The Hippocratic Method for the Reduction of the Mandibular Dislocation, an Ancient Greek Procedure Still in Use in Maxillofacial Surgery.

Mandibular dislocation remains an acute medical condition in maxillofacial surgery. Since the Hippocratic era its reduction has been performed exactly in the same way it is now performed in modern surgery. We report an example of an elderly female patient with bilateral mandibular dislocation, who came to our department and was treated under sedation using the Hippocratic bimanual intraoral technique by two medical personnel, depicting the timeless usage of the method. Although some characteristics of the procedure were wrongfully attributed to others, such as Barton and Lewis, after a thorough examination of the ancient Greek medical texts, its originality should in fact be attributed solely to the Hippocratic School of Medicine. Furthermore, we recommend the use of the term "mandibular dislocation" instead of the "temporomandibular joint dislocation", as a more accurate medical definition.

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.

A historical perspective on the Essex-Lopresti injury.

An Essex-Lopresti injury is a fracture of the radial head with concomitant dislocation of the distal radioulnar joint and rupture of the interosseous membrane. Poor outcomes have been associated with this rare injury if the dislocation of the distal radioulnar joint is missed in the acute setting. This injury is named after the British orthopedic surgeon Peter Essex-Lopresti, who made a number of important observations about this injury in 1951. Peter Essex-Lopresti was a promising young surgeon, and his untimely death at the age of 35 brought an early end to a remarkable career. This article investigates the evolution of treatment for this injury and sheds light on the life of the surgeon for whom the injury is named.

A historical report on Riccardo Galeazzi and the management of Galeazzi fractures.

Fracture of the shaft of the radius associated with a dislocation of the distal radioulnar joint is an uncommon injury. In 1934, Riccardo Galeazzi of Milan reported his experience with the management of 18 such cases before the Lombard Surgical Society and subsequently received the eponym for this injury. Galeazzi was one of Italy's pioneering orthopedic surgeons, with an extensive bibliography that included nearly 150 publications. This article examines the evolution of management of the Galeazzi fracture and sheds light on this notable physician's life.

Misreading pictures: Fabricius Hildanus (1560-1634) and the cure of spinal dislocation.

In 1646, Fabricius Hildanus accompanied his description of a new way to apply a setaceum (seton) in the neck with a nicely carved woodcut. In 1951, this same woodcut was used by an author of the History of Neurological Surgery to illustrate Hildanus's method of "reducing cervical dislocation." In 1997 this striking misreading found its way into the History of Neurosurgery in its Scientific and Professional Contexts. The paper discusses how this ahistoric interpretation was possible and why it was perpetuated for nearly half a century.

Orthopaedic techniques of Sabuncuoglu in the 15th century Ottoman period.

Serefeddin Sabuncuoglu (1385-1468) was the author of the surgical textbook Cerrahiyyetü'l-Haniyye (Imperial Surgery). It was the first illustrated surgical textbook in the Turkish-Islamic medical literature. Cerrahiyyetü'l-Haniyye is significant because it includes Sabuncuoglu's color illustrations of surgical procedures, incisions, fracture dislocation reduction techniques, and instruments. There are only three handwritten copies. Two originally were written by Sabuncuoglu and are exhibited in Paris and Istanbul. The book was rediscovered in 1936, but some parts are suspected to be missing. The book currently consists of three chapters divided into 193 sections. The third chapter includes orthopaedics and traumatology, reduction techniques of lower and upper extremities, fractures and dislocations, and relevant Greek, Arabic, and Persian textbooks are cited. Sabuncuoglu also wrote about surgical treatment of congenital hand anomalies. He was the first to advise placing a wooden splint under the palmar side after hand surgery. We reviewed the sections of Cerrahiyyetü'l-Haniyye related to orthopaedics and traumatology. Compared with previous writings by Hippocrates, Ibn-i Sina, and Al-Zahrawi, there are no major differences in the treatment of fracture dislocations.

Avulsed posterior edge of the tibia. Earle's or Volkmann's triangle?

