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Pinelli jfk2011

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Pierre Trudelle
Pierre Trudelle

1. Orthopedic surgery has evolved significantly over the centuries from initially focusing on treating fractures, dislocations, and wounds to becoming a clinical science that utilizes modern technologies. 2. Major developments included Nicolas Andry establishing orthopedics as a field focused on preventing deformities in children, the introduction of anesthesia allowing less conservative and more minimally invasive surgeries, and advances in materials, antibiotics, imaging, and arthroplasty techniques. 3. Continued progress is expected in areas like computer-assisted surgery, real-time information integration, and tissue engineering as orthopedics works to solve problems like joint instability and seeks to operate robots in the future.

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History of Orthopedic Surgery J.F.M.K. Parc Chanot, Marseille , 2011 P-O Pinelli popinelli@gmail.com
Key Periods • Before Nicolas Andry • From Andry to « Ether Day » • Mid XIXth to 1st World war • Modern Era, Science • Tomorrow ?
Before From Andry Mid XIXth Modern Era Tomorrow ? Nicolas Andry to « Ether Day » to 1st World War Science The Future • For centuries Orthopedic Practice was limited to the treatment of : – Bone Fractures – Dislocations – Wounds • Hippocrates (400 bc) • Galen (130-200) • A. Paré (1517-1590) – Major Rules for treatment …
Before From Andry Mid XIXth Modern Era Tomorrow ? Nicolas Andry to « Ether Day » to 1st World War Science The Future • Bone-Setting … – Bone-Setter : Empiric practitioner who claims the power of diagnosing and setting Fractures, reducing Dislocations, and relieving painful Stiff Joints – Art transmitted by « word of mouth » – No systemic or distantly removed effects are predicated – Leave the « care field » as soon as possible • … gave Famous families of Orthopedic Surgeons
Before From Andry Mid XIXth Modern Era Tomorrow ? Nicolas Andry to « Ether Day » to 1st World War Science The Future Nicolas Andry (1658-1742) → Birth of Orthopedics (1741) « L’Orthopédie, ou l’Art de Prévenir et de Corriger dans les Enfants, les Difformités du corps » « Orthopedics, or the Art of correcting and Preventing Deformities in Children »  This name (Orthopedics) will focus attention upon a group of long- neglected crippling conditions :  Congénital Deformities  Infantile Paralysis  Scoliosis  Chronic Affections of the Joints  …etc…
Before From Andry Mid XIXth Modern Era Tomorrow ? Nicolas Andry to « Ether Day » to 1st World War Science The Future Two Major Problems 1. Post-operative Sepsis (Hospital Grangrene) 2. Absence of Anesthesia Conservative Treatments by consecutive Splints → Jean-André Venel (1740-1791) Fast and Minimal Invasive Surgical Techniques such as Percutaneous Tenotomies → Jacques-Mathieu Delpech (1777-1832) 1st Achile’s Tenotomy : May 16th, 1816
- Georg Friedrich Louis Stromeyer (1804-1876) Influenced by Delpech’s works : Achile’s tenotomy in 1831 Pioneer of Orthopedic Surgery in Germany - William John Little (1810-1894) Was suffering a Clubfoot condition : Operated on by Stromeyer Infantile Paralysis as Little desease ; Pioneer in England - William Ludwig Detmold (1808-1894) Created the First Hospital for Crippled Children in New York Considered as the Father of American Orthopedic Surgeons
Before From Andry Mid XIXth Modern Era Tomorrow ? Nicolas Andry to « Ether Day » to 1st World War Science The Future October the 16th, 1846 : « Ether Day » Massachusetts General Hospital of Boston
Before From Andry Mid XIXth Modern Era Tomorrow ? Nicolas Andry to « Ether Day » to 1st World War Science The Future Doctor Gross’ Clinic Thomas Eakins, 1875 Jefferson Medical College Philadelphie
Before From Andry Mid XIXth Modern Era Tomorrow ? Nicolas Andry to « Ether Day » to 1st World War Science The Future • 1865 : Two open fractures were operated on by James Syme’s fellow, Joseph Lister (1827-1912) – Birth of Antiseptic Method : The Lancet, 1867 « On a new method of treating compound fractures , … » – Influenced by Pasteur’s works • 1880-1890 : The Aseptic Method William S. Halsted (1852-1922) – He visited Volkmann in Europe – Miss Caroline Hampton’s Affair
Before From Andry Mid XIXth Modern Era Tomorrow ? Nicolas Andry to « Ether Day » to 1st World War Science The Future Now, hands are definitely free … One more Major Discovery for Orthopedic Practice • Radiology – Wilhelm Conrad Röntgen (1845-1923) The Daily Chronicle, January 6, 1896
State of the Art Just Before World War 1 • Osteotomy – For Rickets, Ankylosed Joints, …etc… – William MacEwen (1848-1924) Pupil of Lister, the « Osteotome »
State of the Art Just Before World War 1 • Operative Treatment of Fractures – William Arbuthnot Lane (1856-1943), England – Albin Lambotte (1866-1956), Belgium – William O’Neill Sherman (1880-1979), U.S.A.
