Nursing, history, and orthopedics in manuals (1875-1928)

OBJECTIVES

to discuss the content of manuals, with emphasis on orthopedics, in support of the development of nursing care culture.

METHODS

cultural-historical method articulated with document analysis technique. The sources were nursing manuals - Portuguese, French, English, and Spanish - from 1875 to 1928.

RESULTS

this study pointed to 12 works - 6 authored by physicians, 2 by nurses, 3 institutional, and 1 by a Sister of Charity - that presented, in a transversal way, the professionalization process initiated in Europe. The manuals addressed first aid care and immobilization methods, from the simplest, such as improvised splints, to the application of plaster casts.

CONCLUSIONS

the nurses' work, even in a limited capacity, showed that they were able to observe warning signs so that doctors could act, with some exceptions.

Professor Andrzej Zembaty (1935-2022) - Visionary and Co-founder of Polish Physiotherapy

Based on an analysis of source materials from the private collection of the Zembaty family, the Medical Library of the Marian Weiss Rehabilitation Center in Konstancin, articles from daily press, and a few publications, we present the professional career, and academic and organizational activities of the late Professor Andrzej Zembaty (1935-2022), Doctor Habilitatus in Physical Culture Studies. While working at the Capital City Rehabilitation Center in Konstancin (Stołeczne Centrum Rehabilitacji), he served as an assistant to and close collaborator of Professor Marian Weiss. Affiliated with the Warsaw University of Physical Education for many years, he was known as a scholar, demanding teacher, author of well-known textbooks, and organizer of physiotherapy education. His vision of the professional development and role of physiotherapists in healthcare was realized only after the enaction of the Physiotherapist Profession Act. He undoubtedly ranks among the pioneers and founders of Polish physiotherapy.

Gabriel Nové-Josserand, co-founder of the SICOT

Gabriel Nové-Josserand (1868-1949) studied medicine in Lyon under Professor Louis Léopold Ollier at the very end of Ollier's career. He wrote his thesis on a subject close to his master's heart, bone growth disorders due to growth plate alteration, with an experimental and a clinical part, following the principles of Claude Bernard. In 1894, he came top in the first ever recruitment examination for surgeons in Lyon and became head of paediatric surgery at the Hôpital de la Charité, where he spent most of his surgical career. A brilliant and sought-after teacher, his work on congenital hip dislocation led to very early national and international recognition. After training with Lorenz in Vienna, he imported and improved on Lorenz's technique for surgical reduction, highlighting the importance of the labrum. He worked on a variety of conditions including tuberculous arthritis, coxalgia, poliomyelitis and clubfoot. He helped establish the French Society of Orthopaedics (Société Française d'Orthopédie) in 1918. In 1921, he became the first chair of paediatric surgery in Lyon, and in 1929, he and Prof. Louis Ombrédanne from Paris were among the ten French cofounders of the SICO(T), a society he chaired at its second conference in London in 1933. He was received on this occasion as an honorary fellow of the Royal College of Surgeons. A brilliant surgeon with a keen analytical sense, he left his mark on the Lyon school of orthopaedic surgery founded by his mentor, Ollier, which he helped to perpetuate.

Albin Lambotte: Pioneer of Osteosynthesis (Bone Fixation)

Stamp Vignettes focus on biographical details and accomplishments related to science and medicine, and not individual views and prejudices except when they had a major impact on the subject's life. The authors of Stamp Vignettes do not intend to imply any endorsement of such views when discussing a Stamp Vignette on Medical Science.

Emile Letournel: Pioneer of Acetabular Surgery

Stamp Vignettes focus on biographical details and accomplishments related to science and medicine, and not individual views and prejudices except when they had a major impact on the subject's life. The authors of Stamp Vignettes do not intend to imply any endorsement of such views when discussing a Stamp Vignette on Medical Science.

