創傷及疾病種類    Injuries and Diseases

歡迎蒞臨香港骨科醫學院公共資訊委員會網站

香港骨科醫學院 (下稱「學院」) 屬於法定機構,旨在奠下專業骨科培訓的標準,認可專業骨科課程和舉行專業資格考試。學院亦與香港骨科醫學會攜手,在本地與國際的層面上,竭誠為香港骨科同業貢獻,給予大力支持。

學院的培訓課程,以至香港專業骨科中心的外科工作,皆獲公認達致國際水平。當中,香港大學骨科學系在脊柱變形、兒童骨科與上肢手術上突破性的外科成就,更廣受稱道;香港中文大學矯形外科及創傷學系的成就,尤其在帶血管骨移植、運動手術與生理機能,以及兒童骨骼變形等範疇上種種卓越的成果,更獲得國際肯定。悠悠50年來,香港骨科專科醫生為全球骨科醫學發展貢獻良多,從不間斷。


香港骨科醫學院歷史簡介

1993年,香港骨科醫學院隨香港醫學專科學院成立,成為專科學院下12個分科學院之一,亦是本港首批成立的專科學院之一。學院創立的緣起追溯至1951年,由香港大學在瑪麗醫院創立了骨科專科部門說起。正式的香港骨科醫生訓練則要在10年以後,隨著香港大學骨科學系成立才首度出現;香港骨科醫學會則於1965年成立,全力為本地的骨科同業籌劃各式學術與社會事務,一直至今。

香港最初的骨科專科培訓課程不論在訓練內容或是認可專業資格方面,都沿用英國體制。骨科醫學員需要通過重重嚴峻的考試,加上一段時間的海外實習經驗,才可合符專業資格的要求。

1960年代至1984年,香港骨科培訓需吻合英國皇家外科醫學院院士的考試資格。及至1985至1991年,澳洲皇家醫學院取代了舉辦終期試的角色。1991至1996年,學院把角色取而代之。由1997年起,學院便與英國愛丁堡皇家外科醫學院攜手,主持考試安排。

隨著全球骨科醫學概念與技術不斷創新,例如專科分項、微創技術與電腦輔助手術等,學院亦與時並進,不斷更新課程內容,同步向前。

骨科發展日新月異,學院有感骨科醫生亦需要不斷進修知識與技巧增值,就此為在港執業的註冊骨科醫生提供了持續專業進修課程。


誰是骨科專科醫生 (簡稱骨科醫生)?

骨科醫生的專業職責就是致力於診斷、治療、預防及復康這些肌肉骨骼系統的創傷、失調及病患,涉及部位包括脊柱,盤骨及四肢肢體的骨骼、關節、韌帶、肌肉、神經和筋腱等。

骨科醫生非常熟悉肌肉骨骼系統,不少更選擇專注研究某些身體部位,諸如足踝、手部、肩肘、髖關節或膝關節等。骨科醫生亦可以專注某些專門的服務範疇,例如兒童矯形及創傷科、創傷科、關節置換矯形科、骨腫瘤科或運動醫學等。


教育及訓練

香港的骨科醫生須要最少12年專業教育及訓練:包括修畢五年大學醫學院課程;一年駐院臨床見習和兩年普通外科;通過中期專業考試後,才能申請接受由香港骨科醫學院舉辨為期四年的骨科專業訓練 。

最後還要通過嚴謹的專業考核,才可以成為一位能在香港專科醫學院註冊的骨科專科醫生。

成為骨科專科醫生後,根據香港醫務委員會規定,每名專科醫生需要在每三年累積最少90個持續醫學進修學分。因此,每位骨科專科醫生都會定期参與骨科醫學研討會和不同專科的工作坊,以終生學習的精神持續進修,掌握最新科技與新知,確保能向病人提供最優質的專業服務。


骨科醫生治理甚麼病症?

骨科醫生的服務對象遍及各個年齡,由初生兒到年老長者。治理的病患由骨骼與關節功能失調/折裂,以至肌肉、韌帶及筋腱撕裂或病症等。患者、家屬和醫生通力合作至為重要,能確保後者針對患者的需求、期望及益處套用合適的療法。骨科醫生尊重多元價值,致力服務社群及有獨特需要的人士。

治理肌肉骨骼系統疾病的時候,都不一定需要施行手術。很多時候利用藥物、肌肉舒展運動或其他復康及相關的療法,都能夠達到一定的效果。當以上各種療法都對病人起不到作用的時候,骨科醫生可能會建議做一些外科手術,矯正病源,以期達到療效果。


概略而言,骨科醫生治理的病症包括:
1. 手指/足趾病變
2. 腰背疼痛、椎間盤突出、坐骨神經痛及脊柱側彎
3. 骨腫瘤、軟組織肉瘤、肌肉萎縮及大腦麻痺
4. 馬蹄足、足姆趾囊腫、弓形腿(膝內翻)、膝外翻及雙腿長度不一
5. 骨折及脫臼
6. 發育不健全
7. 骨關節炎
8. 骨質疏鬆及老人骨折
9. 類風濕性關節炎
10. 運動或職業上的肢體勞損、創傷
11. 筋腱創傷、肌肉拉傷、黏液囊炎及關節內軟組織撕裂
12. 韌帶撕裂、扭傷及勞損
13. 肌肉及骨骼各類的感染,例如脊柱結核病


骨科醫生施行哪類手術?

