The complete spectrum of musculoskeletal surgical and non-surgical care with special mphasis on the hip and knee prostheses and hand surgery is available at this institution.  We offer our expertise in these areas having been fortunate to have gained extensive experience in the implantation of the most modern and innovative joint prostheses.

Those wishing to make an appointment for traumatological or emergency care, may do so at our Emergency Clinic.

For information regarding orthopedic and traumatological treatments not financed by the National Health Service (OEP) please call us at +36-1-489-5200.
 

The History of Musculoskeletal Surgery

Nicholas André: L'Orthopédie, 1741            Hans Gersdorff: Feldbusch der Wundartzney, 1517
 

The peoples of prehistoric times as well as the present primitive man experienced not only great pain with fractures but had to endure the shortening of limbs and deformities as a consequence of healing.   The pain-induced muscle spasms cause the bone fragments to move closer together, the injured will not put weight on the extremity due to pain, but keeps moving it, and will continue to not put weight on it until the easing pain allows him to do so.  The scientific study of this process of healing has allowed us to be able to successfully treat musculoskeletal injuries and diseases.   The calluses observed on prehistoric fossils evidence spontaneously healed fractures.  In some cultures, signs of specific medical interventions were observed that the patients survived for several months.

Trepanated skull from Ancient Peru      Anglo-Saxon skeleton with trepanated skull (England)
 

Fossils showing the splinting and healing of bone fractures, Harvard University

Hippocrates was the first well-known school of thought doctor who developed simultaneous trauma-orthopaedic activities.  One example is the relocation method of a dislocated shoulder that has been successfully used throughout the ages, to this day.

Galenus, 1562                              Thomas, 1912                                  Netter, 1987
Hippocrates (460-377 BC) and shoulder relocation method still in use today.

Trauma surgery and orthopedics concerns itself with the diagnoses and treatment of musculoskeletal pathological conditions resulting from congenital developmental anomalies, or diseases incurred or suffered as the result of accidents or acquired during the course of life.  Considers the necessary treatment possibilities and chooses from among conservative and surgical interventions to reduce or end pain all together, as quickly as possible, or in order to regain the anatomical status quo.   Enables self-contained daily living, work, sport and hobby activities, restores complete physical activity and forestalls deformities and secondary pathological occurrences such as Sudeck's syndrome, atrophy, paralysis, breathing difficulties and physical disabilities.  The goal is “Restitutio ad integrum" that is restitution to the original anatomical condition and function.

In addition to the state-of-the-art diagnostic tools, the assessment of a patient's medical history is a fundamental part of this work.  Physical examination of the musculoskeletal system may include, besides diagnostic examinations such as digital x-rays and cinematography, contrast material examinations such as Ultrasonography, Computer Tomography (CT), Magnetic Resonance Imaging (MRI) and Bone Densitometry that provide exact information regarding joint and soft tissue disorders of the extremities.  A blood test and laboratory tests are also often necessary to obtain a better insight into possible illnesses such as gout, rheumatic fever, Lyme disease, psoriasis or malignant tumors that might have an impact on the musculoskeletal system.

Once a diagnosis is obtained, the treatment that is to follow should be discussed with the patient, especially, in the case of more than one possible treatment, in order to choose the one that would bring about the best results for the given condition, *** előremutató . The patient should be able to make a decision with proper information and the medical staff insures all the required conditions for the process to move forward unencumbered.  

Musculoskeletal conservative surgical treatment methods:

 1.   Functional Treatments:

• Non-weight bearing mobilization, walking on crutches.
• Joint decompression, hemarthrosis punction.
• Deep vein thrombosis profilaxis, with LMWH, and exercise.
• NSAID pain medication either systemic or local.  The latter may be, for instance, the so-called block injection that may, simultaneously, be given for diagnostic and therapeutic purposes.
• Bandaging to provide proper rest and painless conditions for healing.  An example is the flexible wrap. 
• Rest, Ice, Compression, Elevation (RICE).

