Dr. Bernard Portner is considered by many of his peers to be a pioneer in the field of non-surgical orthopedics — and his recent endeavors show he’s not slowing down any time soon. Dr. Portner’s current work-in-progress is a handbook of “Geriatric Orthopedics,” a term he may have coined.
He pulls from his 35+ years as a clinical physiatrist sub-specializing in medical orthopedics to present a series of guidelines for other medical professionals. His goal is to help the medical community, specifically those involved in geriatric care, understand the basic soft tissue diagnosis as well as the effective, safe and non-surgical treatment options available. The new book targets a wide medical audience, including geriatrists, internists, family practitioners, generalists and nurse practitioners working with the geriatric population.
Dr. Portner states that his idea for the handbook came from a desire to help end unnecessary suffering of elderly patients with musculoskeletal disorders. After seeing so many elderly patients misdiagnosed and mistreated, he realized a lot of the problem is a lack of information about an age group with distinctive needs, and an area of medicine (non-surgical orthopedics) not emphasized in medical training.
Dr. Portner had this to say about his decision to write the book:
As I knew that there was much suffering ahead for these patients that was perhaps unavoidable, my frustrations were enhanced by those that did not need to suffer but were doing so for lack of better care. To help improve this situation, I have decided to write this handbook to assist the physician in diagnosing and effectively and expeditiously treating the most common presenting orthopedic complaints of the elderly patient.– Dr. Portner
The handbook follows a logical progression, beginning with a thorough look at the physical exam, an evaluation of various common pain complaints (hip, knee, sciatica, foot, lower back pain, etc.), followed by careful analysis of specific orthopedic solutions and their effectiveness in treating the lesion, including therapeutic exercise.
Here’s an excerpt from his current draft:
The great majority of these conditions can be readily diagnosed simply with a careful history and skilled orthopedic exam. The art of history taking and the meticulous physical exam is increasingly being lost in today’s medical student and resident training programs… I will first outline important principles of both orthopedic medicine and rehabilitation medicine that are important to understand in this endeavor. Next I will present hypothetical cases and go through the important historical and physical findings for each of these common conditions, and suggest reasonable treatments for each of these.– Dr. Portner
He adds helpful bonus content, such as “Orthopedic Manifestation of Internal Disorders” and “Non-orthopedic Manifestations of Orthopedic Conditions,” along with an intriguing final section called “Beware the Dogma,” which addresses “a few of the common misconceptions, conventional non-wisdom and dogmatic foolishness that plague this area of medicine.”
Dr. Portner will speak to Hui o Kilauea at the Kilauea District Park on Feb. 21st regarding the topic of Geriatric Orthopedics. Check The Moving Body Blog in February for our next piece on the topic entitled: “Red Flags for Geriatric Patients: How to Get the Most from your Orthopedic Visit”
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—Lindsey Kesel, Orthopedic Consultant
Tune in to “The Moving Body” Radio Show every Saturday at 7 a.m. on KHVH–AM 830.