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先天性高肩胛症:罗伯特·D·施罗克医学博士(1884 - 1960)。1940年美国矫形外科医师学会第九任主席。

Congenital elevation of the scapula : Robert D. Schrock MD (1884-1960) . The 9th president of the AAOS 1940.

作者信息

Schrock Robert D

出版信息

Clin Orthop Relat Res. 2008 Jan;466(1):74-80. doi: 10.1007/s11999-007-0025-2.

DOI:10.1007/s11999-007-0025-2
PMID:18196376
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2505287/
Abstract

Dr. Robert D. Schrock was born in 1884 in Delaware, Ohio [3]. His father, William A., was a physician, as was his son, Robert D., Jr. The family subsequently moved to Decatur, Indiana. Dr. Robert Schrock obtained his undergraduate work at Wabash College, Crawfordsville, Indiana, in 1908 [2] and his medical degree at Cornell University Medical School in 1912 [2]. He completed postgraduate work at the New York Hospital in New York City. He briefly practiced in Omaha with Dr. John Lord, then served as a surgeon in WW I, working under Lt. Col. Joel Goldthwait in France. After the war he returned to Omaha to again practice with Lord. In 1921 he was appointed to the faculty of the University of Nebraska School of Medicine and became Professor and Chair in 1932, a post he held until 1949, when he became Professor Emeritus. Dr. Schrock became active in many medical organizations and in 1928 was elected President of the Clinical Orthopaedic Society, one of the two major groups that founded the AAOS, and was also active in the other, the American Orthopaedic Association. He was, as a result, involved in the early foundations of the AAOS, and became its President in 1940. He served as a civilian consultant to the Secretary of War from 1943 to 1945. With great prescience he commented in his Presidential Address to the AAOS in 1941 about Board certification, “This is not a hallmark of excellence in perpetuity. Products are frequently certified for a definite period of time if maintained under certain optimum conditions. Some people, like products, improve with advancing years, others deteriorate and some in cold storage remain frigidly good but no better. Orthopaedic surgeons, like human beings, are influenced by environment, necessity, ambition, health and avocational interest in other pursuits of happiness…If the measure of continued merit is to be maintained through our oncoming years, there need be an awareness of change, open mindedness to new concepts, elasticity in viewpoint, with a ready reception and stimulating encouragement to the newer generation whose future is in the making” [3]. The article we reprint describes a seemingly radical approach to a difficult problem: congenital elevation of the scapula (Sprengel’s deformity) [4]. Shrock noted the few previous attempts to address this problem were “…rather indefinite and in too many the results seemed discouraging. Most of the reports indicated considerable conservatism in the operative attack” [4]. He advocated “a far more radical procedure, but based upon the suggestions obtained from previous reports” [4]. As in earlier reports, he recommended sectioning the chondroosseous scapulothoracic bridge, but he then described a radical subperiosteal dissection of the scapula leaving the rhomboids, serratus magnus, and subscapularis muscles with the periosteal sleeve, then distally transplanting the entire scapula within that sleeve. (Interested readers can also see Campbell’s description in 1939 [1]). If this did not allow adequate drop of the scapula, he then performed an osteotomy at the base of the acromion. A postoperative dressing which maintained downward and backward pressure on the scapula was, he insisted, a critical detail. He reported two cases with good results in followup at 15 and 16 months postoperatively [4]. [Figure: see text] 1. Campbell WC. . Saint Louis, MO: CV Mosby Co; 1939. 2. Cornell Alumni News. 1912. Cornell College Web site. Available at: http://ecommons.library.cornell.edu/bitstream/1813/3529/5/014_36.pdf. Accessed August 17, 2007. 3. Robert D. Schrock, M.D. 1884–1960. . 1961;43:155–157. 4. Schrock RD. Congenital elevation of the scapula. . 1926;8:207–215.

摘要

罗伯特·D·施罗克医生于1884年出生在俄亥俄州的特拉华 [3]。他的父亲威廉·A. 是一名医生,他的儿子小罗伯特·D. 也是一名医生。随后,这个家庭搬到了印第安纳州的迪凯特。罗伯特·施罗克医生于1908年在印第安纳州克劳福德斯维尔的瓦巴什学院完成了本科学习 [2],并于1912年在康奈尔大学医学院获得医学学位 [2]。他在纽约市的纽约医院完成了研究生学业。他曾与约翰·洛德医生在奥马哈短暂行医,之后在第一次世界大战中担任外科医生,在法国的乔尔·戈德思韦特中校手下工作。战后,他回到奥马哈再次与洛德一起行医。1921年,他被任命为内布拉斯加大学医学院的教员,并于1932年成为教授兼系主任,他担任这个职位直到1949年,之后成为名誉教授。施罗克医生积极参与了许多医学组织,1928年当选为临床骨科学会主席,该学会是创立美国骨科学会的两个主要团体之一,他还积极参与了另一个团体美国骨科学会的活动。因此,他参与了美国骨科学会的早期创建,并于1940年成为其主席。1943年至1945年,他担任战争部长的文职顾问。他在1941年给美国骨科学会的主席致辞中对委员会认证有着极具前瞻性的评论:“这并非卓越的永恒标志。如果在某些最佳条件下保存,产品通常会在一定时期内获得认证。有些人,就像产品一样,会随着年龄的增长而进步,有些人会退化,有些人在冷藏状态下保持良好但并无改善。骨科医生,就像人类一样,会受到环境、需求、抱负、健康以及对其他幸福追求的业余兴趣的影响……如果要在未来的岁月里保持持续的功绩衡量标准,就需要意识到变化,对新观念保持开放的心态,观点具有灵活性,随时接受并积极鼓励正在塑造未来的新一代” [3]。我们重印的这篇文章描述了一种针对一个难题——先天性肩胛骨抬高(斯普伦格尔畸形)——看似激进的方法 [4]。施罗克指出,之前解决这个问题的少数尝试“……相当不明确,而且在太多情况下结果似乎令人沮丧。大多数报告表明在手术攻击方面相当保守” [4]。他主张“一种更为激进的手术方法,但基于从之前报告中获得的建议” [4]。与早期报告一样,他建议切断软骨骨化的肩胛胸壁桥,但随后他描述了一种激进的肩胛骨骨膜下剥离术,保留菱形肌、大菱形肌和肩胛下肌及其骨膜袖,然后将整个肩胛骨向远侧移植到该袖套内。(感兴趣的读者也可以参考1939年坎贝尔的描述 [1])。如果这不能使肩胛骨充分下降,他随后会在肩峰基部进行截骨术。他坚持认为,术后敷料对肩胛骨保持向下和向后施加压力是一个关键细节。他报告了两例病例,术后15个月和16个月的随访结果良好 [4]。[图:见原文] 1. 坎贝尔WC。. 密苏里州圣路易斯:CV莫斯比公司;1939年。2. 康奈尔校友新闻。1912年。康奈尔学院网站。可在:http://ecommons.library.cornell.edu/bitstream/1813/3529/5/014_36.pdf获取。2007年8月17日访问。3. 罗伯特·D·施罗克医学博士。1884 - 1960年。. 1961年;43:155 - 157。4. 施罗克RD。先天性肩胛骨抬高。. 1926年;8:207 - 215。

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本文引用的文献

1
Congenital High-Scapula, with Which Is Included a Consideration of Brevicollis.
Edinb Med J. 1924 Jan;31(1):22-44.