The history of orthopaedic surgery in India: from antiquity to present.

Indian orthopedists have a legacy dating back more than 4000 years. Starting with the Harappan civilization, ancient orthopaedic surgeons reduced fractures and conducted therapeutic trepanations. Since then, Indian physicians have pioneered many of the orthopaedic techniques still used today - including the use of prosthetics, fracture tables, and rehabilitative physical therapy. Today, orthopaedic surgeons coexist with traditional Indian bonesetters. Although bonesetting practices can have complication rates as high as 40%, bonesetters still handle a majority of fractures in India and are often culturally preferred. Importantly though, bonesetters are often the only expedient option available in both rural and urban settings.

The history of bone marrow in orthopaedic surgery (part I trauma): trepanning, bone marrow injection in damage control resuscitation, and bone marrow aspiration to heal fractures.

PURPOSE: One of the oldest procedures performed by man is trepanning of the bone and yet it was only in the last 40 years that bone marrow aspiration has been used to treat nonunion disorders. MATERIAL AND METHODS: These advances were possible due to improvements in instruments and in techniques to make holes in the bone, an history that began with skull trephinations around 8000-10,000 years ago, and continued with sternum bone marrow injection for trauma resuscitation in the beginning of the twentieth century; this procedure had improved at the beginning of the twenty-first century to allow pelvis bone marrow aspiration for the treatment of nonunion. RESULTS: Trephined skulls from antiquity have been found in many parts of world, showing that trephining was ancient and widespread. Beginning with Neolithic period and the pre-Columbian Andean civilizations, the authors have traced the development of this surgical skill by describing the various surgical tools used to perform holes in the skull. These tools (trephines or trepan) were proposed at the end of the nineteenth century to study the bone marrow. At the beginning of the twentieth century, the sternum became the center of interest for the "in vivo" study of the bone marrow and the fluid injection in the sternum's bone marrow was described for resuscitation from shock during the World War II. With the introduction of plastic catheters and improved cannulation techniques, the need for intraosseous infusion as an alternative route for intravenous access diminished and sometimes abandoned. However, during the mid-1980s, James Orlowski allowed renaissance of the use of intraosseous infusion for paediatric resuscitation. Since then, this technique has become widespread and is now recognized as an alternative to intravenous access in adult emergencies; particularly, the intraosseous access has received class IIA recommendation from the Advanced Trauma Life Support program supported by the American College of Surgeons Committee on Trauma and bone marrow infusion is now recommended for "Damage Control" resuscitation. Although the pelvis bone contains half of the body's marrow volume, it was only in 1950 that the pelvis was proposed as a source for bone marrow aspiration and bone marrow-derived mesenchymal stem cells to improve healing of fractures. CONCLUSION: It will be many years before doing holes in the bone as orthopaedic trauma procedure will be relegated to the annals of history.

Abulcasis (936-1013): his work and contribution to orthopaedics.

AIM OF THE STUDY: The purpose of this historic review is to summarize the life and work of Abulcasis (936-1013) and his contribution to surgery and orthopaedics. METHOD: We conducted an extensive search in libraries as well as online in PubMed and Google Scholar. RESULTS: Abulcasis in his work combines the knowledge of ancient Greek and Roman physicians and surgeons with the extensive knowledge of Arabic medicine and pharmacology. He also pioneered surgical technique with the invention of numerous surgical instruments and with several revolutionary surgical techniques. CONCLUSION: Abulcasis made an impact with his medical writings in which he summarized the works of ancient Greek and Roman physicians like Hippocrates and Galen with the influence of medieval authors and the knowledge of the Arabic medicine and pharmacology. His descriptions and innovations in his work remained a work of reference in the West and East for many centuries to come.

History of orthopaedics in China: a brief review.

BACKGROUND AND PURPOSE: Chinese orthopaedic surgeons have made a substantial contribution to the development of orthopaedics worldwide, and traditional Chinese medicine (TCM) in orthopaedics has a very long history in China. We make a brief review of the development of orthopaedics in China, intending to pave the way for further understanding of Chinese orthopaedics for scholars all over the world. RESULTS: The description of fractures firstly appeared in 3600 years ago in China, and the theories, experience, and treatment strategies of TCM still play important roles in clinical diagnosis and treatment of orthopaedic disorders in our country. Western orthopaedics was first introduced into China in the early twentieth century. After decades of development, Chinese scholars have made some gratifying achievements in orthopaedics. CONCLUSIONS: Orthopaedics is constantly evolving, and we need to strengthen the ability of independent innovation to achieve orthopaedic surgeons' Chinese dream, and better serve our patients.