                  Cold therapy- shoulder              Poelchen's Method, walking with crutches

2.      Bracing: splints, circular splints

      

      Lorenz Böhler (1885-1973),            Gypsum crystal                                 Artificial cast
      developed principles
       of fracture treatment

 

 

              Braces with Velcro fasteners

 

3. Traction treatments; permanently attached or movable for freely mobilizing patients

       

                     Le Mesurier, 1918                       The Böhler frame, 1948              The Appley-Treatment, 1998
 

The outpatient clinic is, generally, for conservative treatment only, but we will also treat wounds, perform surgeries requiring only local anesthesia, do joint punctures and give block injections, when necessary.   Also included are tissue and ganglion removal under and on the surface of the skin, smaller scab corrections, exposures, excisions, as well as injections into joints for anti-inflammatory and cartilage regeneration purposes.

 

 

 

Musculoskeletal rehabilitation is also part of the outpatient clinic care

The Patient must know the rehabilitation process and be cooperative. Isometric contraction exercises should be begun even while the brace is still in place. Joints that are free should be exercised immediately.   

Strengthening conscious functions: it is important that the Patient mentally perform the coordination exercises throughout the treatment. The basic aim is to gradually push the limits of movement farther out to actual weight bearing capacity. The passive-active exercising of the joints, the use of Continuous Passive Motion (CPM) machines, Transcutaneous Electrical Nerve Stimulation (TENS) for atrophy, alleviation of local and systemic pain, the iontophoresis device, exercising the joints, stretching treatments, connective tissue massage, conservative treatments and remediation of motion function are all indispensable tools following surgery.

 

 

 
Hand exercises

 

Most of these exercises may be done on an outpatient basis, however, some of the above and especially those following more extensive surgeries where the entire musculoskeletal surgical team was involved, may only be attempted on an inpatient basis. The pre-operation process, consultations and post-operation checkups may all be on an outpatient basis.

 

Trauma surgery instruments, 18th-19th Century

Surgical interventions went through paradigm changes following the 20th Century revolutionary developments in research, the drug industry, implant manufacturing and the health care industry. The implantation of joint prostheses, corrective surgery, lengthening of extremities, the supplementation of lost function through plastic surgery became possible.   The possibility of knee ligament tear surgery, meniscus removal, joint arthroscopy or plastic surgery of the hand, tendon and nerve reconstruction is limited only by the available instrumentation, experience and expertise.

The complete spectrum of musculoskeletal surgical and non-surgical care with special mphasis on the hip and knee prostheses and hand surgery is available at this institution.  We offer our expertise in these areas having been fortunate to have gained extensive experience in the implantation of the most modern and innovative joint prostheses.

Those wishing to make an appointment for traumatological or emergency care, may do so at our Emergency Clinic.

For information regarding orthopedic and traumatological treatments not financed by the National Health Service (OEP) please call us at +36-1-489-5200.
 

The History of Musculoskeletal Surgery

                                         
     Nicholas André: L'Orthopédie, 1741            Hans Gersdorff: Feldbusch der Wundartzney, 1517
 

The peoples of prehistoric times as well as the present primitive man experienced not only great pain with fractures but had to endure the shortening of limbs and deformities as a consequence of healing.   The pain-induced muscle spasms cause the bone fragments to move closer together, the injured will not put weight on the extremity due to pain, but keeps moving it, and will continue to not put weight on it until the easing pain allows him to do so.  The scientific study of this process of healing has allowed us to be able to successfully treat musculoskeletal injuries and diseases.   The calluses observed on prehistoric fossils evidence spontaneously healed fractures.  In some cultures, signs of specific medical interventions were observed that the patients survived for several months.

Trepanated skull from Ancient Peru      Anglo-Saxon skeleton with trepanated skull (England)

Fossils showing the splinting and healing of bone fractures, Harvard University

Hippocrates was the first well-known school of thought doctor who developed simultaneous trauma-orthopaedic activities.  One example is the relocation method of a dislocated shoulder that has been successfully used throughout the ages, to this day.

                                   ^{Galenus, 1562                              Thomas, 1912                                  Netter, 1987}

Hippocrates (460-377 BC) and shoulder relocation method still in use today.

Trauma surgery and orthopedics concerns itself with the diagnoses and treatment of musculoskeletal pathological conditions resulting from congenital developmental anomalies, or diseases incurred or suffered as the result of accidents or acquired during the course of life.  Considers the necessary treatment possibilities and chooses from among conservative and surgical interventions to reduce or end pain all together, as quickly as possible, or in order to regain the anatomical status quo.   Enables self-contained daily living, work, sport and hobby activities, restores complete physical activity and forestalls deformities and secondary pathological occurrences such as Sudeck's syndrome, atrophy, paralysis, breathing difficulties and physical disabilities.  The goal is “Restitutio ad integrum" that is restitution to the original anatomical condition and function.

