Clinical Remarks ON THE OPERATIVE TREATMENT OF FRACTURES

Lane, W. Arbuthnot

doi:10.1136/bmj.1.2418.1037

Cited by 13 publications

(5 citation statements)

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“…Asepsis developed in the 1890s and in the early 20th century and it was further advanced by the surgeon William Arbuthnot Lane (1856–1943) who was effectively the first to routinely perform internal fixation for fractures of the lower limb. 11 Lane also advanced aseptic surgery with his ‘no-touch’ technique. Surgeons’ hands were not allowed into the wound, his instruments were long handled to keep hands away from the tissues.…”

Section: Th Centurymentioning

confidence: 99%

Surgeon-anatomist to robotic technician? The evolving role of the surgeon over three centuries

Hughes

Macintyre

2022

J R Soc Med

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In the 18th century, anatomy was the principal science underlying surgical practice. Over the next three centuries, the scientific basis of surgery changed dramatically. Morbid anatomy led to the understanding of organ-based pathologies that allowed surgeons to remove, reconstruct and in some cases replace internal organs. In the 19th century, the new science of microbiology facilitated antisepsis, then asepsis as surgery progressed from a craft to a scientific discipline. Yet many surgeons believed that surgery was not merely a science but also an art, in which the creativity of the doctor was necessary for progress. Surgical advancement depended on creative individuals with innovative flair, prepared to pioneer often risky procedures in the face of mainstream opposition. The 20th century saw a series of changes that made such individualism more difficult. ‘Scientific Management’ when applied to surgery decreed that procedures be performed according to predetermined schedules, a drive to uniformity producing better outcomes and diminishing individual variation. Yet inventive individuals continued to produce surgical advances. In the 21st century, moves toward standardisation developed further. The escalating safety culture in surgery moderates the introduction of novel, potentially riskier procedures, while more and more regulation increasingly requires surgeons to adhere to guidelines and protocols, further restricting surgical individualism. Moreover, the role of the individual is further diminished, as surgical care is delivered by teams, both in deciding management in major cases and in the operating theatre. The introduction of robotics into surgery has led to the suggestion that the role of the surgeon may become that of a technician. Will these constraints, and greater patient involvement in decisions, allow tomorrow’s surgeons the freedom to innovate? We believe that the pioneering spirit, imagination and flair will not be lost. Tomorrow’s surgeons must remain doctors, showing the compassion and empathy that robots cannot provide.

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Section: Th Centurymentioning

confidence: 99%

Surgeon-anatomist to robotic technician? The evolving role of the surgeon over three centuries

Hughes

Macintyre

2022

J R Soc Med

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“…In Britain, they not only saw firsthand Jones' practice and methods but also Sir William Arbuthnot Lane's revolutionary use of plates and screws to fix fracture fragments, the innovation that transformed fracture management. 26 Jones worried that entry of the United States into the conflict in April 1917, would divert the Americans from his centers, but they continued to come. A second Goldthwait unit of 43 surgeons, along with 12 nurses, arrived in October.…”

Section: Organization Of Orthopedic Centersmentioning

confidence: 99%

The Welsh Clan that Transformed Orthopedic Surgery

Nakayama

2019

The American Surgeon™

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Modern orthopedic surgery arose from Hugh Owen Thomas (1834–1891) and Sir Robert Jones (1857–1933), uncle and nephew, two descendants of a family of bonesetters from North Wales and Liverpool, respectively. Thomas combined a formal medical education with his hereditary vocation into treatments that have endured for more than a century. The epitome is the Thomas splint, which was credited with a decrease in the mortality from open femur fractures to 20 from 80 per cent during World War I and is still in use for the emergency transport of lower extremity injuries. Jones was 15 when he became Thomas’ apprentice. By the end of the century, he was a leading figure in orthopedic surgery, at the forefront of the treatment of childhood deformities and the clinical use of X-rays. Enlisting in the Royal Army Medical Corps with the onset of World War I, he saw the need for a system of orthopedic care to treat soldiers with injured limbs that threatened to flood the country with crippled, disabled men. The centerpiece was the military orthopedic center, where surgeons devised integrated programs of surgery, physical therapy, and “curative workshops” to return war-injured soldiers to productive lives. With British surgeons conscripted to work at the Western Front, hundreds of American surgeons with little prior experience in orthopedics volunteered to work in the centers and thus received intensive training under Jones. Orthopedic surgery, traditionally part of the broader practice of surgery, thus emerged from the war as a full-time endeavor and a distinct surgical specialty.

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“…Traumatic fixation devices typically consist of “single/multiple‐component metallic bone fixation appliances and accessories” in the form of one or more metallic components and their metallic fasteners (12). Initially, orthopedic surgeons began using steel plates and screws for fixation early in the 20th century (13). Today, devices typically consist of a plate or a nail/plate combination made of alloys, such as cobalt–chromium–molybdenum, stainless steel, and titanium (12).…”

Section: —Variety and Count Of Orthopedic Devices In The William M Bmentioning

confidence: 99%

The Use of Orthopedic Surgical Devices for Forensic Identification*

Wilson

Bethard

DiGangi

2011

Journal of Forensic Sciences

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Surgically implanted devices have become increasingly common in modern skeletal material. Therefore, having the knowledge of the variety of implanted orthopedic devices, their manufacturer, and where to find and how to use identifying numbers in such implants can assist in the identification process when traditional methods are not applicable. Orthopedic device manufacturers are required by the Safe Medical Devices Act of 1990 and the FDA Modernization Act of 1997 to track permanently implanted devices. Manufacturer information on orthopedic devices associates the orthopedic surgeon who implanted the device with the patient. By providing a current list of the most common orthopedic device manufacturers in the U.S.A. and the associated contact information, investigators will have updated tools for the individuation process. Despite numerous complicating factors regarding how device data are tracked, the information presented here can assist forensic professionals with obtaining presumptive and/or positive identifications.

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Clinical Remarks ON THE OPERATIVE TREATMENT OF FRACTURES

Cited by 13 publications

References 0 publications

Surgeon-anatomist to robotic technician? The evolving role of the surgeon over three centuries

Surgeon-anatomist to robotic technician? The evolving role of the surgeon over three centuries

The Welsh Clan that Transformed Orthopedic Surgery

The Use of Orthopedic Surgical Devices for Forensic Identification*

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