Reciprocal Learning Between Military and Civilian Surgeons: Past and Future Paths for Medical Innovation.

Numerous surgical advances have resulted from exchanges between military and civilian surgeons. As part of the U.S. National Library of Medicine Michael E. DeBakey Fellowship in the History of Medicine, we conducted archival research to shed light on the lessons that civilian surgery has learned from the military system and vice-versa. Several historical case studies highlight the need for immersive programs where surgeons from the military and civilian sectors can gain exposure to the techniques, expertise, and institutional knowledge the other domain provides. Our findings demonstrate the benefits and promise of structured programs to promote reciprocal learning between military and civilian surgery.

The Iron Man of the Renaissance: the contribution of Girolamo Fabrizi d'Acquapendente.

PURPOSE: To highlight the most relevant contributions of the Italian Renaissance surgeon Girolamo Fabrizi d'Acquapendente in the field of orthopaedics and traumatology. METHODS: An extensive research on the life and achievements of Girolamo Fabrizi was conducted on University Libraries as well as on electronic databases like PubMed. RESULTS: Girolamo Fabrizi d'Acquapendente is known for his embryology and physiology studies, particularly on sensory organs and blood circulation. He founded the world's first permanent anatomical theater established at the University of Padua and inaugurated in 1595. His most notable publications include surgical and definitely orthopedics works such as "De fracturis" (On fractures) and "De luxationibus" (On joint displacement). He outlined some principles of treatment that are still valid nowadays such as anatomical reduction and stabilization of the fracture, that were applied using the equipment available at that time. He described and illustrated maneuvers and instruments, such as pulleys, winches, splint, and bandages. He further depicted the famous "Oplomochlion" ("the armored man"), which is actually a collection of all of the braces used at the time to correct congenital and post-traumatic deformities. CONCLUSION: Bracing and prosthetic replacements have accompanied medical history throughout the centuries, from Ancient Egypt to the present, but it was the ingenuity of Renaissance surgeons that pushed biomedical technology to new heights: Girolamo Fabrizi d'Acquapendente was one of the most illustrious contributors to these great achievements.

Jean-Louis Petit (1674-1750): a pioneer anatomist and surgeon and his contribution to orthopaedic surgery and trauma surgery.

PURPOSE: The purpose of this review is to summarize the life and work of Jean-Louis Petit, his inventions, his discoveries, and his impact on the evolution of surgery of his era. METHOD: A thorough search of the literature was undertaken in PubMed and Google Scholar as well as in physical books in libraries to summarize current and classic literature on Petit. RESULTS: Jean-Louis Petit (1674-1750) was an eminent anatomist and surgeon of his era with an invaluable contribution to clinical knowledge, surgical technique, and instrumentation as well as innovative therapeutic modalities and basic scientific discoveries. CONCLUSION: Jean-Louis Petit was an innovative anatomist and surgeon as well as an excellent clinician of his era. He revolutionized the surgical technique of his era with a significant contribution to what would later become orthopaedic surgery.

The contribution of intellectuals to the history of traumatology during the Renaissance: treatment of femoral fracture through François Rabelais' glossocomion.

During the Middle Ages and the Renaissance, intellectuals often included clinical cases and medical descriptions in their literary works. These authors appeared to be more interested in internal and infectious diseases rather than in musculoskeletal disorders and orthopaedics. François Rabelais (1490-1553) was one of the most renowned humanists and philologists of the sixteenth century. He was also a physician with an interest in translating ancient texts of medical authors. Rabelais rediscovered a device for treating femoral fracture originally described by the Roman physician Galen and named as glossocomion. Since the original apparatus had some imperfections, Rabelais redesigned and modified it. This new, improved version became a model for new devices for treating femoral fracture, as also reported by the great French surgeon Ambroise Paré. For this contribution, Rabelais deserves major consideration in the history of orthopaedics and traumatology.

"Doomed to go in company with miserable pain": surgical recognition and treatment of amputation-related pain on the Western Front during World War 1.