In addition to the state-of-the-art diagnostic tools, the assessment of a patient's medical history is a fundamental part of this work.  Physical examination of the musculoskeletal system may include, besides diagnostic examinations such as digital x-rays and cinematography, contrast material examinations such as Ultrasonography, Computer Tomography (CT), Magnetic Resonance Imaging (MRI) and Bone Densitometry that provide exact information regarding joint and soft tissue disorders of the extremities.  A blood test and laboratory tests are also often necessary to obtain a better insight into possible illnesses such as gout, rheumatic fever, Lyme disease, psoriasis or malignant tumors that might have an impact on the musculoskeletal system.

Once a diagnosis is obtained, the treatment that is to follow should be discussed with the patient, especially, in the case of more than one possible treatment, in order to choose the one that would bring about the best results for the given condition, *** előremutató . The patient should be able to make a decision with proper information and the medical staff insures all the required conditions for the process to move forward unencumbered.  

Musculoskeletal conservative surgical treatment methods:

 1.   Functional Treatments:

• Non-weight bearing mobilization, walking on crutches.
• Joint decompression, hemarthrosis punction.
• Deep vein thrombosis profilaxis, with LMWH, and exercise.
• NSAID pain medication either systemic or local.  The latter may be, for instance, the so-called block injection that may, simultaneously, be given for diagnostic and therapeutic purposes.
• Bandaging to provide proper rest and painless conditions for healing.  An example is the flexible wrap. 
• Rest, Ice, Compression, Elevation (RICE).

                  Cold therapy- shoulder              Poelchen's Method, walking with crutches

2.      Bracing: splints, circular splints

      

      Lorenz Böhler (1885-1973),            Gypsum crystal                                 Artificial cast
      developed principles
       of fracture treatment

 

 

              Braces with Velcro fasteners

 

3. Traction treatments; permanently attached or movable for freely mobilizing patients

       

                     Le Mesurier, 1918                       The Böhler frame, 1948              The Appley-Treatment, 1998
 

The outpatient clinic is, generally, for conservative treatment only, but we will also treat wounds, perform surgeries requiring only local anesthesia, do joint punctures and give block injections, when necessary.   Also included are tissue and ganglion removal under and on the surface of the skin, smaller scab corrections, exposures, excisions, as well as injections into joints for anti-inflammatory and cartilage regeneration purposes.

 

 

 

Musculoskeletal rehabilitation is also part of the outpatient clinic care

The Patient must know the rehabilitation process and be cooperative. Isometric contraction exercises should be begun even while the brace is still in place. Joints that are free should be exercised immediately.   

Strengthening conscious functions: it is important that the Patient mentally perform the coordination exercises throughout the treatment. The basic aim is to gradually push the limits of movement farther out to actual weight bearing capacity. The passive-active exercising of the joints, the use of Continuous Passive Motion (CPM) machines, Transcutaneous Electrical Nerve Stimulation (TENS) for atrophy, alleviation of local and systemic pain, the iontophoresis device, exercising the joints, stretching treatments, connective tissue massage, conservative treatments and remediation of motion function are all indispensable tools following surgery.

 

 

 
Hand exercises

 

Most of these exercises may be done on an outpatient basis, however, some of the above and especially those following more extensive surgeries where the entire musculoskeletal surgical team was involved, may only be attempted on an inpatient basis. The pre-operation process, consultations and post-operation checkups may all be on an outpatient basis.

 

Trauma surgery instruments, 18th-19th Century

Surgical interventions went through paradigm changes following the 20th Century revolutionary developments in research, the drug industry, implant manufacturing and the health care industry. The implantation of joint prostheses, corrective surgery, lengthening of extremities, the supplementation of lost function through plastic surgery became possible.   The possibility of knee ligament tear surgery, meniscus removal, joint arthroscopy or plastic surgery of the hand, tendon and nerve reconstruction is limited only by the available instrumentation, experience and expertise.