In 1919 the Faculty of Medicine at the University of Cape was established, with Professor C.F.M. Saint the head of Surgery.

In 1930 The Maitland Cottage Homes were opened to alleviate the suffering of needy children. Due to problems accommodating non-traumatic musculo-skeletal disorders, some children were placed here. In 1939, more cottages were made available, increasing the capacity to 108 children. A school for children of the home was initiated at the site by the Methodist Mission in 1940. In 1946, A.J. Helfet was appointed Honorary orthopaedic surgeon, to be joined by A. Singer in 1952, when the new Maitland Cottage Home was opened in Newlands. The hospital has continued to provide care for long-term paediatric orthopaedic patients.

In 1932, The Princess Alice Home of Recovery was opened in Retreat. It was later extended to include the management of elective orthopaedics.

In 1939, Groote Schuur Hospital was opened although no provision was made for an Orthopaedic department. Through the efforts of Drs Roux and Hamilton Bell, the committees of the Cape Cripple Care and Groote Schuur Hospital Committee, the Orthopaedic department was created.

Despite the presence of H. Bell, Dr P. Roux and Dr P Moll practising Orthopaedics in Cape Town, they were inundated with service demands. It was only with the untimely death of Dr Moll in 1934 that a fund was established and offered to the university towards a Orthopaedic Professorial Chair. In 1953 the "Pieter Moll and Nuffield Chair" of Orthopaedic Surgery was established. Professor C.E. Lewer-Allan assumed office in January 1955.

Groote Schuur Hospital is divided broadly into two sections.  There are 64 acute admission beds for Trauma and Emergencies, providing a predominantly adult orientated service.  A third ward of 32 beds deals with adult trauma related reconstructive surgery.  In addition to the trauma service, there is a well established Hand Unit headed by Dr Michael Solomons. Recent developments have seen the establishment of specialised clinics, including the Knee and Sports Injuries Clinic, the Amputation Clinic, Shoulder Clinic, Chronic Osteitis Clinic, Intra-articular Fracture Clinic and the Club Foot Clinic.

Princess Alice Orthopaedic Unit (located within Groote Schuur Hospital) has 32 adult, 20 paediatric and 4 High Care beds.  Elective non-traumatic orthopaedics is practised in this Unit. The service is broadly and equally divided into a paediatric orthopaedic service, the Arthritis and Arthroplasty Unit and the spinal service.

Red Cross Hospital is a children's hospital. The orthopaedic service comprises an acute paediatric trauma and emergency service, fracture clinics, and a spinal defects clinic. Cerbral palsy clinics are held in the community.