Department History

Although physician involvement with disorders of the musculoskeletal system dates back to medical antiquity, the specialty of orthopaedic surgery was not designated as such until just 83 years before the founding of Jefferson Medical College. Before this formal naming occurred and allowed a specific focus to begin, disorders and injuries of the musculoskeletal system were cared for by that large group of practitioners known simply as surgeons. It is noteworthy that as orthopaedic surgery struggled for its separate identity and began to disassemble from general surgery, Jefferson became one of the first medical schools in the country to recognize the new specialty by founding a Department of Orthopaedic Surgery in 1904.

The term "orthopaedics" was coined in 1741 by Nicholas André, Dean of the Faculty of Medicine of the College de France. He combined two Greek words orthos, meaning straight or free of deformity, and paidios, a child. It called attention to his belief that the prevention of deformity in adults lay in the development of straight children. André had no idea that this newly invented word would be later adopted to identify the important medical discipline that concerns itself with the disorders and injuries affecting the musculoskeletal system.

Gradual acceptance of the new term sharpened the focus among those mechanically minded general surgeons of the time who had developed a special interest in the musculoskeletal system. A few of them founded the American Orthopaedic Association in 1887, the first formal orthopaedic organization in the world. Their vision and sense of purpose can be better appreciated when it is noted that the founding of this association predated the founding of the American College of Surgeons by 26 years.

World War I, with its large volume of musculoskeletal injuries, provided the catalyst for the ultimate emergence of this special field from beneath the mantle of general surgery. By 1935 the American Board of Orthopaedic Surgery had been formed and the American Academy of Orthopaedic Surgeons established. This second national orthopaedic organization was needed to give an organizational home to the hundreds of emerging board-certified orthopaedic surgeons not eligible for membership in the American Orthopaedic Association. The latter organization continued to restrict its membership and be professor-oriented. By 1985 the American Academy of Orthopaedic Surgeons had become the largest orthopaedic organization in the world, with a membership in excess of 11,000 board-certified orthopaedists.

Samuel D. Gross was outstanding in the early American literature relating to the later specialty of orthopaedics. At age 25 and only two years after his graduation from Jefferson in 1828, he published Anatomy, Physiology and Diseases of Bones and Joints (1830). This octavo volume of 382 pages sold 2,000 copies in fewer than four years. In 1859 when he was Professor of Surgery at Jefferson, Volume II of his System of Surgery contained 253 pages devoted to bone and joint disease, including fractures. Additionally, Eakins' Gross Clinic, painted in 1875, depicted Gross removing a sequestrum from the femur.

As early as 1839 Thomas Dent Mutter, Professor of Surgery at Jefferson (1841-1856), published a monograph of 104 pages on clubfoot. In his textbook Operations of Surgery (1846), he devoted four out of 19 chapters to amputations, injuries of muscles and tendons, contractions of the leg and thigh, ankylosis, and clubfoot. Joseph Pancoast, Professor of Surgery from 1839 to 1841 and of Anatomy from 1841 to 1874, wrote extensively on operations for diseases of the bones and joints in his Operative Surgery (1844).

The development of orthopaedic surgery at Jefferson closely paralleled the development of the specialty in the country as a whole. Traditionally, formal emergence of the term orthopaedic surgery in the curricula and on the faculties of most medical schools can be traced to the identification of a general surgeon with a mechanical turn of mind, who evinced interest in disorders of bones and joints. The first such person at Jefferson (after Gross, Mutter, and Pancoast) was Dr. Oscar Huntington Allis, an 1866 graduate of Jefferson.