State of the Art Just Before World War 1 • Arthroplasty – Anecdotic Foreign Bodies Implantations • Themistocles Gluck, Jules Emile Pean (1830-1898) – John Benjamin Murphy (1857-1916) 1. It is possible to replace an important portionStability is also essential Movement is important but of the skeleton, even an enarthrodial joint. 2. To be well tolerated, prostheses must not only be sterile but also made of nonresorbable (non-reactive) materials. 3. They will be tolerated by the organism provided one carries out the necessary precautions. have observed these cases « We 4. This procedure can replace immediate amputation of aare for so long a time that we limb when the patient refuses such an operation.correctness of assured of the 5. In the ordinary large excision, this method had the advantage this statement. Homo- and of preventing the immediate collapse of the soft parts. Hetero-transplants are not 6. Finally, such prostheses can provide a method which permits the preservation of joint motion uniform in results »
Before From Andry Mid XIXth Modern Era Tomorrow ? Nicolas Andry to « Ether Day » to 1st World War Science The Future Orthopedics as a Clinical Science • The Débuts – Joseph-François Malgaigne (1806-1865) & Claude Bernard (1813-1878) Statistics in Medecine • The Mayo Clinic – Founders : Charlie & William Mayo Revitalize contacts between European and American Physicians, broken during World War 1
Before From Andry Mid XIXth Modern Era Tomorrow ? Nicolas Andry to « Ether Day » to 1st World War Science The Future Major Advances of the XXth • Medical Discoveries – Antibiotics (1928), Heparin (1948) Immunosupressors (1949) • Technological Advances – Biocompatible Materials … (Prostheses) – Miniaturization The come-back of Percutaneous Surgery (Arthroscopy)
Before From Andry Mid XIXth Modern Era Tomorrow ? Nicolas Andry to « Ether Day » to 1st World War Science The Future Hip Arthroplasty • First Steps – Marius Nygaard Smith-Petersen (1886-1953) – Jean (1905-1995 ) & Robert Judet (1909-1980 ) – Austin Taley Moore (1899-1963) – George Kenneth Mac Kee (1906-1991)
Before From Andry Mid XIXth Modern Era Tomorrow ? Nicolas Andry to « Ether Day » to 1st World War Science The Future Hip Arthroplasty • Charnley’s Era – Sir John Charnley (1911-1982) The « Low-Friction Concept »
Before From Andry Mid XIXth Modern Era Tomorrow ? Nicolas Andry to « Ether Day » to 1st World War Science The Future Knee Arthroplasty • Problem of Stability – Hinged Prostheses Börje Walldius (1913-) GUEPAR Group in France – Condylar Prostheses Scientific Approach of Knee Kinematics Frank H. Gunston (1933-) John N. Insall (1930-2000)
Before From Andry Mid XIXth Modern Era Tomorrow ? Nicolas Andry to « Ether Day » to 1st World War Science The Future Orthopedics in 2050 ? • C.A.O.S – Shall we be operated on by Computers and Robots ? • Real Time Information – We used to travel by the seas … • Medical Research – Tissue Engineering, Molecular Biology, …etc…
« Who is Familiar with what were Art and Science in the Past, is also competent for judging their Future Advances … » C. A. Theodor Billroth, 1890 « Our today’s truths are our tomorrow’s errors and our actual knowledge is neither better nor worse than our predecessors’ … » Maxime Laignel Lavastine, 1950
Bibliography
Thank You very much and … … Remain close to your Dentist !! popinelli@gmail.com

More Related Content

Pinelli jfk2011

  • 1. History of Orthopedic Surgery J.F.M.K. Parc Chanot, Marseille , 2011 P-O Pinelli popinelli@gmail.com
  • 2. Key Periods • Before Nicolas Andry • From Andry to « Ether Day » • Mid XIXth to 1st World war • Modern Era, Science • Tomorrow ?