In Memoriam : Robert Danis, an inspiration for Maurice Müller and origins of the AO Foundation

Robert Danis (1880-1962) was a Belgian general surgeon mostly remembered for his contributions in the field of bone and joint surgery, a medical subdiscipline currently known as orthopaedic trauma surgery. He initiated this with his first book (1) on the subject in 1932. Danis was the first to develop a concept for biomechanically stable internal fracture fixation, creating and producing his own screws and plates with self-developed machine tools. In 1938 he produced a steel plate with screws that exerted axial compression during use. A device known as the "coapteur". By 1949 he had reported on 1500 clinical cases. His surgical technique with bone frag- ment repositioning and plate fixation allowed early movement and rehabilitation, one of the four main principles of the AO/ASIF [Arbeitsgemeinschaft für Osteosynthesefragen/Association for the Study of Internal Fixation] which is the AO Foundation today. Danis' clinical and scientific work caught the attention of Maurice Müller, a swiss surgeon and researcher, who was the originator of the AO/ASIF and one of its founders later on. Both surgeons met personally in Brussels in 1950.

Razi and his Concepts on Bone and Joint Disorders

This brief review presents Razi's concepts of bone and joint disorders. Razi differentiated between ligaments, tendons, and nerves and recognized the role of the brain, spinal cord, and peripheral nervous system in the perception of senses and voluntary movements. He described paralysis and loss of sensation following brain, spinal cord, and peripheral nervous system injuries. Razi presented an early concept of compartment syndrome. Razi's approach to fracture management is very similar to the current concept of functional bracing for some fractures. Razi mentioned suturing the wounds and ligation of bleeding large vessels. He cautioned about phlebotomy in the antecubital fossa as it may become complicated by the adjacent arterial and nerve injuries. Razi treated osteomyelitis by removing the infected and necrotic bone by sawing, cutting, and rasping. He also documented arthralgia, painful hip, and sciatic pain and made a sharp distinction between arthralgia and gout. He indicated the gout origin as the production of a waste substance that the body fails to expel. Razi's basic concepts on the bone and joint disorders established a foundation for modern orthopedic science.

[From Physician's Biography of Primarius Ljubica Bosner]

Previously were published well-known data on Rijeka physician, Dr Ljubica Bosner, about her work in the Ogulin, Bjelovar, Petrinja and Rijeka hospitals during her excellent surgical and gynaecological and obstetric practice. The new and now accessible archives of personal and professional items complete incomplete and unknown biographical information. After her internship, Dr Bosner worked at a public county hospital in Velika Gorica as a secondary doctor at a well-known orthopaedic ward of that hospital. Circumstances of going to the Ogulin hospital with an oath to the reigning King Peter II for fidelity, then her professional activity as a surgeon at the newly opened Foundation Hospital Rebro Zagreb, with occasional departures to the position of director of the hospital and surgeon in Petrinja and Varaždin, and after the war to new positions at the Regional People's Board in Istria, are of particular social and historical interest. Recommendations from her bosses have been found to recognise the profession of surgeon specialist that particularly emphasise her skills, clinical judgment, and performance of major surgical procedures, especially during the war. Her life and medical career went through periods of great crisis between the two world wars (during the Kingdom of Serbs, Croats and Slovenes), then World War II (during the Independent State of Croatia), and after the war and the Republic of Yugoslavia in which she acted as a surgeon. The above data in the biography of Dr Ljubica Bosner are completed by previously unknown and unpublished photographs from her personal and professional surgical life.

The Welsh Clan That Transformed Orthopedic Surgery

Modern orthopedic surgery arose from Hugh Owen Thomas (1834-1891) and Sir Robert Jones (1857-1933), uncle and nephew, two descendants of a family of bonesetters from North Wales and Liverpool, respectively. Thomas combined a formal medical education with his hereditary vocation into treatments that have endured for more than a century. The epitome is the Thomas splint, which was credited with a decrease in the mortality from open femur fractures to 20 from 80 per cent during World War I and is still in use for the emergency transport of lower extremity injuries. Jones was 15 when he became Thomas' apprentice. By the end of the century, he was a leading figure in orthopedic surgery, at the forefront of the treatment of childhood deformities and the clinical use of X-rays. Enlisting in the Royal Army Medical Corps with the onset of World War I, he saw the need for a system of orthopedic care to treat soldiers with injured limbs that threatened to flood the country with crippled, disabled men. The centerpiece was the military orthopedic center, where surgeons devised integrated programs of surgery, physical therapy, and "curative workshops" to return war-injured soldiers to productive lives. With British surgeons conscripted to work at the Western Front, hundreds of American surgeons with little prior experience in orthopedics volunteered to work in the centers and thus received intensive training under Jones. Orthopedic surgery, traditionally part of the broader practice of surgery, thus emerged from the war as a full-time endeavor and a distinct surgical specialty.

