the face of stem cell research forever by developing induced pluripotent stem cells.

Orthopaedic surgeons are probably the most influential and innovative specialists we have, just I guess it's still fun to have a giggle at their expense!