  • 3. Before From Andry Mid XIXth Modern Era Tomorrow ? Nicolas Andry to « Ether Day » to 1st World War Science The Future • For centuries Orthopedic Practice was limited to the treatment of : – Bone Fractures – Dislocations – Wounds • Hippocrates (400 bc) • Galen (130-200) • A. Paré (1517-1590) – Major Rules for treatment …
  • 4. Before From Andry Mid XIXth Modern Era Tomorrow ? Nicolas Andry to « Ether Day » to 1st World War Science The Future • Bone-Setting … – Bone-Setter : Empiric practitioner who claims the power of diagnosing and setting Fractures, reducing Dislocations, and relieving painful Stiff Joints – Art transmitted by « word of mouth » – No systemic or distantly removed effects are predicated – Leave the « care field » as soon as possible • … gave Famous families of Orthopedic Surgeons
  • 5. Before From Andry Mid XIXth Modern Era Tomorrow ? Nicolas Andry to « Ether Day » to 1st World War Science The Future Nicolas Andry (1658-1742) → Birth of Orthopedics (1741) « L’Orthopédie, ou l’Art de Prévenir et de Corriger dans les Enfants, les Difformités du corps » « Orthopedics, or the Art of correcting and Preventing Deformities in Children »  This name (Orthopedics) will focus attention upon a group of long- neglected crippling conditions :  Congénital Deformities  Infantile Paralysis  Scoliosis  Chronic Affections of the Joints  …etc…
  • 6. Before From Andry Mid XIXth Modern Era Tomorrow ? Nicolas Andry to « Ether Day » to 1st World War Science The Future Two Major Problems 1. Post-operative Sepsis (Hospital Grangrene) 2. Absence of Anesthesia Conservative Treatments by consecutive Splints → Jean-André Venel (1740-1791) Fast and Minimal Invasive Surgical Techniques such as Percutaneous Tenotomies → Jacques-Mathieu Delpech (1777-1832) 1st Achile’s Tenotomy : May 16th, 1816
  • 7. - Georg Friedrich Louis Stromeyer (1804-1876) Influenced by Delpech’s works : Achile’s tenotomy in 1831 Pioneer of Orthopedic Surgery in Germany - William John Little (1810-1894) Was suffering a Clubfoot condition : Operated on by Stromeyer Infantile Paralysis as Little desease ; Pioneer in England - William Ludwig Detmold (1808-1894) Created the First Hospital for Crippled Children in New York Considered as the Father of American Orthopedic Surgeons
  • 8. Before From Andry Mid XIXth Modern Era Tomorrow ? Nicolas Andry to « Ether Day » to 1st World War Science The Future October the 16th, 1846 : « Ether Day » Massachusetts General Hospital of Boston
  • 9. Before From Andry Mid XIXth Modern Era Tomorrow ? Nicolas Andry to « Ether Day » to 1st World War Science The Future Doctor Gross’ Clinic Thomas Eakins, 1875 Jefferson Medical College Philadelphie
  • 10. Before From Andry Mid XIXth Modern Era Tomorrow ? Nicolas Andry to « Ether Day » to 1st World War Science The Future • 1865 : Two open fractures were operated on by James Syme’s fellow, Joseph Lister (1827-1912) – Birth of Antiseptic Method : The Lancet, 1867 « On a new method of treating compound fractures , … » – Influenced by Pasteur’s works • 1880-1890 : The Aseptic Method William S. Halsted (1852-1922) – He visited Volkmann in Europe – Miss Caroline Hampton’s Affair
  • 11. Before From Andry Mid XIXth Modern Era Tomorrow ? Nicolas Andry to « Ether Day » to 1st World War Science The Future Now, hands are definitely free … One more Major Discovery for Orthopedic Practice • Radiology – Wilhelm Conrad Röntgen (1845-1923) The Daily Chronicle, January 6, 1896
  • 12. State of the Art Just Before World War 1 • Osteotomy – For Rickets, Ankylosed Joints, …etc… – William MacEwen (1848-1924) Pupil of Lister, the « Osteotome »
  • 13. State of the Art Just Before World War 1 • Operative Treatment of Fractures – William Arbuthnot Lane (1856-1943), England – Albin Lambotte (1866-1956), Belgium – William O’Neill Sherman (1880-1979), U.S.A.