A Bibliometric Study of Authorship and Collaboration Trends Over the Past 30 Years in Four Major Musculoskeletal Science Journals

This study explored changes in bibliometric variables over the last 30 years for four major musculoskeletal science journals (BONE®), Calcified Tissue International® (CTI®), Journal of Bone and Mineral Research® (JBMR®), and Journal of Orthopaedic Research® (JOR®), with a specific focus on author gender. Bibliometric data were collected for all manuscripts in 1985 (BONE®, CTI®, JOR®), 1986 (JBMR®), 1995, 2005, and 2015; 2776 manuscripts met inclusion criteria. Manuscripts from Europe were more often published in BONE® or CTI®, while those from North America in JBMR® or JOR®. All journals demonstrated an increase over time in the number of authors (3.67-7.3), number of countries (1.1-1.4), number of institutions (1.4-3.1), and number of references (25.1-45.4). The number of manuscript pages increased (6.6-8.9) except for JOR® which showed a decline. CTI® had the lowest number of authors (4.9 vs. 5.6-6.8). There was a change in the corresponding author position from first to last for all journals; this change was highest for CTI® (35%) and lowest for BONE® (14.0%). All journals demonstrated an increase over time in female authors; however, CTI® was the highest amongst these four journals. The percentage of female first authors rose from 24.6 to 44.3% (CTI® 29.1-52.3%). The percentage of corresponding female authors rose from 17.5 to 33.6% (CTI® 22.9-40.0%). The proportion of female authors is increasing, likely reflecting the increasing number of women obtaining doctorates in science, medicine, and engineering.

On the shoulders of giants: a history of success and a future of excellence - Istituto Ortopedico Rizzoli

In 1896 the Rizzoli Orthopedic Institute was inaugurated in Bologna, an important hospital whose history is strictly connected with the development of the orthopedic discipline in Italy. The aim of this manuscript was to retrace the history of the institution by analyzing the work of the main personalities who have contributed to making the Italian Orthopedic Institute still famous in the world today.

Excellence in orthopaedic surgery: an overview of Nobel Prize nominees 1901-1960 with focus on Friedrich Pauwels and Gerhard Küntscher

PURPOSE

This paper provides for the first time an overview of orthopaedic surgeons nominated for the Nobel Prize in physiology or medicine during the first six decades of the twentieth century. The study is part of the project "Enacting Excellency: Nobel Prize nominations for surgeons 1901-1960".

METHODS

The nomination letters were gathered in the archive of the Nobel Committee at the Karolinska Institute in Solna, Sweden.

RESULTS

Among the nominees, we find renowned scholars like Pierre Delbet, Themistocles Gluck, Gerhard Küntscher, Adolf Lorenz, Friedrich Pauwels, Leslie Rush, and Marius Smith-Petersen. The focus of the paper is on nominations for Pauwels (work on biomechanics) and Küntscher (the Küntscher nail). Both were nominated by German surgeons.

CONCLUSIONS

Although no orthopaedic surgeon has yet received a Nobel Prize for an orthopaedic achievement, Nobel archive files can help reconstruct important trends in the field during the twentieth century.

Francisco Arceo de Fregenal and the treatment of clubfoot up to the sixteenth century

The correction of clubfoot as a subject of study is somewhat unusual, especially if one considers that up until the Renaissance only two authors dealt with the subject of this inherited disorder. On the one hand is Ambroise Paré, whose contributions to traumatology and orthopaedics are staggering, and on the other, Francisco Arceo de Fregenal, also known as the Ambroise Paré of Spain. Both men developed a method for treating this condition, and a special orthopaedic shoe. So, why is it that in the Spanish literature the French surgeon was considered the pioneer in the development of an orthopaedic boot from the start and not Arceo? Why was the work of the Spaniard not studied in depth, as it deserves to be? These questions troubled us and led us to write this paper, in which as the primary objective we decided to highlight Arceo's contributions to the field of orthopaedics. Concrete arguments and works exist today that have led to common agreement among scholars of the subject that the Spanish surgeon was a Jewish convert. The social, economic and political conditions in Europe at that time may give us some idea of the difficulties for a Jewish convert in the sixteenth century, and clearly, it was difficult for a scientist to have followers who would defend his methods and technical ideas. Nevertheless, we believe that Francisco Arceo de Fregenal deserves more recognition and his work should continue to be studied in more depth.

