The history of orthopaedics

November 20th, 2015

If it wasn’t for the invention of the plaster cast, there probably wouldn’t be such thing as a LimbO. Here’s a little bit about the history of orthopaedics…

You might be wondering why it’s called orthopaedics. Well, Nicholas Andry coined the term in 1741, deriving from the Greek words for ‘correct’/‘straight’ (‘orthos’) and ‘child’ (‘paidion’). This is because originally, orthopaedics was only used to treat musculoskeletal deformities in children.

Wartime was one of the main reasons for developments in orthopaedics. Throughout the Middle Ages, injured limbs were treated with bandages soaked in horses’ blood which dried to produce a stiff, but of course unhygienic, splint.

Back in ancient Egyptian times, splints were made out of bamboo, reeds, wood or bark, and padded with linen. During the era of the rise of Rome, the Greek man Galen (129-199 BC) worked as a gladiatorial surgeon. Galen’s studies focused on the skeleton, muscles and how the brain responds from the nerves to the muscles.

Also during this time period, people attempted to create artificial prostheses. Wooden legs, iron hands and artificial feet were found.

Now let’s move on to some early modern history. Jean-Andre Venel established the first ever orthopaedic institute in 1780 – a hospital which focused on treating skeletal deformities in children.

Also during the 18th century, advances were made in surgical technique. For example, John Hunter carried out research on the healing of tendons and Percival Pott studied spinal deformity.

The first we saw of the plaster cast was in 1851 when Antonius Mathijsen, a Dutch military surgeon, created the plaster of Paris cast which is still used today. Until 1890, though, orthopaedics remained restricted to treating children.

A major development in orthopaedics was in the 19th century when Hugh Owen Thomas, a Welsh surgeon, recommended resting as the best treatment for fractures and produced the ‘Thomas Splint’ to support a fracture and prevent infection. It was only once WW1 had started that Thomas’ methods started to be used for injured soldiers.

Thomas’ nephew, Robert Jones, had learned new techniques and was able to improve the quality of fracture care, which physicians from around the world came to learn. Teamed with Alfred Tubby, Jones founded the British Orthopaedic Society in 1894.

During WW1, Jones work as a Territorial Army surgeon and this led to the arrival of military orthopaedic hospitals. Jones promoted use of the Thomas Splint for initial treatment of fractures of the femur, decreasing mortality from compound femur fractures from 87% to less than 8% between 1916 and 1918.

Later on, Gerhard Küntscher of Germany established the use of intramedullary rods to treat fractures of the femur and tibia. This noticeably sped up the German soldiers’ recoveries during WW2 and opened the doors to a more widespread use of intramedullary rods to treat fractures around the world.

Until the late 1970s, traction was the main technique used for treatment of thigh bone fractures but then intramedullary fixation without opening up the fracture became the more popular method.

The contemporary total hip replacement was initiated by Sir John Charnley in the 1960s. Charnley found that damaged joint surfaces could be replaced by implants attached to the bone. This formed the foundation for modern hip implant surgery.

Additionally, the hip replacement system of Exeter developed at the same time and since Charnley, joint replacements have continued to improve.

On top of hip replacements, knee replacements using alike technology were established for rheumatoid arthritis patients and then for osteoarthritis patients in the 1970s.

Modern orthopaedics aims to make surgery less intrusive and to improve implants and increase their durability.


History Of Orthopedics, Shady Grove Orthopedics:

Orthopedic Surgery, Wikipedia: