Division of General Orthopaedics


The Division of General Orthopaedics is the biggest division in the department, having more than 6 orthopaedic specialists to provide the best care to our patients. Our clinical services cover almost all common orthopaedic acute and chronic problems ranging from acute hospital admissions to outpatient specialist clinic referrals. These include:

  • Soft tissue acute trauma
  • Musculoskeletal infection
  • Lumps and bumps in extremities
  • Overuse conditions
  • Nerve entrapment syndrome in limbs
  • Fragility hip fractures
  • Fragility vertebral fractures
  • Degenerative spine disease
  • Degenerative joint diseases
  • Foot and ankle diseases

Our aims

  1. Provide the best, most appropriate and timely first line care for all acute orthopaedic admissions together with their subsequent follow-up and rehabilitation.
  2. Provide comprehensive basic and intermediate orthopaedic education to our trainees, to equip them with essential knowledge and skills to deal with most of the general orthopaedic problems for their future career.

Our services

All the common acute orthopaedic problems and trauma admitted to hospital will be first managed by our team. Complex cases will be triaged to the subspecialty team after our initial assessment and management. We also follow-up for most of these cases in our out-patient clinic service, providing the best continuation of care. Our strength is to manage the most diverse musculoskeletal problems. Among all these, we are focusing on the following areas:

Fragility fractures

Fragility hip and vertebral fractures are one of the major challenges worldwide in the last decade because of ageing population. Our department has the longest established Geriatric hip fracture clinical pathway in Hong Kong since 2007. It is a multidisciplinary clinical model which includes orthopaedic surgeons, anaesthetists, geriatricians, nurses, physiotherapist, occupational therapists, medical social workers and outpatient support group for the best and most comprehensive care of the fragility hip fracture patients. Our hip fracture clinical pathway has won the Hong Kong West Cluster Outstanding Team award in 2008 and 2011. Our Key Peformance Indexes (KPI) were always the best among all public hospitals in Hong Kong.

Besides hip fractures, we also have the osteoporotic vertebral fracture pathway to take care of the elderlies suffering from acute osteoporotic fractures. These comprehensive pathways aim at “whole patient care”. The aim is to take care of all the aspects from acute management as an in-patient and more importantly the rehabilitation, osteoporosis prevention and education.

Cement augmentation surgical fixation in severe osteoporotic hip fracture
Outstanding team award in Hong Kong West Cluster 2008
Sharing of our team experiences in hospital

Degenerative joint diseases

Osteoarthritis is one of the commonest orthopaedic problems in our society. And knee osteoarthritis is also the leading orthopaedic referral. Our division works closely with Division of Adult Joint Replacement and also Division of Rehabilitation to establish the One-Stop clinic in the MacLehose Medical Rehabilitation Centre to manage the newly diagnosed patients. The One-Stop clinic provides a multidisciplinary assessment from orthopaedic surgeons, nurses, physiotherapists, occupational therapists and clinical psychologists in order to formulate the quickest and most effective management for patients with different degrees of degeneration. This shortens these patients waiting time to see an orthopaedic specialist as well as the time to start proper physiotherapy training. This also helps to prevent this group of patients from avoidable surgical procedures.


Our division mainly focuses on joint preserving surgery for the early degenerated knee in younger and higher demand patients whom fail conservative treatment. High tibial osteotomy with 3D pre-planned cutting jig is our standard of surgical care in these patients nowadays. It shortens the operative time with more precise re-alignment of the knees. Patients could go back to work early in their previous high demand work environment.

Bilateral simultaneous high tibial osteotomy


Patients with early stage avascular necrosis of hip are usually relatively young and do not require a total joint replacement yet. Early intervention with vascularized bone graft is done by our skillful microvascular surgeon. Patients can have their hip joint preserved in their relatively young age without taking the risks of short and long term potential complications of a major artificial joint replacement.

Early AVN of the hip
Free vascularized fibula graft harvest
2 years after free vascularized fibular graft showed no collapse of femoral head

Elbow arthritis

Early elbow osteoarthritic problem results in pain and stiffness. It is often a problem in manual labour worker in their working life. Patient failed conservative treatment will receive minimal invasive arthroscopic surgical release and removal of loose bodies by our experienced arthroscopic surgeon. Small surgical trauma, quicker recovery, together with the experienced therapists in our rehabilitation centres for the post operative rehabilitation, allowing the patients return to their work quickly.

Arthritic stiff elbow before (Left) and after (Right) arthroscopic removal of loose bodies and elbow release.
Good functional range of movement with minimal surgical scars

Overuse conditions

Overuse conditions are more common in the upper limbs following repetitive movement. The do not just limited to specific occupational acts but also in patients involving in intensive sporting activities and daily housework. Conditions varied widely in different regions including shoulder (impingement), elbow (tennis elbow and biceps tendonitis +/- rupture) and hand and wrist (De Quervains disease, extensor carpi ulnaris tendonitis and trigger finger. While most of these conditions can be treated by the family physicians in a conservative manner, intervention including injections and surgical debridement may be indicated when the conditions persisted. Our team works closely with our allied health professionals including physiotherapist, occupational therapists, and prosthetists to educate and treat these conditions.

Musculoskeletal infection

A majority of our patients belongs to this group. The type of musculoskeletal infection ranges from mild soft tissue infection such as cellulitis, chronic ulcers from pre-existing comorbidities like diabetes or peripheral vascular diseases, joint infection like acute pyogenic septic arthritis, acute or chronic osteomyelitis in children or in adult, infected hip implants in elderly, to the most severe and deadly form of infection, necrotizing fasciitis etc. Our team is the first among Hong Kong hospitals to have a multidisciplinary team dealing with this group of patients with so much diversity. The team involves different disciplines including:

  • Orthopaedic surgeons
  • Microbiologist
  • Nurse specialists
    • Advance nurse specialist in infection
    • Community nurses
  • Allied health professions
    • Physiotherapist
    • Occupational therapist
    • Dietician
    • Medical social worker

Our goal is to achieve the best and realistic clinical outcomes, result in optimal patient’s satisfaction and decrease the length of unnecessary hospital stay.

Chronic femur osteomyelitis manged with antibiotics cement rod and spacer. Successful infection controlled and bone graft the bone defect using Masquelet technique.

Sport injuries

We provide acute and subacute management for the patients with sport injuries relating to shoulders and knees. A timely and accurate diagnosis is important for future successful management of the problem. Therefore, sport injuries such as rotator cuff injury, traumatic shoulder dislocation, acute anterior cruciate ligament injury, meniscal injury or other injuries are first managed by us. Appropriate investigations and physiotherapy will be arranged as soon as it is required. And if complex surgical intervention is required, they will be referred to our sport specialist for timely care. Uncommon tendon injuries, e.g. Achilles tendon rupture, Quadriceps tendon rupture or other soft tissue trauma will also be managed by us both conservatively and surgically if required.

Foot and Ankle

Our Division also manages a wide range of foot and ankle disorders, ranging from the acute fractures of the feet, to chronic deformities that have been present for years. Common problems such as flat feet, bunions, and hammer toes are managed appropriately after a close discussion between the surgeon and patient on the benefits of either operative or nonoperative treatment. Subsequently, the patient’s journey will be closely monitored by a dedicated team including podiatry, prosthetics and orthotics, and orthopaedic surgeons to bring to life the concept of personalized medicine.