LEAD ARTICLE – JULY 2018

Can Lower Limb Surgeons Comment Upon All Orthopaedic Matters?

In general terms, yes.

Orthopaedic Surgeons in Australia, with Australasian qualifications from our College, undergo an exceedingly rigorous programme before Fellowship is conferred. All facets of orthopaedic surgery are covered in the training programme over an extended period and whilst subspecialisation is both recognised and encouraged, the basic elements of orthopaedic surgery should never be forgotten.

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At a personal level, I have concentrated on hip and knee surgery for the last decade or so. Prior to that however, I spent two decades performing lumbar spinal surgery, upper limb surgery and dealt with maladies of the foot and ankle.

Orthopaedic Surgeons also regularly attend Continuing Professional Development programmes at national and international levels. Refresher courses, updates and new horizons are canvassed and covered. Most of us also subscribe to international journals which concentrate not only on our subspecialty interests, but also have articles of generic orthopaedic value.

We are trained with the relevant tomes used to assess impairments. The American Medical Association publication entitled “Guides to the Evaluation of Permanent Impairment” (5th Edition) is our most common reference text but others similarly exist. All of those reference texts have chapters dealing with all regions of the musculoskeletal system. Accreditation as Independent Medical Examiners demands competence with all of those systems and regions.

In essence therefore, it is not necessary to send an upper limb problem to an upper limb surgeon or a spinal problem to a spinal surgeon. That is not to say that you do not have the ability to sub-select as you so choose. Instead, it means that you can also choose your medicolegal expert according to his or her competence as an analytical reporter, an objective observer and a credible Court performer. You don’t necessarily have to expect him or her to have a subspecialty in the anatomical region that has been adversely affected for your plaintiff.

Whilst it is always important to choose your medicolegal reporter wisely, you can take some comfort from the thought that your orthopaedic expert will have a broad coverage of in-depth knowledge across the specialty.