  • 14. State of the Art Just Before World War 1 • Arthroplasty – Anecdotic Foreign Bodies Implantations • Themistocles Gluck, Jules Emile Pean (1830-1898) – John Benjamin Murphy (1857-1916) 1. It is possible to replace an important portionStability is also essential Movement is important but of the skeleton, even an enarthrodial joint. 2. To be well tolerated, prostheses must not only be sterile but also made of nonresorbable (non-reactive) materials. 3. They will be tolerated by the organism provided one carries out the necessary precautions. have observed these cases « We 4. This procedure can replace immediate amputation of aare for so long a time that we limb when the patient refuses such an operation.correctness of assured of the 5. In the ordinary large excision, this method had the advantage this statement. Homo- and of preventing the immediate collapse of the soft parts. Hetero-transplants are not 6. Finally, such prostheses can provide a method which permits the preservation of joint motion uniform in results »
  • 15. Before From Andry Mid XIXth Modern Era Tomorrow ? Nicolas Andry to « Ether Day » to 1st World War Science The Future Orthopedics as a Clinical Science • The Débuts – Joseph-François Malgaigne (1806-1865) & Claude Bernard (1813-1878) Statistics in Medecine • The Mayo Clinic – Founders : Charlie & William Mayo Revitalize contacts between European and American Physicians, broken during World War 1
  • 16. Before From Andry Mid XIXth Modern Era Tomorrow ? Nicolas Andry to « Ether Day » to 1st World War Science The Future Major Advances of the XXth • Medical Discoveries – Antibiotics (1928), Heparin (1948) Immunosupressors (1949) • Technological Advances – Biocompatible Materials … (Prostheses) – Miniaturization The come-back of Percutaneous Surgery (Arthroscopy)
  • 17. Before From Andry Mid XIXth Modern Era Tomorrow ? Nicolas Andry to « Ether Day » to 1st World War Science The Future Hip Arthroplasty • First Steps – Marius Nygaard Smith-Petersen (1886-1953) – Jean (1905-1995 ) & Robert Judet (1909-1980 ) – Austin Taley Moore (1899-1963) – George Kenneth Mac Kee (1906-1991)
  • 18. Before From Andry Mid XIXth Modern Era Tomorrow ? Nicolas Andry to « Ether Day » to 1st World War Science The Future Hip Arthroplasty • Charnley’s Era – Sir John Charnley (1911-1982) The « Low-Friction Concept »
  • 19. Before From Andry Mid XIXth Modern Era Tomorrow ? Nicolas Andry to « Ether Day » to 1st World War Science The Future Knee Arthroplasty • Problem of Stability – Hinged Prostheses Börje Walldius (1913-) GUEPAR Group in France – Condylar Prostheses Scientific Approach of Knee Kinematics Frank H. Gunston (1933-) John N. Insall (1930-2000)
  • 20. Before From Andry Mid XIXth Modern Era Tomorrow ? Nicolas Andry to « Ether Day » to 1st World War Science The Future Orthopedics in 2050 ? • C.A.O.S – Shall we be operated on by Computers and Robots ? • Real Time Information – We used to travel by the seas … • Medical Research – Tissue Engineering, Molecular Biology, …etc…
  • 21. « Who is Familiar with what were Art and Science in the Past, is also competent for judging their Future Advances … » C. A. Theodor Billroth, 1890 « Our today’s truths are our tomorrow’s errors and our actual knowledge is neither better nor worse than our predecessors’ … » Maxime Laignel Lavastine, 1950
  • 23. Thank You very much and … … Remain close to your Dentist !! popinelli@gmail.com