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.

[Therapy of scoliosis from a historical perspective]. / Therapie der Skoliose aus historischer Sicht.

Scoliosis can be considered as one of the classical orthopedic diseases of the spine. The history of orthopedics is closely connected to the development of the therapy of scoliosis. In the eighteenth and the beginning of the nineteenth centuries the therapy of scoliosis was mainly a conservative corrective orthopedic treatment with a variety of corset forms and extension bed treatment. In the middle of the nineteenth century physiotherapy (movement therapy) became established as an supplementary active treatment. The first operations for treatment of scoliosis were carried out in 1839. The real success with surgical procedures for improvement in corrective options was connected to the introduction of metal spinal implants in the early 1960s.

[Sciatica. From stretch rack to microdiscectomy]. / Ischias. Von der Streckbank zur Mikrodiskektomie.

In ancient times as well as in the Middle Ages treatment options for discogenic nerve compression syndrome were limited and usually not very specific because of low anatomical and pathophysiological knowledge. The stretch rack (scamnum Hippocratis) was particularly prominent but was widely used as a therapeutic device for very different spinal disorders. Since the beginning of the nineteenth century anatomical knowledge increased and the advances in the fields of asepsis, anesthesia and surgery resulted in an increase in surgical interventions on the spine. In 1908 the first successful lumbar discectomy was initiated and performed by the German neurologist Heinrich O. Oppenheim (1858-1919) and the surgeon Fedor Krause (1857-1937); however, neither recognized the true pathological condition of discogenic nerve compression syndrome. With the landmark report in the New England Journal of Medicine in 1934, the two American surgeons William Jason Mixter (1880-1958) and Joseph Seaton Barr (1901-1963) finally clarified the pathomechanism of lumbar disc herniation and furthermore, propagated discectomy as the standard therapy. Since then interventions on intervertebral discs rapidly increased and the treatment options for lumbar disc surgery quickly evolved. The surgical procedures changed over time and were continuously being refined. In the late 1960s the surgical microscope was introduced for spinal surgery by the work of the famous neurosurgeon Mahmut Gazi Yasargil and his colleague Wolfhard Caspar and so-called microdiscectomy was introduced. Besides open discectomy other interventional techniques were developed to overcome the side effects of surgical procedures. In 1964 the American orthopedic surgeon Lyman Smith (1912-1991) introduced chemonucleolysis, a minimally invasive technique consisting only of a cannula and the proteolytic enzyme chymopapain, which is injected into the disc compartment to dissolve the displaced disc material. In 1975 the Japanese orthopedic surgeon Sadahisa Hijikata described percutaneous discectomy for the first time, which was a further minimally invasive surgical technique. Further variants of minimally invasive surgical procedures, such as percutaneous laser discectomy in 1986 and percutaneous endoscopic microdiscectomy in 1997, were also introduced; however, open discectomy, especially microdiscectomy remains the therapeutic gold standard for lumbar disc herniation.

[Sauveur-Henri-Victor Bouvier (1799-1877): orthopaedist, surgeon and promoter of physical education]. / Sauveur-Henri-Victor Bouvier (1799-1877): orthopédiste, chirurgien et promoteur de l'education physique.

This article establishes the biography of a little known physician of the 19th century., whose commitment with orthopaedics and formulation of medical gymnastics was important: the surgeon-orthopaedist Sauveur-Henri-Victor Bouvier. Several constitutive processes of the medical field of the 19th century are analysed: specialization (around orthopaedics), professionalization and development of various therapeutic and hygienic methods (among them medical gymnastics). Bouvier's biography is particularly instructive and sheds new light on these different processes, as well as on the institutionalization of orthopaedics from the 1820's up to the 1870's, at the intersection between medical and educative fields, between hospital, medical faculty and teaching of gymnastics.

[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.

The role of Edward Harrison's (1766-1838) disciples, Thomas Engall, John and George Epps, Charles Hoyland, John Evans Riadore, John Robinson and John Baptiste de Serney in the treatment of spinal deformity in the Victorian medical world.

Edward Harrison was a distinguished and innovative physician, an educationalist who had a profound influence on the treatment of spinal deformities. He founded the first infirmary for the treatment of spinal diseases in London in 1837. Little is known of this institution but much of Harrison's legacy rests with his disciples who followed Harrison's principles of treatment to treat spinal deformity. Like Harrison they were unconventional individuals, influenced by religious beliefs and liberal political and social ideologies. After his death, initially they followed his methods of treatment but subsequently they were not afraid to pursue new forms of treatment including homeopathy at a time when traditional medicine had little to offer.