The principal feature of injuries from World War 1 was musculoskeletal trauma and injury to peripheral nerves as a result of damage to the upper and lower limbs caused by gunshot wounds and fragments of artillery munitions. Amputation was used as a treatment in field hospitals to save lives; limb conservation was a secondary consideration. A century later, the principal feature of injuries to soldiers in today's wars in Iraq and Afghanistan is also musculoskeletal trauma and injury to the peripheral nerves caused by improvised explosive devices. Common to both types of injury is postamputation pain. We searched The Lancet's archives in this Series paper to show the efforts of surgeons in World War 1 to understand and treat postamputation pain in its own right both during and immediately after the war. Despite unprecedented patient numbers and levels of civilian medical expertise, little progress was made in providing relief from this type of pain, a grave concern to the surgeons treating these soldiers. Today postamputation pain is understood beyond a surgical context but remains a complex and poorly understood condition with few effective treatments.

Non-operative advances: what has happened in the last 50 years in paediatric surgery?

Paediatric surgeons remain paediatric clinicians who have the unique skill set to treat children with surgical problems that may require operative intervention. Many of the advances in paediatric surgical care have occurred outside the operating theatre and have involved significant input from medical, nursing and allied health colleagues. The establishment of neonatal intensive care units, especially those focusing on the care of surgical infants, has greatly enhanced the survival rates and long-term outcomes of those infants with major congenital anomalies requiring surgical repair. Educational initiatives such as the advanced trauma life support and emergency management of severe burns courses have facilitated improved understanding and clinical care. Paediatric surgeons have led with the non-operative management of solid organ injury following blunt abdominal trauma. Nano-crystalline burn wound dressings have enabled a reduced frequency of painful dressing changes in addition to effective antimicrobial efficacy and enhanced burn wound healing. Burns care has evolved so that many children may now be treated almost exclusively in an ambulatory care setting or as day case-only patients, with novel technologies allowing accurate prediction of burn would outcome and planning of elective operative intervention to achieve burn wound closure.

[History of the German Spine Society]. / Geschichte der Deutschen Wirbelsäulengesellschaft.

The objective of this article is to summarize the history of the German Spine Society (DWG). This society resulted in the year 2006 after several attempts from the fusion of two established German societies, which were dealing with topics around the spine, der "German Society for Spine Research" founded in the year 1958 and the "German Society for Spine Surgery" founded in the year 1987. This fusion was the beginning of a success story, as from this time on the annual membership increased so much that the DWG became the largest spine society in Europe and one of all spine societies worldwide.

Postcards from the past: the Third SICOT Congress, Bologna 1936.

This manuscript describes the events and eminent personalities who animated the third Congress of the "Société Internationale de Chirurgie Orthopédique et Traumatologie", held in Bologna (Italy) in 1936. During this meeting the Society acquired its definitive name and the acronym under which it is now internationally recognized, SICOT. Some of the most illustrious clinicians and scientists of those times gathered in Bologna to discuss the progress of orthopaedic science, thus contributing to highlight the relevance of this discipline in the medical field. Italian surgeon Vittorio Putti was the Congress Chairman and his words, together with some original pictures from his 1936 photo gallery, are shown to celebrate appropriately a prestigious moment in the history of SICOT.

[Étienne Destot (1864-1918): the first radioanatomist in Lyon, France]. / Étienne Destot (1864-1918) : l'anatomie radiographique.

