Donald Gunn Lecturer 2002

History of Orthopaedic Surgery in Singapore

Low Yin Peng
Dept of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore

The development of orthopaedic surgery in Singapore is very much tied up with the island’s eventful modern political and social history, the advances of modern medicine, and the philanthropy and vision of community leaders of old whose unfailing efforts and unstinting financial support had resulted in the building of hospitals and the founding of the medical school. The early immigrants to Singapore after its establishment as a trading post by Sir Stamford Raffles in 28 January 1819 were generally left to their own devices when they were injured or sick. Probably the native bone-setters were treating the fractures of the poor coolies. Bone and joint infections were invariably fatal as antibiotics were available only in the 1930s.

Perhaps the greatest impetus to medicine in general and orthopaedic surgery in particular was the founding of the Straits Settlements and Federated Malay States Government Medical School in Singapore in July 1905 after an unsuccessful attempt in 1889. The Faculty of Medicine, National University of Singapore is its direct descendent. Hitherto, orthopaedic problems and surgical procedures were handled by general surgeons. With the creation of the chair of orthopaedic surgery in 1951, orthopaedic surgery in Singapore underwent an accelerated pace of development. Professors J.A.P. Cameron, Anders Karlen and Donald R. Gunn laid the foundation of orthopaedic knowledge and practice in Singapore. Professor Cameron started the Artificial Limb Centre. Professor Karlen started the Burns Unit in 1958.

Professor Gunn was a great teacher and academician and was responsible for planning a well structured training programme and the starting of a formidable slide library and an orthopaedic research laboratory. Professors V K Pillay, PB Chacha and K Bose led in the teaching, research and improvement of service in the post colonial era. Professor Lee Eng Hin took over from Professor Bose in 1998 and guided the University Orthopaedic Department and that of Kandang Kerbau Women’s and Children Hospital to a higher level of service and research. With his promotion to Dean of the Medical Faculty in 2001, Professor Satkunananthan was the natural choice to take over the helm of the department in NUH. Orthopaedic surgery in the Government side was equally active and vibrant under the leadership of Mr William Fung and the late Professor N Balachandran. Among the latter’s many achievements were the training of the present leaders of the orthopaedic profession, the setting up of the Rehabilitation Center and the inauguration of orthopaedic departments in all the regional hospitals in 1979. It was a tradition then that government orthopaedic surgeons were also heads of the Accident and Emergency Departments in the various hospitals, including SGH. Professor S K Tan assumed the headship of the Orthopaedic "O" Department in SGH when Professor Balachandran retired in June 1988. Dr. S Krishnamoorthy assumed headship of Orthopaedic "C" Department when the University Orthopaedic Department moved to Kent Ridge. A/Professor Tay Boon Keng became head of the merged "O" and "C" Departments when Dr S Krishnamoorthy retired and Professor S K Tan became the Head of the Surgical Division 1995. A/Professor Tay Boon Keng assumed the post of Chairman, Medical Board in 2002 and Dr Tan Seang Beng is now heading the departments of orthopaedic surgery in SGH and KKWCH. The specialty of hand surgery in Singapore had its origins in orthopaedic surgery. Professors PB Chacha, Robert Pho and Tan Ser Kiat were the successful pioneers. They have passed the baton to Dr Teoh Lam Chuan and A/Prof Lim Beng Hai who have taken the specialty to greater heights. Orthopaedic surgery in the other regional hospitals is equally vibrant. The department in Tan Tock Seng Hospital is ably led by Dr Yu Chun Sing. It is perhaps the department with the greatest work output. Dr Low Cheng Ooi and Dr Chin Thaim Wai head the departments at Changi General Hospital and Alexandra Hospital, respectively.

Orthopaedic surgery has come a long way. From its humble beginning, there are subspecialties like paediatric orthopaedic surgery, spine surgery, adult joint reconstruction, orthopaedic trauma, sports injuries and orthopaedic oncology. On-going research is being done in these areas by the staff of the various departments. To guide the development and training of orthopaedic surgery, a Specialist Accreditation Board was set up in 1999. This has led to the formation of the Joint Committee of Specialist Certification and the Specialist Training Committee. A structured programme, mandatory rotation over three years to accredited centers and scheduled assessments and exit examinations help to maintain standards of orthopaedic practice