Outline of medical rehabilitation history in Poland and worldwide.

The study is an outline of the historical development of rehabilitation as a new medical discipline in Poland and worldwide. Rehabilitation has developed dynamically in the interwar period. In the US, it was pioneered by Howard Rusk, while in Poland, rehabilitation was introduced by Wiktor Dega. Medical rehabilitation is an interdisciplinary approach and is an integral and irremovable element of treatment at all treatment stages. Of note is the contribution of Wiktor Dega, who has developed and presented the Polish concept of rehabilitation, considered by the World Health Organization (WHO) as worth of being followed. Wiktor Dega believed that rehabilitation should be started possibly early--as soon as in the active disease stage and should provide and maintain good functional results after surgical treatment. The article discusses the contribution of pioneer specialists in rehabilitation in two first rehabilitation centers in Poland, established after World War II in Poznan and Konstancin near Warsaw.

The internet and the physician-patient relationship.

BACKGROUND: Since the emergence of the public Internet in the early 1990s, the healthcare industry has been struggling to understand how best to utilize this resource. During the last decade there has been an increase in both the interest and participation by healthcare providers in the Internet space, but many observers continue to push for more development of healthcare resources to better support the provider-patient relationship. QUESTIONS/PURPOSES: This paper will review the historical development of the Internet, the core concepts that have driven the emergence and evolution of the Internet as a mass medium of information exchange, and how the healthcare industry can harness the Internet to improve the provider patient relationship. WHERE ARE WE NOW?: The healthcare industry continues to lag behind other industries that have been transformed by the Internet. Numerous industries including travel, real estate, retail sales, and banking have migrated both comprehensive information resources and transactions to the Internet in order to improve efficiency and customer satisfaction. That same process is occurring now in the healthcare industry. Credible and comprehensive Information resources are beginning to mature. Transactions are still in their infancy, reflecting a continued concern about privacy and security. WHERE DO WE NEED TO GO?: We need to improve information resources to educate and inform patients. Improving the availability and credibility of information resources will empower patients to make better healthcare decisions and I contend will ultimately reduce the cost of delivering care. HOW DO WE GET THERE?: Orthopaedists must first recognize the value of information resources to the patient. Effective communication with patients is a critical component of providing healthcare services. All healthcare providers should reflect on the importance of developing an effective communications strategy for their own practice and consider the benefits of participating in efforts by professional organizations to improve existing information resources.

Spinal institutions in post-Revolutionary France.

STUDY DESIGN: Literature review. SETTING: Europe with special reference to France. OBJECTIVES: To describe the first known orthopaedic rehabilitation units founded in France in the first half of the nineteenth century for the treatment of spinal curvature and deformity and analyse their impact on the future provision of rehabilitation treatment in Europe. CONCLUSION: Despite the pioneering work of a few French orthopaedic surgeons and doctors, no long-lasting legacy remains from the establishment of innovative and holistic institutes for the treatment of spinal curvature and deformity as early as the 1830 s.

[Pott's disease before antibercular agents: from Pott to Ménard]. / Le mal de Pott avant les antituberculeux: de Pott à Ménard.

Percival Pott (1714-1788), an eminent surgeon, has given his name to a spinal pathology with curvature due to tuberculous abscesses; he was the first to show that it may cause paralysis of the lower limbs and that tragic consequences could be avoided or reversed through surgery. Victor Auguste Ménard (1854-1934) played a major role in the orthopaedic treatment of this disease in the Maritime Hospital of Berck-sur-Mer where he was the founder of a surgeon school. In 1900, he published a work entitled : A Practical Study of Pott's Disease. Since there were no antibiotics to treat tuberculosis and because most patients were children, they had to be submitted to intensive care. Ménard's treatment consisted of a complete and long immobilization associated to strict rules of hygiene, involving sun and sea-air therapy. The use of surgery in some cases recalls Pott's general principles.

History of spine surgery in the ancient and medieval worlds.

There is a paucity of surviving texts from ancient and medieval times that can shed light on the early development of spine surgery. Nevertheless, the author reviews many of the available books and fragments and discusses early developments in the field of spine surgery from the point of view of physicians' personalities, general themes, and actual surgical practices. For purposes of an overview and to highlight changing trends in spine surgery, he divides the paper into four eras of medicine: 1) Egyptian and Babylonian; 2) Greek and early Byzantine; 3) Arabic; and 4) medieval.