The romance of orthopaedic development (1961)

e [Music] for over 40 Years sir Harry you've been an outstanding personality in the field of Orthopedics and yet I know you might quite easily become a musician yes that is true a childhood injury developed into a Tubac ofous knee and uh I was much restricted in my activities for many years miss a lot of schooling but I read a great deal and became very interested in music in fact I wanted to be a composer did you have any real incentive at this time to lead an active life yes I was spurred on by the example of three athletic Brothers I wanted to do what they could do but by 194 I made my choice profession of medicine although I was reluctant to abandon music that was rather a surprising Choice really wasn't it because there was no family medical background at all no do you think perhaps consciously or unconsciously your decision was determined by the experiences which you had with your own Physicians and surgeons oh very probably I had a good fortune to be a patient of Robert Jones of Liverpool who was then a young man but of course destined to be the greatest orthopedic surgeon of all time may we come back to Sir Robert Jones Le yes of course you went to Manchester to University and uh during your undergraduate career you picked up many prizes on the way and then you qualified and what did you do then I did house surgeon jobs in Manchester and in London I taught Anatomy for a year I got my f frcs and my mhip in surgery and and were you actually that time in close touch with Sir Robert Jones not again until 193 when I was in London getting further experience the idea because a general surgeon then came the turning point in my career Dr Elliot breett the Boston who was attending the international Congress of medicine invited me to go to the United States and to work under him in the hospitals there this was a unique offer later in the year I went to Boston and I stayed there for eight months working in the hospitals I came back in 1914 and soon after was appointed to the staff the anot hospital as a general surgeon there were no Orthopedic departments uh in the general hospitals outside London at that time but I had two colleagues WR Douglas and John moley who knowing my interest in Orthopedics turned over the treatment of all fractures to me this generous and farsighted action laid the foundation of a very busy Orthopedic Service at ancoats which attracted crippled patients of all ages then came the 194 War at first I was not accepted for military service and in the absence of my two colleagues on service in galipoli I carried on the whole surgical work of vot's hospital for a Time later when I was commissioned as a captain in the ramc I was appointed by Sir Robert Jones to take charge of the orthopedic section of the Army hospital in Manchester this special unit of about 250 beds with other larger units in the country had been organized by Sir Robert with the powerful support of such leading British surgeons as s Barkley minin of Leeds and Sir hero styles of Edinburgh was s Robert Jones then such a power in the land well Sir Robert was a many sided personality he was a most inspiring and lovable man as a surgical leader he was unique he liked to have around him young men with ideas and he encouraged them to try out their own techniques which quite often differed from the classical methods of the great Liverpool School of Orthopedics he was indeed a most tolerant man from what you said it is obvious that Sir Robert Jones exerted a tremendous influence on you and your contemporaries oh yes he became a world figure a revered leader as much in the United States as in the United Kingdom but in spite of the remarkable organization which had been built up in the 19141 18 period is it not true to say that you and your colleagues in preaching the doctrine of the segregation of fracture units met with very great resistance we did surgical specialism was slow to be accepted particularly in the great teaching hospitals and it was not until 1934 that I myself was appointed as an orthopedic surgeon to a teaching Hospital the mener Royal infirmary what in your opinion were the determining factors which eventually led to the general acceptance of the principles propounded by Sir Robert Jones yourself and your colleagues I think there were three main factors first of all the success of the regional Orthopedic schemes for the treatment of long-term crippling affections secondly the report of a BMA Committee in 193 5 and thirdly the report of a government committee on the treatment of accidents in 1937 the 1935 BMA committee recommended very strongly the setting up of specialized fracture units in all hospitals based on certain principles segregation Unity of control and continuity of treatment and special mention indeed was made of your work in this 193 5 BMA committee yes because I had set up the first segregated fracture service at enods hospital in 1914 the result of all this experience was that when the 1939 war came we had a complete scheme for the specialized treatment of Aid battle and Industrial injuries in this section of of the Emergency Medical Service Sir Thomas Fairbank and I myself were the consultant advisers to the government I am still a consultant adviser in this field may we go back to 1939 an important Landmark for all of us and for you yes because in that year I was appointed the first professor of orthopedic surgery in the University of Manchester so the period 1939 to 1945 uh was a very busy one for me honors have poured in upon you a Knighthood in 1948 election as president of the Royal College of Surgeons of England for three years running a Barony in 1958 and then the same year election as president of the newly formed International Federation of surgical colleges what prodigious changes you've seen over these 40 years in which you yourself have so notable a part indeed yes the most significant perhaps the growth of surgical specialization and in this movement I think Orthopedics led the way in this specialty alone I have lived through great changes in techniques in the mobilization of fractured bones for example the old wooden Sprints now discarded then the metal malleable splints the Robert Jones practice and the remarkable Revival of plast Paris in the form of the unpadded plaster splint in the operative treatment of fractures the use of new Metals in reconstructive surgery massive bone grafting made possible by bone Banks and the Reconstruction of joints by the insertion of prosthetic substitutes then most important the widespread application of Rehabilitation methods and finally the Advent of antibiotics and the remarkable advances in the techniques of resuscitation and anesthesia all these are made possible a more adequate treatment of the massive injuries of modern road traffic thus there is a continuing need for the Education and Training of the surgeon and others in this field and for an organization to deal with these seriously injured people this problem and Allied problems have occupied a great deal of my time since 1952 not only in this country but all over the world and thus you see that all these developments stem from the mind and work of Robert Jones [Applause] [Music] h [Music] [Applause]