Destot was born in Dijon, France, in 1864. He began his education in Burgundy, then he started his preclinical curriculum in Lyon, France, from 1884. He had to leave Lyon, and spent some times in Algeria to treat a tuberculosis. He came back in Lyon as a resident in 1886. Destot worked as an assistant in the laboratory of anatomy of Leo Testut in 1880. His thesis, in 1892, analyzed mortality in the departments of surgery of the Lyon hospitals. The polemical results he presented compromised his surgical career. He went on as prosector by Leo Testut, and then became electrician-physician in 1895 (electrotherapy and galvanotherapy). Étienne Destot of Lyon, France, developed in 1895 the first radiography room ever at the Hôtel-Dieu of Lyon, France. Wilhelm Röntgen discovered the X-rays in the same year, and Destot felt his discovery could revolutionize the approach of anatomy and traumatology. He studied wrist, ankle and calcaneus fractures, and described a new anatomy: "traumatic anatomy". For example, he focused on the posterior talar surface hollow in posterior tarsus fractures. He proposed the term of "thalamus" for this articular surface; this term is nowadays widely used by the clinicians. He introduced the term of "third malleolus" to describe the posterior part of the distal extremity of the tibia. He was the first author to analyze the normal and pathological movements of the scaphoid bone and the lunatum in wrist extension.

The Renaissance and the universal surgeon: Giovanni Andrea Della Croce, a master of traumatology.

All the medical knowledge of all time in one book, the universal and perfect manual for the Renaissance surgeon, and the man who wrote it. This paper depicts the life and works of Giovanni Andrea della Croce, a 16th Century physician and surgeon, who, endowed with true spirit of Renaissance humanism, wanted to teach and share all his medical knowledge through his opus magnum, titled "Universal Surgery Complete with All the Relevant Parts for the Optimum Surgeon". An extraordinary book which truly represents a defining moment and a founding stone for traumatology, written by a lesser known historical personality, but nonetheless the Renaissance Master of Traumatology.

[Oskar Müller-Meernach: a practically forgotten pioneer of intramedullary osteosynthesis]. / Oskar Müller-Meernach: Ein beinahe in Vergessenheit geratener Pionier der intramedullären Osteosynthese.

Oskar Müller-Meernach was a surgeon, gynecologist and tropical disease specialist who published numerous papers dealing with a variety of topics; nevertheless, almost no information about his life or legacy is available on the internet. A citation by Gerhard Küntscher, who is generally accepted as being the father of intramedullary nailing, brought attention to this forgotten pioneer. Therefore, the aim of this study was to shed light on his life and achievements as well as to highlight his contribution to intramedullary osteosynthesis (the use of an intramedullary pin made of stainless steel), which has to be considered as the greatest accomplishment of this very versatile physician.

[Research and analysis to Shui nationality medicine treatment orthopedics & traumatology].

To investigated Shui nationality folk medicine's awareness to orthopedics & traumatology, the history of orthopedics & traumatology treatment, Shui nationality folk doctors' practicing medicine, heritage, diagnosis and treatment methods and tools, etc, through investigated drug resources category and distribution characteristics of Shui nationality medicine to orthopedics & traumatology treatment, explored and finished Shui nationality medicine orthopedics & traumatology treatment theoretical system. After more than 5 years' exploration and finishing, preliminarily formed the theoretical system framework and medicine application characteristics of Shui nationality medicine treating orthopedics & traumatology. Shui nationality medicine treatment orthopedics & traumatology has distinctive national style, and worthy to further exploration and research.

International Association for Trauma Surgery and Intensive Care (IATSIC): a historical vignette.

IATSIC was conceived in the mid-1980s by Martin Allgöwer. Its goal was to provide an international forum and to disseminate knowledge of trauma care globally. It has met and continues to meet this goal. IATSIC provides a forum for scholarly exchange and thus for elevating the global discussion of trauma. The organization propagates standards of care and provides courses for training surgeons and other healthcare professionals. Further, IATSIC continues to provide a solid foundation for quality practice and management of trauma by emphasizing not only the need to prioritize care of the injured worldwide, but also the knowledge, skills, tactics, and techniques needed to provide the care in a wide variety of environments around the globe. With the other specialty societies (IAES, IASMEN, ISDS, and BSI), it provides a substantial and sustaining underpinning for the ongoing activities of ISS/SIC. Martin Allgöwer died on October 27, 2007, but his vision lives on (Fig. 6).

René Le Fort 1869-1951.

