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.

From the wax cast of brain ventricles (1508-9) by Leonardo da Vinci to air cast ventriculography (1918) by Walter E. Dandy.

The mold of the human cerebral ventricles produced in 1918 by Walter E. Dandy had an experimental precedent, a wax cast of ox ventricles made four hundred years earlier (1508-9) by Leonardo da Vinci (1452-1519). This paper is an homage to the epitome of Renaissance and polymath Leonard da Vinci, as well as to Walter Edward Dandy (1886-1946) who developed the ventriculography (1918) and pneumoencephalography (1919) techniques. Pneumoencephalography was applied broadly up to the late 1970s, when it was replaced by less invasive and more accurate neuroimaging techniques.

The Historical Background of Plaster Cast.

The pivotal role of plaster of Paris (POP) cast as an immobilization tool to promote healing in complex and/or other types of fractures is irrefutable. We clearly know that Antonius Mathysen extensively applied plaster cast during Crimea and/or other wars and reportedly saved thousands of lives. However, the exact origin of using POP in orthopedic cast is yet to be clear. In his famous report from Bandar-e Rig, a city in Iran, William Eton paved the way for the conclusion that POP cast might have originated from the Persian Empire. In this paper, we provide more supporting evidences which make the aforementioned claim more probable.

History of clubfoot treatment, part I: From manipulation in antiquity to splint and plaster in Renaissance before tenotomy.

Idiopathic clubfoot is one of the most common problems in paediatric orthopaedics. The treatment is controversial and continues to be one of the challenges in paediatric orthopaedics. The aim of this review is to assess the different methods of clubfoot treatment used over the years in light of the documentation present in the literature and art paintings from the antiquity to the end of the 19th century. The aim of this paper is to review all treatment methods of the clubfoot over the years that were proposed to provide patients a functional, pain-free, normal-looking foot, with good mobility, without calluses, and requiring no special shoes. Hippocrates was the first to write references about treatment methods of clubfoot. After the Middle Ages and the Renaissance where patients were treated by barber-surgeons, quacks and charlatans, bonesetters, and trussmakers, there were more detailed studies on the disease, with the help of famous names in medicine such as Venel and Scarpa.

Plaster: our orthopaedic heritage: AAOS exhibit selection.

BACKGROUND: Plaster has been used for centuries as a stiffening agent to treat fractures and other musculoskeletal conditions that require rest, immobilization, or correction of a deformity. Despite modern metallurgy and internal stabilization, plaster casts and splints remain an important means of external stabilization. Casting is a dying art as modern internal and external fixation replace external immobilization. Proper casting technique is paramount. This manuscript outlines the history and chemistry of immobilization materials and techniques as well as the differences among them and the advantages and disadvantages of each. METHODS: Historical references, peer-reviewed journals, textbooks, and primary sources were reviewed to provide data for this review. RESULTS: The history of immobilization reveals a progressive development and refinement of materials that culminated in Mathijsen's plaster bandage in 1851. In 1798, calcium sulfate (plaster of Paris) was introduced. By 1927, crinoline rolls dipped in plaster treated with binding agents facilitated application. Synthetic casting "tapes" (45% polyurethane resin and 55% fiberglass) were introduced in the 1970s. Splinting techniques are ancient, with development spurred by treatment of war wounds. Plaster relies on soft-tissue contact to maintain rigidity. There are well-known advantages, disadvantages, and complications of plaster management. Casting materials all create an exothermic reaction. Burns are associated with water temperatures of >24°C, more than eight layers (ply), and inadequate ventilation. The maximum water temperature must be lower with fiberglass casts. Plaster was the definitive management for most fractures for over 100 years until it was replaced by modern surgical techniques involving internal fixation in the latter part of the twentieth century. CONCLUSIONS: Plaster casts and splints remain an important treatment method for acute and chronic orthopaedic conditions.

[Mathijsen and plaster casts]. / Mathijsen en het gipsverband.

In 1851, Antonius Mathijsen (1805-1878), a Dutch military surgeon, developed a practical method for immobilizing limb fractures with plaster casts. Previous attempts had been made by using soluble material for moulding casts to replace the traditional methods of traction or splinting. Disadvantages included the long drying-time required (e.g. with glue) or the requirement for hot water plus the resultant skin irritation (e.g. with gutta-percha). Plaster of Paris had occasionally been tried but proved unwieldy. Mathijsen used plaster of Paris in various different ways, the most successful being cotton bandages impregnated with plaster in powder form to which water had been added. His method was adopted worldwide within a decade. Mathijsen never married and spent his old age with relatives in the south of the Netherlands.

"To illustrate and increase Chyrurgerie": Ambroise Paré (1510-1590).

The quincentenary of Ambroise Paré's birth celebrates a man who rose from a humble origin to become the leading surgeon of the Renaissance. Now remembered as a celebrated war surgeon, especially for his gentle treatment of gunshot wounds, it is generally forgotten that Paré also treated children and wrote about them. Despite his little schooling, Paré was appointed as the Head of the French College of Surgeons in 1567. Paré's contributions to child health include conservative management of childhood deformities, such as clubfoot and scoliosis. He also gave descriptions of conjoined twins and intersex. Paré managed childhood trauma and bladder stones using devices that he invented. This article will briefly demonstrate Paré's wide-ranging contribution to pediatric surgery, adding new insights and material to earlier work.

Clubfoot: etiology and treatment Ignacio V. Ponseti, MD, 1914-.

This biographical sketch of Ignacio V. Ponseti, MD, corresponds to the historic text, The Classic: Congenital Club Foot: The Results of Treatment, available at DOI 10.1007/s11999-009-0720-2 and The Classic: Observations on Pathogenesis and Treatment of Congenital Clubfoot, available at DOI 10.1007/s11999-009-0721-1.

The history of fracture fixation of the hand and wrist.

UNLABELLED: The treatment of fractures of the hand and wrist has evolved over the centuries from one of rest and immobilization to internal fixation and early motion. Although today's technology (anesthesia, antibiotics, metal implants) has allowed us more freedom in treating these injuries, a number of our patients continue to experience stiffness, nonunion, malunion, and chronic pain. We explore the techniques used to treat hand and wrist fractures throughout the centuries and determine what beneficial aspects of fracture care have been maintained and those that have changed as a result of new technology. We are now realizing that rigid immobilization of fractures at the expense of the soft tissues can be just as damaging as the ancient physician's techniques of prolonged immobilization with frequent dressing changes. New implants and lighter cast materials have allowed improved digital motion and early functional use of the extremity. This has become especially important in the treatment of the aging population, which demands improved function and a quicker return to activities. The optimal treatment of these fractures for each patient remains elusive, however, and there remains a tendency to rely on technology at the expense of sound clinical care. We must not loose sight of the goals of fracture treatment and should heed the lessons learned throughout centuries of treating these injuries. LEVEL OF EVIDENCE: Level V (expert opinion).