Pakistan Orthopaedic Association POA
Pakistan Orthopaedic Association POA
Flat-8/1 Dadabhoy Center
Uan: (+92-42) 111 348 348 (Ext: 344)
Fax: (+92 42) 658 0267
The first breeze of orthopaedic surgery blew in Dow Medical College, Karachi in 1947, the year Pakistan came into existence. A ward attached to the Department of Surgery set apart for casualty trauma and was headed by a Military Surgeon from the second World War. Colonel Ronnie Simcox. By 1952, it became an orthopaedic ward, and then a full‑fledged Department was established by Prof. A. Rahim, who had returned from U.K, with FRCS and MCh (Liverpool), the recognized orthopaedic qualification, however, in most institutions, orthopaedic surgery was done by trained general surgeons, as part of General surgery.
In 1955, an Orthopaedic Unit was established in Jinnah post graduate Medical Centre, which later became a full‑fledged Department headed by a Professor. In 1956, Major Ayyub, with a degree of M. S. in Orthopaedic form University of Punjab opened a ward for Orthopaedic cases in Mayo Hospital & King Edward Medical College, which is the oldest Medical College in Pakistan, now nearly 140 years old. The department continued under Prof. Manzoor Ahmed, a M. S. from University of Punjab, and later flourished under Prof. Naseer Mahmood Akhter, a FRCS from U.K ‑ under him worked Dr. Zarina Niazi, our first lady Orthopaedic Surgeon, with FRCS from England and Edinburgh.
Prof. Manzoor Ahmed later shifted to Peshawar to start and head a Department of Orthopaedic Surgery in the Khyber Medical College, while Dr. Zarina Niazi shifted to Gangaram Hospital Fatima Jinnah Medical College, Lahore, to head the Department there.
Hyderabad in Sindh, was the next place to establish a large department of orthoapedic surgery, in Liaquat Medical College, Jamshoro, under Prof. A. M. Ansari in 1962. He had his initial introduction to Orthopaedic Surgery under Col. Simcox at the Dow Medical College, Civil Hospital, Karachi. He later went to UK for his FRCS and MCh from Liverpool.
Thereafter, young surgeons returned from UK with FRCS one by one, with training in Trauma and Orthopaedics, and managed the Department of Orthopaedics in every Medical College in Pakistan, working independently, progressing to establishment of Professional units.
Initially, the universities in Pakistan gave the degree of MS in Orthopaedics, but than the College of Physician & Surgeons of Pakistan took up the main task of providing qualified orthopaedic surgeons. The college was established as an examining body for general surgery after a specified training in recognized institutions in 1962. the first batch of specialists was produced in 1968. With demand for specialization, amongst other branches of surgery, fellowship of the college in orthopaedics was introduced in 1983, and the first exam was held in 1986, when two student were successful ‑Dr. Ghulam Mehboob who is now professor and head of department at Jinnah post graduate Medical Centre, Karachi, and Dr. Khalid Hassan Baloch, who is now professor and head of department in Bolan Medical College Quetta, a department which he started.
Thereafter the college has produced 134 fellows in orthopaedics, who are in different Medical Colleges, working and training students for the fellowship of the college. Additionally most universities grant M. S. in orthopaedics after specified training.
Today, there are orthopaedic departments in every Medical College, State run or privately owned, in every medium size hospitals and Nursing homes in the large cities of Pakistan. In Karachi, Lahore, and other cities orthoapedic Nursing homes are run by private orthopaedic consultants and some retired Professors from Medical Colleges.
Specialization in Orthopaedic Surgery has also started. Excellent hand surgery being done by Prof. Cheema, in Bahawalpur. Spinal Surgery and Scoliosis surgery was established in Multan by Prof. Ashiq Pervaiz and Nasser Mahmood Akhter, and it is now being done at Karachi by Dr. Riaz Lakdawala at AKUH, Arif Khan at Baqai, and lmtiaz Hashmi at Ziauddin as well as at JPMC and CHK.
Dr. Muhammad Ali Shah who returned to Pakistan in 1980 with fellowship, established the first trauma centre. This is purely a private venture, but many young Surgeons take advantage for initial training of trauma Surgery by working here for a while.
However the first pure trauma centre in public sector was established at Abbasi Shaheed Hospital by the City Government of Karachi, with the bed strength of 850. This caters to all type of trauma, & has got all facilities of a modern trauma centre, with Surgical, Neurosurgical, Vascular & Orthopaedic Teams in house and with the necessary backups including C.T Scan facilities.
Joint Replacement surgery esp. that of Hips and Knees has become a routine, and Arthroscopic surgery is being done at quite a lot of places. Dr. Shahid Noor, Dr. Amin Chinoy, Dr. Nooruddin Sadruddin and Dr. K. M. Shah at Baqai, Prof. Umer and Rehman Baig at AKUH, and others are all carrying out this type of surgery. Ilizarov technique for Limb Lengthening has also come to stay and the stalwart in the surgery is Prof. Yunis H. Soomro who has had training in Kurgan, Russia. At the Ilizarov Institute, which he has visited twice for training. Younger Orthopaedic surgeons, trained in Pakistan have also taken up Vascular surgery including reattachment of severed limb parts.
Malignant bone tumor has progressed. No longer is it just a quick amputation. Cytopathology service is available in all the big cities. C.T. Scan and MRI facilities and CT guided biopsies are available, thus a fairly accurate staging is possible. CT guided embolisation is another facility available. Limb saving is considered every time the possibility exists.
Orthopaedic surgery has had great help form well‑established physiotherapy and rehabilitation departments in every Medical College, and with workshops for making Orthosis and Prosthesis. Schools of Physiotherapy have been setup and some Universities grant B.Sc. degrees. The C.P.S.P. grants a fellowship diploma after a recognized training, initially started by Mrs. Zulekha Subhani & matured under S.R. Kirmani.
The major part of surgery is surgery of Trauma, and here advances in Internal Fixation of fractures with intramedullary nailing has become routine, where indicated. The initial device was a Rush pin, put in 1950 at the JPMC. These were initially imported, but soon were made in the country by surgical instruments makers, and have stood the test of time. Later were introduced K‑nails and then interlocking nails. With workshops held by the A.O. group form Base, Switzerland. And training given by them, AO technique of fracture fixation has become routine in most centres.
We now make most of the surgical instruments including implants and prosthesis locally, and there are many places, both in private, and public sector for the fitting of Orthoses.
Our academic activities in Orthopaedic Surgery have kept pace. Pakistan Orthopaedic Association was launched in 1964 and registered in Hyderabad. Professor Ali Muhammad Ansari was elected its first President, and a new president was elected every two years initially. Now, a new President is elected every year. The annual academic meeting of the Association is held every year, by rotation, in different cities.
Weekly meetings of Orthopaedic Surgeons for discussing cases are held in many cities. Monthly full dress meetings are also held in some cities, by rotation, amongst different centres.
Articles are regularly being produced, and the Pakistan Orthopaedic Association has its own journal. Other journals where articles of Orthopaedic interest are published are Journal of College of Physician & Surgeons of Pakistan and Journal of Society of Surgeons of Pakistan.
We feel proud of our achievements, however small they may be, and we feel proud that the younger generation of Orthopaedic surgeons ‑ both local and overseas trained ‑ are keeping the flag flying.
Pakistan Orthopaedic Association,
Pak Orthocon 2009,
Nov 12 - 14 2009