骨科醫生會因應需要,施行不同形式的手術,大致上分為:
1. 內窺鏡關節手術:運用特別的攝影機及器材把,把關節內的問題視像化,加以診斷和治療
2. 融合手術:猶如「焊接」的過程,採用骨移植物及內部工具(例如金屬條)把骨骼融合起來,成為單一堅固的骨骼
3. 內部穩定手術:當骨折部份康復期間,運用金屬板、釘或螺絲把碎骨扶正至合適的位置
4. 人工關節置換(局份、全部和更換)手術:清除出現炎症或損壞的關節,換上人工關節,稱為「假體」
5. 截駁骨手術:把畸形的骨骼切割後重新定位,加以矯正
6. 軟組織(韌帶、筋腱)修補:修補諸如筋腱或韌帶等軟組織
7. 減壓手術:減少脊柱中樞神經、神經根及外圍神經的減壓手術


病人對骨科醫生的正確期望

一般而言,骨科醫生會首先根據病人的病歷及身體檢查作出初步評估。如有需要會進行深層次的檢驗,例如X光檢驗,血液分析,電腦掃描(CT)或核磁力共振(MRI)等。在很多情況下,同一種病癥可能會有多於一種的療法;骨科醫生會與患者研討各種治療的方案,一同取決最合符患者健康狀況和生活模式的治療方法。

病向淺中醫,不論身體任何部份產生問題,都應該及早求醫,以免延誤。骨科醫生在其專業範圍內,會盡力幫助病者 認識病源、病因,並作出正確判斷,合適的治療方案,以服務社羣。



Welcome to the website of the Public Information Committee of the Hong Kong College of Orthopaedic Surgeons

The Hong Kong College of Orthopaedic Surgeons (HKCOS) is the statutory body responsible for setting the standards of professional orthopaedics training, accrediting professional orthpaedics education programmes and conducting professional qualifying exams. The College also works alongside the Hong Kong Orthopaedic Association to serve and support the interests and aims of the Hong Kong orthopaedic community, both domestically and across the world.

The College's training programmes are recognized as world class as is the surgical work carried out within Hong Kong's specialist orthapedic centres. The Department of Orthopedic Surgery at the University of Hong Kong is particularly well known for its groundbreaking work in spinal deformity, children's orthopedics and upper limb surgery while the contributions from the Department of Orthopedics & Traumatology at the Chinese University of Hong Kong are also internationally recognized, especially with its preeminent work in vascularized grafts, sports surgery and physiology and children's deformity. Hong Kong surgeons have been making a significant contribution to worldwide orthopedics for more than 50 years and continue to do so today.


The history of the Hong Kong College of Orthopaedic Surgeons

The HKCOS was founded in 1993, with the formation of the Hong Kong Academy of Medicine. The HKCOS became one of 12 colleges under the Academy umbrella and was one of the first specialty colleges to be established. The roots of the College, however, stretch back to 1951 when Hong Kong University establishment a specialist orthopedic unit at Queen Mary Hospital.

The formal training of orthopaedic surgeons in Hong Kong came a decade later, with the inception of the Department of Orthopaedic Surgery in 1961 while the Hong Kong Orthopaedic Association, formed in 1965, started to organize the academic and social affairs for the Orthopaedic fraternity in Hong Kong. It is a role it continues today.

Hong Kong's first orthopaedic training programmes followed the practice of the United Kingdom in terms of the training and accreditation of specialised doctors, where orthopaedic trainees have to pass stringent exit exams, followed by a period of overseas practice.

Initially, from the 1960s to 1984, orthopaedics training fulfilled the requirements of the UK's Fellow of the Royal College of Surgeons exam. From 1985 to 1991, the Australasian College took up the role of organising the exit exams. From 1991 to 1996, this role was replaced by the HKCOS. From 1997 to the present day, the HKCOS has been sharing this responsibility with the Royal College of Surgeons of Edinburgh.

With the development of new concepts and techniques in orthopaedic medicine worldwide, such as sub-specialisation, minimally invasive procedures and computer-assisted surgery, the HKCOS is constantly evolving and updating its training curriculum to reflect these radical changes.