The term Volkmann's triangle for the avulsed posterior edge of the tibia in fracture-dislocations of the ankle is incorrect. Volkmann did not publish any articles relating to the posterior edge of the tibia. Credit should go to Henry Earle, who was an outstanding British surgeon of the first half of 19th century. He described avulsion of the posterior edge of the tibia in 1828. In 1823 he also published a monograph entitled Practical observations in surgery in which he described a specially designed bed for the conservative treatment of proximal fractures of the femur.

Historic perspectives of treatment algorithms in knee dislocation.

Knee dislocation remains a devastating injury with many complications. It necessitates prompt diagnosis, reduction if needed, and emergent repair of any vascular injury. Serial physical examinations and frequent use of arteriograms are necessary to avoid late vascular complications. Many authors are concerned that normal pulses, normal Doppler signals, and normal ABIs have preceded late ischemia and documented intimal tear, demonstrated by arteriography. More recently, other authors have challenged the gold standard of mandatory arteriography by describing studies in which physical examination was 100% accurate in diagnosing patients without operative vascular injury. If pedal pulses, Doppler signals, or ABIs are asymmetric before or after reduction then either immediate operative exploration or arteriography should be performed. If the initial physical examination is normal, serial examinations are used in the hospital to check for late artery thrombosis. Opponents of mandatory arteriography point to a 5% false-negative rate, high cost, and an 8% complication rate, such as contrast allergy, pseudoaneurysm, local hematoma, and arteriovenous fistula. Today a consensus is that repair and reconstruction of the PCL and posterolateral corner injuries are the primary concerns in the multiple-ligament injured knee after dislocation. The ACL may be repaired later if instability persists, but some investigators believe it should not be repaired acutely, thereby avoiding increased surgical trauma and possible stiffness. Recently one of the goals of ligamentous repair and reconstruction has been to provide stability with the least invasive surgical technique to avoid postoperative stiffness. Recent treatments have focused on early arthroscopic-assisted allograft reconstruction of the ACL and PCL. Allograft provides a less invasive means of graft support than autograft. Early, limited range of motion in a brace helps to maintain flexion and extension.

Pott, pedantry and precision.

The historical section of the Gordon Craig Library at the Royal Australasian College of Surgeons contains a copy of Pott's major work, which includes most of his surgical papers. It also contains three volumes by Sir James Earle, which include most of Pott's papers, together with an account of the life of Pott. What follows is the basis of an illustrated lecture that sought to sample and review these books for those who do not have an opportunity to read them.

Hippocrates, the true father of hand surgery.

The methods used by Hippocrates for treating fractures and dislocations formed the basis for further development in operations performed upon the hand. He described the common distal radial fracture, and the method to reduce and immobilize it. Of carpal dislocations, he mentioned two patterns which are similar to the common "anterior dislocation of the lunate" and the "perilunar dislocation." He treated pressure sores and wound infection with frequent dressings, application of heat and mechanical debridement; limb necrosis was treated with delayed amputation, and tetanus, with immediate exploration and drainage of the wound. His general principles of fracture management include the value of early reduction, strict fluid diet after reductions of large joints, keeping sites of fracture warm and changing splints as the swelling resolves. It is obvious that many of the principles for the treatment of fractures and dislocations of the wrist and hand are still valid today. The genius of Hippocrates surpassed all those whom we know at a corresponding stage of civilization and for many years to come. The discovery of roentgenograms an antiseptics only furthered his established sound principles. On the basis of these principles, perhaps Hippocrates should be considered the true father of operations performed upon the hand.

Facial fractures: Hippocratic management.

Hippocrates, the famous Greek physician of the fifth century B.C., is considered to be the "Father of Medicine." Little, however, is known about his principles for the management of facial trauma. In this article, the Manuscripts in Ancient Greek, which deal with the management of mandibular fractures and dislocations, and with nasal and midfacial fractures have been translated and discussed. Hippocrates' methods for reducing mandibular dislocations and treating fractures of the mandible by wiring the teeth and immobilizing the jaw are described. His technique of closed reduction and immobilization of deviated nasal fractures with internal packing and rigid dorsal splints remains timeless. Hippocrates has taught us how to achieve medical wisdom through accurate clinical observation and practical creative ideas. The discovery of x-rays and antisepsis only furthered his established sound principles for the management of facial trauma.