Skiers, Sportsmen and suffered from Anterior cruciate ligament injury, which ruined their career. David l McIntosh was the first to operate on an anterior cruciate ligament injury successfully. After this numerous developments have made this procedure invaluable for sportsmen and is usually done by sports medicine specialists.Modern surgery has made this operation less invasive and better implants have given surer results.

Early Ortopaedics

Jean Andre Venal, often described as the father of orthopaedic surgery, established a hospital for the treatment off skeletal deformities in children in the year 1780.

Most of the developements in orthopaedics occured, as can be expected, during wars.

Antonius Mathysen was the first to describe and use plaster of Paris in1851.

Galen and post Galen in Greece.

Galen became a gladiatoril surgeon and we can consider him as the 'Father of sports Medicine'.
He gave an excellant account of the skeleton and the muscles which move it. He was the first ti describe a cervical rib.He introduced the words scoliosis, kyphosis and lordosis and also decribed some treatment for them. He was able to recognise infection in bone and described 'sequestra' and their treatment.During this period and attempt was made to use artificial limbs.Soranus of Ephesus described rickets.Ruphus of Ephesus was the first to describe tendon ganglia and their treatment by compression.In the third century BC Antyllus described subcutaneous tenotomy for the correction of deformities.

Contribution of Greece.(cont)

Although the teachings of Hippocrates continued to dominate there are others whose work we must take note of, notable among these is Galen. He was originally fro Peragamon, he became a gladiatorial surgeon and went to Rome. All this happened just before200BC.

Ancient Greece.

Greek history probably provides a scientific approach to medicine. Even in Homers Trojan war and the Iliad there are descriptions of various injuries of the skeletaon and how they were treated in those days.Herophilus was the first to distinguish the motor system from sensory system and poit out the differance between arteries and veins.Hegetor of Alexandria was the first to describe the anatomy of the hip joint.Hippocrates who is considered as the 'Father of Modern Medicine' lived about 430 to 330 BC.He published his work Corpus Hippocraticus.He was systematic and scientific in his approach and the oath named after him is still taught to medical students, although the oath is not being taken.One of the volumes in th Corpus is devoted to dislocations and most common dislocations are described along with their treatment. We still teach the Hippocrates method of reducing dislocations of the shoulder.

He saw the importance of unnessarily probing compound fractures.
He knew the principles of traction and counter traction.
He was the first to decribe treatment of club foot.
The history of Ancient Greece will be continued in the next posting.

After the work put in by Ancient Physicians, Greek Medical history deals with Orthopaedics.

Ancient India

Sushruta should be considered the father of Surgery itself His outstanding work on 'Repair of the nose' is still quoted in textbooks on the subject. His Charitas include chapters on orthopaedics. He has described various types of dislocations and fractures. Ge has also included a chapter on war injuries.These texts were in Sanskrit, and were translated into German before they were studied in India.

ANCIENT EGYPT>

ANCIENT EGYPT: The knowledge which we have is from a parchament known as the 'Edwin Smith Papyrus'. Edwin Smith had only purcahased it from a robber who got it from one of the many tombs. The author of the payrus was probably Imhotep. He is considered a genius of those times. Definitly splints were used in those days and crutches have been found upon mummies. In additio Imhotep has described a large amont of his thinking on Cardiovascular diseaes.

Orthopaedics before Nicholas Andry

Primitive man must have come across various injuries during his hunting trips. Fossil evidence shows fractures which have united with a fair degree of alignment. They, most probably used some form of splints. At first they prabably used simnple sticks and twine, but later recognising the importance of these splints they might have modified it. In addition they probably did amputation of the fingers and possibly trephinig of the skull.

Orthopaedics..Definition and scope

The word Ortopaedics was coined by Nicholas Andry, from two Latin words, Orthos meaning Straight and Paedios meaning Children. Nicholas Andry was Professor of Medicine at the University of Paris and at the age of 81 published a book 'Orthopaedia' in which he outlined various deformities of the skeleton in children and the methods available for their treatment. His contributions to Orthopaedics as we know it is minimal and other than coining the word Ortopaedics he cannot be called the father of orthopaedics.