Present Overview of NITOR

National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR) is a 1000 bed tertiary center, receiving referral patients from all over the country. The following departments are working side by side with co-ordination between each other.

Casualty department: Round the clock an orthopaedic team is available for management of orthopaedic trauma patients. There are shifting duties of 12 hourly rotations. In each shift there are six senior residents. Assistant Registrars, Registrars and Consultants are on duty. Professor, Associate Professor and Assistant Professors remain on Call.

Out-patient department: Professor in charge of unit remains physically present with the whole team to cover OPD. About 10 doctors attend the OPD clinic 6 day a week.

In Patient Services at NITOR: Functionally there are 12 units (teams) for Orthopaedics and Traumatology named after the natural colors, such as Blue I & II, Green I & II, Pink I & II, Red I & II, Violet I & II, YellowI & II. There is also Department of Plastic and Reconstructive surgery, Department of Anaesthesiology and Department of Physiotherapy and Occupational therapy. Other auxiliary department includes Department of Radiology and imaging, Department of Pathology, Department of Blood Transfusion, Limb Brace workshop and Social welfare department. Over the last 10 years there has been a tremendous increase in the number of patients being treated at NITOR. The following data shows this increase in the number of patients.

Patient Attendance & Operation at NITOR

Yearly Patient Statement- 2011 to 2017
Year	Patient attendance	Patient admission	Total operation
2011	117903	117903	24560
2012	130667	21001	25994
2013	135609	17410	25515
2014	135537	19947	31443
2015	155303	21698	27920
2016	162602	22787	28203
2017	178862	25065	27785

ORTHOPAEDIC SUBSECIALTY IN NITOR

Orthopaedic subspeciality is a present day need for developing country like Bangladesh to ensure best care of orthopaedic and trauma patients.In Bangladesh we have to face a huge burden of trauma patients which is gradually increasing day by day so all orthopaedic centers including NITOR is mainly `engaged in treating mainly trauma patients. Inspite of this NITOR is still delivering services to non traumatic patients as well. Though hospital has no separate departments for orthopaedic subspecialities like spine, hand, sports injury, paediatric orthopaedics, adult reconstruction, arthoplasty etc. We were providing subspecialty services sporadically. Recently separate units are formed to develop organised subspeclty services in NITOR and units started working under the guidance of unit chief who have special skilled in respective field.

Name of sub-speciality units	Name of prof/Assot Prof in charge
Arthoplasty & Arthroscopic surgery	Prof. Dr. Md. Wahidur Rahman Prof. Dr. Monaim Hossen
Hand & Micro surgery	Prof. Dr. Md. Jahangir Alam
Paediatric orthopaedic surgery	Prof. Dr Sarwar Ibne Salam
Musculo-skeletal tumor surg
Spine Surgery	Dr. Rezaul Korim (Asoc. Prof)
Reconstruction & Deformity correction surgery

Interested orthopaedic surgeons (Asst prof, Consultants) are engaged in the respective fields and developing their skills in the above mention subspecialties.

Academic Activities

Vast arrays of academic activities are performed at NITOR.

From 7:00am to 08:00 am lecture by the professor and associate professors on a prescribed schedule so as to cover the entire syllabus of M.S. (Ortho) and D. Ortho course in 2 years time.

The daily morning clinical conference, which is held form 8.00am to 9.30am is unique among all the Medical colleges and Medical Institutes in Bangladesh. First 60 minutes is spent for presentation of cases listed for operation on that day. This is like a medical board including all the senior and junior orthopaedic surgeons of NITOR and post graduate residents. The residents present the cases scheduled for operation for that day and audiences in the house listen to the unit plan. A brief but informative discussion is held on the case presented before the house and definitive operation plan is formulated and further follow-up schedule of the particular patient is planned. This endeavor is not only beneficial to the patient but also for the students as they can learn the management of cases. Rest 30 minutes is for discussing the activities of past 24 hours which includes the presentation of the total number of cases attending the emergency and casualty department and postoperative x-ray presentation.

Clinical demonstrations are made in ward round which starts as soon as the morning session ends. Clinical demonstrations are also made in OPD and at class room; case of academic interest attending the OPD are discussed at 1.30pm. This session is taken by the assistant professor, consultants and registrars. This session also covers practical demonstration like x-ray, specimen, brace, orthosis and orthotics. An arrangement for Cadaver dissection is available almost throughout the year.

Every Wednesday morning is the Journal club meeting and Thursday clinical presentation of those cases requiring discussion and opinion by the specialists and whole house.

Presentation of research projects are done periodically. Visiting consultants are incorporated with the daily functions of the institute along with other consultants of the hospital.