Over a century ago, The French surgeon René Le Fort described the anatomical basis for fractures of the mid-face. His nomenclature is still used today using the eponym "Le Fort fractures." Although Le Fort's name is well known in association with the fractures that he described, little is known of his life. Therefore, the present article will discuss the background of this important individual in craniofacial trauma.

[The Orthopaedic and Traumatology Research Laboratory]. / Le Laboratoire de Recherche en Orthopédie Traumatologie - LROT.

The history of the Orthopaedics and Traumatology Research Laboratory (LROT) is summarized during the last thirty years. The approach, initially focused on bone biomechanics and strength of materials, underwent a rapid diversification as expressed by the list of research topics: monitoring of bone healing; bone strains measurements for different level of activities including microgravity and prevention of disuse osteoporosis; biological effects of electromagnetic fields; evolution of the viscoelastic properties of the callus during bone healing; improvement of the osteoinductive properties of bone substitutes produced by the Tissues Bank of the University Hospital Erasme; Kashin-Beck disease; SICOT telediagnostic, and biomechanics of threaded implants. Those topics, event the most fundamental ones, have immediate significant clinical applications allowing a decrease of the morbidity and an acceleration of the rehabilitation of the patients. The results show the need of multidisciplinary collaborations coordinated around one autonomous laboratory, able to handle specific protocols requiring a dedicate environment.

A Review of "First Rib Fracture: A Hallmark of Severe Trauma" (1975).

This review is submitted for inclusion in the literary festschrift in honor of J. David Richardson, MD.

D-Day to December 1944: The odyssey of the third auxiliary surgical group in World War II.

ABSTRACT: As a Major in the US Army Medical Corps, Darrell A. Campbell, MD, led Team 13 of the Third Auxiliary Surgical Group in Europe in World War II. The team began work on June 7, 1944, in a clearing station tent near the beach at Normandy. Subsequently, over the next 7 months, it was assigned to mobile hospitals in 15 different locations in France, Belgium, Luxembourg, and Germany. Major Campbell kept the log books used to record all of the operations done by his team during this time and brought them home where three were discovered more than 70 years later. These log books contain descriptions of more than 500 consecutive operations done by Team 13. They provide a unique insight into the activities of the surgeons who worked to save lives on the front lines of battle in the European Theater of Operations between June and December 1944 and form the basis for this historical perspective.This is an article on the history of surgery.

A Review of "Changes in the Management of Injuries to the Liver and Spleen" (2005).

Introduction: The article "Changes in the Management of Injuries to the Liver and Spleen" was originally presented as the Scudder Oration on Trauma at the American College of Surgeons' (ACS) 90th Annual Clinical Congress in New Orleans, Louisiana, in October 2004. Charles L. Scudder, MD, a founding member of the College, was the originator and first Chairman of the Committee on the Treatment of Fractures from 1922 to 1933. The first "Fracture Oration" of the ACS by Dr Scudder was entitled "Oration on Fractures," was presented at the Clinical Congress in October 1929, and was published in Surg Gynecol Obstet 1930; 50:193-195. Fracture Orations were presented from 1929 to 1941 and 1946 to 1951, while an Oration on Trauma was presented from 1952 to 1962. From 1963 to present, the Scudder Oration on Trauma has been presented at the annual Clinical Congress by an individual with significant contributions to the field.

A Review of "Prehospital Hypotension as a Valid Indicator of Trauma Team Activation" (2000).

Prehospital hypotension has been utilized for decades as a surrogate marker of injury severity. Several studies have discussed the correlation between injury and hypotension both in the field as well as in the emergency department. Increases have been noted in injury severity score and mortality. Resource utilization is higher in this patient population. This study revisits our original work from 2000 and reviews the current literature regarding hypotension and injury severity. We also examine the role of prehospital hypotension as an indicator of trauma team activation and resource allocation. This review serves as a part of a Literary Festschrift in honor of Dr J David Richardson's role as the Editor-in-Chief of The American Surgeon.