Due to the rapid development in this field, the HKCOS feels it is essential for orthopaedic surgeons to continue to upgrade their knowledge and skills. To this end, it provides training for continuous professional development to all registered orthopaedic surgeons practicing in Hong Kong.


Who are orthopaedic specialists?

An orthopaedic surgeon is a physician devoted to the diagnosis, treatment, prevention and rehabilitation of injuries, disorders and diseases of the body's musculoskeletal systems. This system includes bones, joints, ligaments, muscles, nerves and tendons.

While orthopaedic surgeons are familiar with all aspects of the musculoskeletal systems, many orthopaedists specialise in certain areas, such as the foot and ankle, hand, shoulder and elbow, spine, hip or knee. Orthopaedic surgeons may also choose to focus on specific fields like paediatrics, trauma, reconstructive surgery, oncology (bone tumours) or sports medicine.


Education and training

To practice in Hong Kong, an orthopaedic specialist must have undertaken at least 12 years of professional education and training: five years' medical school and a year's medical residence followed by two years' General Basic Surgical Training. He or she has to pass a qualification examination before being qualified for a four-year professional training programme with the Hong Kong College of Orthopaedic Surgeons.

Upon finishing the training programme, he or she must pass a stringent assessment test before being recognised as an orthopaedic specialist.

After registration as a specialist, the Medical Council of Hong Kong requires a registered surgeon to complete at least 90 credits of continuing medical education every three years. Therefore, all orthopaedic surgeons need to attend seminars and specialist workshops relevant to their practice on a regular basis in order to keep themselves abreast with the latest medical technologies, knowledge and skills. This helps ensure the patients receive the best and latest professional service possible.


What kind of diseases do orthopaedic surgeons treat?

Orthopaedic Surgeons treat patients of all ages (newborns, children, athletes, the middle-aged and the elderly) with conditions that range from bone and joint disorders and fractures to disease or tears of the muscles, ligaments and tendons in all regions of the body. It is essential that patients and their families develop partnerships with their physicians. This will help ensure that decisions about medical treatments honor the patients' wants, needs, preferences and values. Orthopaedic surgeons respect the value of diversity and are committed to serving communities and individuals with unique needs.

An orthopaedic surgeon treats many musculoskeletal conditions without surgery, by using medication, exercise and other rehabilitative or alternative therapies. If necessary, he/she may also recommend surgical treatment if the patient does not respond to other treatments.

Some of the conditions and diseases an orthopaedic surgeon treats include:
1. Abnormalities of the fingers and toes
2. Back pain, ruptured disks, sciatica and scoliosis
3. Tumors in bones and soft tissues, muscular dystrophy and cerebral palsy
4. Club foot, bunions, bow legs, knock knees and unequal leg length
5. Fractures and dislocations
6. Growth abnormalities
7. Osteoarthritis
8. Osteoporosis and geriatric bone fractures
9. Rheumatoid arthritis
10. Sports and work-related injuries
11. Tendon injuries, pulled muscles, bursitis and torn cartilage
12. Torn ligaments, sprains and strains
13. Infectious diseases affecting the bones and muscles, such as spinal tuberculosis.


What types of surgeries do orthopaedic surgeons perform?

Based on the patient's needs, an orthopaedic surgeon would perform the appropriate type of surgery. Common ones include:

  1. 1.Arthroscopy: a procedure using special cameras and equipment to visualise, diagnose and treat problems inside a joint.
    2. Fusion: a welding process by which bones are fused together with bone grafts and internal devices (such as metal rods) to heal into a single solid bone.
    3. Internal fixation: a method to hold the broken pieces of bone in proper position with metal plates, pins or screws while the bone is healing.
    4. Joint replacement (partial, total and revision): an arthritic or damaged joint is removed and replaced with an artificial joint called prosthesis.
    5. Osteotomy: the correction of bone deformity by cutting and repositioning the bone.
    6. Soft tissue repair: the mending of soft tissue such as torn tendons or ligaments.
    7. Decompressive surgery: to reduce pressure on the spinal cord, spinal nerve roots and peripheral nerves.


What can patients expect from orthopaedic surgeons?

In general, visits with an orthopaedic surgeon start with a personal interview, physical examination and review of previous records or tests. This may be followed by additional diagnostic exams, such as blood tests, X-ray or other images like computed tomography scan (CT scan) or magnetic resonance imaging (MRI). For most orthopaedic conditions and injuries, there may be more than one form of treatment. The orthopaedic surgeon will discuss treatment options with the patient to mutually determine the plan best suited for his/her health and lifestyle.

Prevention is better than cure, and early detection of musculoskeletal problems always helps to speed up recovery. If you experience any musculoskeletal symptoms or have sustained an injury, please consult your general practitioner, who will be able to refer you to a registered orthopaedic specialist for proper investigation and treatment.

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