Person or system - What leads to surgical advances?

To understand the relationship between standardisation and originality in surgery, the contributions of three surgeons in the 20th century are analysed. The individual Arbuthnot Lane, the collectivist Robert Jones and the scientist Alexis Carrel changed the practice of orthopaedic surgery. It is argued that the factors influencing innovation are not binary but multifactorial and that advances in surgery occur when individual freedom is permitted within a system. It is concluded that innovation and standardisation in orthopaedic surgery need not conflict with each other.

Apollonius of Citium (first century BC) and his work on the treatment of joint dislocations

The purpose of this study was to summarise the life and work of the Cypriot physician Apollonius of Citium (first century BC). His overall work on medicine is presented, and special emphasis is given to his work on the treatment of joint dislocations. The most famous work of Apollonius is Treatise On Joints, which was preserved on the whole in a manuscript of the tenth century AD. In that manuscript, Apollonius is obviously influenced by the Hippocratic Corpus of Medicine. His description, diagnostic methods and reduction techniques are all based on those described by Hippocrates in his work "On Joints". Apollonius' contribution to this subject concerns accurate depiction in images of the reduction techniques he proposes. His simplifications describe the techniques of Hippocrates in a way they can be understood and used by athletes and nonphysicians in the Greek gymnasia. Perhaps his treatise is one of the earliest works of popularised medicine and surgery in the history of human civilisation.

Leland G. Hawkins, MD-His Life and Orthopaedic Legacy: Talus Fractures and the Hawkins Classification

The long history of excellence and continued success of the University of Iowa Department of Orthopedics and Rehabilitation is due to the dedication and talent of generations of faculty, residents and staff. Many former Iowa Orthopedic residents have made significant contributions and become leaders in Orthopedic surgery. An orthopedic surgeon and scholar with roots at the University of Iowa deserving of tribute is Dr. Leland Greene Hawkins. His seminal investigation and interest in fractures of the talus established the well-known Hawkins Classification for talar neck fractures, which revolutionized treatment and quantified the risk of progression to avascular necrosis, earning him attention and respect worldwide.

[Development of surgery of combined gun-shot osteo-vascular injuries of extremities (middle XIX century - middle XX century)]

The presented review by the example of a long historical period traces the development of surgery of combined gun-shot osteo-vascular injuries of extremities, also describing both objective and subjective causes of unsatisfactory outcomes of treatment and presenting ways of solving the problem of treatment of these injuries during the period after World War II.

The Masters of the Bolognese Orthopaedic School

Bologna is one of the most ancient cradles of medical knowledge, as the city hosts one of the oldest medical faculties in the world. Among its best known institutions there is the Rizzoli Orthopaedic Institute, founded in the late nineteenth century, whose history is strictly connected with the evolution and development of the Italian orthopaedic practice of the last 120 years. The present manuscript acknowledges the main contributions by Francesco Rizzoli, Alessandro Codivilla and Vittorio Putti, who prompted the foundation and the international recognition of the Rizzoli Institute and the related Bolognese Orthopaedic School.

Hallmarks in the history of orthopaedic implants for trauma and joint replacement

This manuscript represents an attempt to review orthopaedic implants and reconstructive orthopaedic surgery for lower limbs lesions or trauma mainly in the 20th century. We emphasized on the type of implants, the biomaterials and their evolution, and we also engaged in a special reference for the pioneers of orthopaedic implant surgery and the innovative designers of those implants, in such a way to understand the ways and the stages through which they evolved to their present forms, as well as the scientific principles that affected their design and progress. A correlation between the evolution of implants and several relevant disciplines (biomaterial chemists and engineers, biomechanics) that developed simultaneously with orthopaedic reconstructive joint surgery is present since the first attempts to reconstruct a damaged joint. In the future, further progress is anticipated in the use of biomaterials, more compatible towards human biology, with minimally invasive applications and a perpetually increased life span. This progress depicts a phenomenon directly related to a multilevel, multifactorial and interdisciplinary scientific and technological field with many expectations.