Bandar Seri Begawan - A presentation entitled 'Orthopaedic Surgery in Brunei Darussalam: Past, Present and Future' was conducted yesterday during a medical conference.

The Acting Specialist Orthopaedic Surgeon at RIPAS Hospital, Dr Hj Abdul Rashid bin Hj Mohammad, informed the audience of the history of orthopaedics in Brunei Darussalam and what the department presently offers as well as what it will likely be able to offer in the future.

Prior to 1988, injuries and diseases of the bone and joints were treated by general surgeons at RIPAS Hospital.

In 1988, the Department of Orthopaedic Surgery branched out as an independent department whose staff performed orthopaedic surgery neurosurgery and plastic surgery.
Some advancements and achievements of the department include its ability to conduct knee arthroscopy, total knee replacements, total hip replacements, paediatric orthopaedic surgery, hand surgery, musculoskeletal tumour surgery and arthroscopic anterior cruciate ligament (ACL) reconstruction surgery of the knee.

Some of the more recent achievements include minimally-invasive plating osteosynthesis, pelvic fracture surgery and in 2008, the department conducted limb-lengthening surgery.

In 2010, it conducted arthroscopic shoulder surgery and last year conducted ankle arthroscopy, revision hip replacement surgery and revision knee replacement surgery

The department also offers the latest treatment for osteoarthritis with total hip and knee arthroplasty, internal fixation of fractures using the principles of AO, in addition to carrying out a wide range of arthroscopic surgeries for sports-related injuries such as ACL reconstructions, shoulder (bankart or rotator cuff muscle repair) and ankle arthroscopy.

At present there are 14 orthopaedic surgeons comprising four specialists at RIPAS Hospital and two at Suri Seri Begawan Hospital in Kuala Belait, which leads to a ratio of one orthopaedic surgeon for every 25,000 people in the local populace. Three trainees are currently undertaking higher specialist training at universities overseas.

The orthopaedic team treats over 20,000 patients annually in the outpatient department and performs around 1,500 surgeries annually and occupies a major share of the operating theatre. It also provides in-patient care tc over 2,000 patients a year.

There is currently one orthopaedic ward with state-of-the-art motorised beds.

On average, the occupancy rate at the orthopaedic ward is 140 per cent.

Services provided by the department includes a 24-hours trauma service at RIPAS Hospital and Suri Seri Begawan Hospital, an outpatient clinic service at RIPAS Hospital on all working days, and the department also carries out elective and semi-elective operations three days a week.

On top of that, emergency trauma cover and surgical procedures are carried out 24 hours a day.

Other services include weekly visits to Kuala Belait by specialists, fortnightly outpatient clinics at Tutong Hospital, monthly outpatient clinics at Temburong Hospital, monthly specialist clinics at the Child Developmental Centre, medical cover for sporting events.

Some of the facilities available include a Lamina flow theatre, which reduces infection, image intensifiers, CT and MRI machines; 24-hours radiology support services, state of the art AO instrumentation, high-definition arthroscopic set both at RIPAS Hospital and Seri Suri Begawan Hospital, as well as a computer navigation system.

The presentation also laid out what the hospital expects to see in the future.

Some of the expectations made are based on Brunei's expected population by 2035 (679,886) and with that, will come a rise in the number of people above-the age of 65 years who could experience age-related problems.

The hospital also expects an increase in high-velocity fractures with complicated configurations as a result of road accidents, more litigations or insurance claims, demands for state of the art treatments such as the utilisation of stem cells, cartilage transplants that are minimally invasive or microscopic, and a rise in diabetes-related problems.

This in turn will lead to more admissions, more surgeries and more space and time required in the operating theatres.

By joining the Asean Orthopaedic Association, Brunei opens the doors for opportunities such as training, research and networking, as well as an opportunity to join the Asia Pacific Orthopaedic Association, with the aim of improving the standard of patient care in orthopaedics in Brunei.

--Courtesy of Borneo Bulletin