A Brief History of Orthopaedics in New Zealand

Orthopaedic surgery as a specialty was not practised in New Zealand until the First World War.  Early in 1918 arrangements in Christchurch were made to receive the first orthopaedic casualties returning from Europe. At the same time military hospitals were set up in Rotorua, Trentham and Auckland.  Six men Wylie, White, Mill, Ulrich, Wallis and Gower were considered New Zealand's first Orthopaedic surgeons.  In June 1919 over 4,800 service patients were being treated in military hospitals but by 1922 the number had fallen to less than 1,000.  Civilian orthopaedic surgery followed on from this initial military focus.

During the next decade and especially during the Second World War orthopaedic surgery was practised by a small number of the pioneers working especially in the main centres with a large proportion of the orthopaedic work completed in the smaller centres by General surgeons.  During the war years a large contingent of New Zealanders trained in orthopaedic surgery either at the Royal National Orthopaedic Hospital in London or at Oswestry in Shropshire.  After the war these young men returned to New Zealand and swelled the ranks of the orthopaedic fraternity. 
 
The New Zealand Orthopaedic Assocation
The New Zealand Orthopaedic Association was formed in 1950.  The association has been in existence ever since and has grown in structure and stature.  The first Annual Scientific Meeting was held at Christchurch Hospital on 21 and 22 September 1950.  One of the issues of concern then was the number of Orthopaedic surgeons in smaller areas and this remains today. To provide a quality cover three surgeons is the bare minimum.  
 
Orthopaedic Training
One of the most important initiatives that the Association has been responsible for is working with the Royal Australasian College of Surgeons (RACS) to develop the orthopaedic training programme.  The training which is undertaken over five years has an excellent reputation and positions are keenly sought.  There is considerable debate about the number of trainees as when times are booming there are not enough New Zealand trained orthopaedic surgeons to fill all vacancies and overseas trained orthopaedic surgeons immigrate to New Zealand.  On the other hand when times are tighter our young Fellows tell us they struggle to get a consultancy appointment.  This debate is likely to continue as more surgeons work for longer as they are fit and healthy and their experience is high.  Nevertheless demand for orthopaedic surgery is increasing and will continue as the population ages.
 
Orthopaedic Research
Research is an essential aspect of the profession and while scientific observation and practise is very important so too is the “art of orthopaedic surgery”. The two, art and science, need to be married together as Henry Thomas over 120 years ago claimed “The crying evil of our art in these times is the fact that much of our surgery is too mechanical, our medical practice too chemical and there is a hankering to interfere which thwarts the inherent tendency to recovery possessed by all persons not actually dying”. He added however “that there are actions which nature cannot do so well as the artist in charge” (Hooker, 1996, 140).
 
The establishment of the New Zealand Joint Registry under the auspice of Professor Alastair Rothwell has proved to be of enormous benefit to the development of the art and science of orthopaedic research and has developed an excellent international reputation.
 
The Wishbone Orthopaedic Research Foundation of New Zealand has been formed from the merger of the Wishbone Trust and the NZOA Research Foundation.  The purpose of the Trust is to promote and raise funds for orthopaedic research.
 
In Colin Hooker’s words “The science of our specialty, then, is the means by which we assess our results, analyse our mistakes, advance our knowledge and further the application of the science of materials and engineering in the treatment of injuries and disease” (Hooker, 1996, 139).
 
International Networks
International networks of orthopaedic surgeons were a founding philosophy of the association and this continues to the present day. The Carousel of Presidents is an important aspect for every President.  Substantial travel is undertaken to attend the annual scientific meetings of these associations by the President or President Elect to develop and promulgate internationally consistent guidelines. This has been one of the strengths of the international orthopaedic community.  Associated with this has been the development of travelling Fellow scholarships; ABC Fellowship, Hong Kong Young Ambassador, ASEAN Fellow, Korean Fellow, ANZAC Fellow and ANZAC Travelling Fellow. These are important aspects of the NZOA whereby young leaders can be developed as part of succession planning for the presidential line.
 
More Information about Orthopaedics in New Zealand
Colin Hooker’s Orthopaedics in New Zealand (1996) provides a detailed history of orthopaedics in New Zealand and the development of the New Zealand Orthopaedic Association.  Contact the NZOA Office if you wish to obtain a copy.