Report of the Visit of the 1959 North American Traveling Fellows to Great Britain

Abstract

The orthopaedic problems in Great Britain certainly are similar to those seen in this country, although their handling probably is more uniform because of the orthopaedic organization. The organization of regional orthopaedic centers, which are largely dominated by one institution, naturally reflects the feelings of the institution on the management of specific diseases. Throughout Great Britain we found that arthrodeses are much more commonly carried out on the major joints than they are in this country. Another contrast was the great individual experiences which many orthopaedic surgeons have had in treating particular entities. This is because of the concentration of patients in a given area where they are under the care of a small number of consultants. The number of patients seen and handled by an individual consultant is many times larger than that cared for by an orthopaedic surgeon in a comparable position in the United States and Canada. Tuberculosis is more common in Great Britain than in this country although its incidence is falling rapidly. The anterolateral approach for the drainage of abscesses is frequently utilized in the surgical treatment of tuberculosis of the spine. Time chemotherapeutical treatment in bone and joint tuberculosis varied a great deal throughout the areas visited. Two radically different views on the early management of spinal cord injuries were presented to us, yet the end results were similar. In Great Britain the emphasis is on a spinal injury centers as an integral unit within a general medical and surgical hospital. In the field of children's orthopaedics there still is great emphasis on treatment of congenital dislocation of the hip, an entity that is seen much more frequently in Great Britain than in the United States and Canada. The staff at the Robert Jones and Agnes Hunt Orthopaedic Hospital presented several different concepts in time management of scoliosis, particularly of the infantile or childhood type. They have done a large number of epiphyseal arrests of the convex side of the curve with interbody fusion. Time end results, however, are of too recent duration for clinical evaluation. In conclusion, the Traveling Fellows wish to express their most sincere thanks to The American Orthopaedic Association and The Canadian Orthopaedic Association for sponsoring and arranging this tour. We have made many friendships which we will cherish for the remainder of our lives. On a personal basis the value of this tour to us will grow in the years to come. Although it is impossible to assimilate all the material presented to us in this relatively brief period, we are certain that exchange fellowships are tremendously important in fostering an exchange of information. The British Orthopaedic Association and all of its members were magnificent hosts and treated us with every possible courtesy and kindness. We wish to extend particular thanks to Mr. Norman Capener and Mr. John Crawford Adams for all of their efforts in preparing such an outstanding itinerary for us. Those of us who were privileged to participate in the tour this year sincerely hope that the Traveling Fellowship Exchange Program will be continued between North America and Great Britain.