Fischer L P, Fischer-Athiel C, Fischer B S
Service de Chirurgie Orthopédique, Hôpital Edouard-Herriot, Lyon.
Ann Chir. 1998;52(3):264-78.
Throughout the XIXth century and until 1945, bone surgery focused primarily on correcting deformities in children. The treatment of injury-related bone lesions in adults (compound fractures and dislocations) remained within the province of general surgeons until circa 1970. Lyons played a unique role in the XVIIIth and XIXth centuries, for three reasons. 1) The term "orthopedics" (which means "straight children", or "children to be made straight") was coined in 1743 by an 80-year-old inhabitant of the Saint Nizier parish in Lyons, Nicolas Andry or André, a former dean of the Paris School of Medicine. The term was adopted throughout the world. 2) The first French orthopedic surgeon was Gabriel Pravaz, who was from the Pont-de-Beauvoisin neighborhood of Lyons. He treated "children to be made upright" in his orthopedic and pneumatic institute located quai des Etroits, and was the first to successfully reduce congenitally dislocated hips (before 1850). 3) In 1987, the most famous bone surgeon was Ollier, who brilliantly applied the method developed by Claude Bernard to the experimental study of the role of the periosteum. He observed that new bone was laid down after "subperiosteal resection" of infected bone or joint tissue. His technique allowed to reduce dramatically the number of limb amputations for infection. In 1897, in addition to Ollier (who died in 1900), many other outstanding surgeons from Lyons demonstrated an interest in bone surgery. Around 1897. Jaboulay (known as a vascular and transplantation surgeon) successfully performed amputations through the middle of the pelvis. Also during this period, Gangolphe used osteotomies to correct limb deformities, and also performed bone grafts. Between 1897 and 1910, the radiologist E. Destot, who worked at the Hôtel-Dieu hospital in Lyons, published two books on the classification of fractures, "The wrist" and "The foot", both of which were promptly translated in English. The Lyons School at the Hôtel-Dieu that demonstrated its excellence in the XIXth century gave birth in the XXth century to a school of infantile bone surgery, headed by G. Nové-Josserand from 1894 to 1937 then by L Tavernier from 1937 to 1947. Tavernier was a sports enthusiast, and was proficient not only in pediatric surgery but also in the areas of meniscal lesions and bone tumors. He was succeeded by Guilleminet (1947-1962), then by Joseph Marion. Two teaching hospital departments of adult orthopedic surgery were created, one headed by Albert Trillat, who, together with H. Dejour and A. Mounier-Khun, was known throughout Europe as an outstanding sports injury surgeon, and the other by Jean Creyssel, who worked with G. de Mourgues and played a significant role in France in bringing trauma-related injuries (traditionally treated by general surgeons) into the field of orthopedic surgery. The first successful total hip arthroplasty procedures were done around 1966. Orthopedics and traumatology became a separate specialty in 1969, and in the wake of this change many departments focusing only or preferentially on one part of the body (e.g., the hand and upper limb, knee, or hip) were created. Over the last century, the Lyons Society for Surgery has played a key role in publishing discoveries in bone surgery and in disseminating knowledge in this field. Although societies for surgery of the hip, knee, spine, hand, foot, and so on now exist, meetings of the Lyons Society for Bone Surgery remain useful since new ideas and techniques sometimes stem from experience acquired in other fields. It is worthy of note that in other European countries traumatology is a specialty in itself, which includes visceral and bone traumatology. It can be anticipated that harmonizing the traumatology specialty in Germay and the orthopedic surgery and traumatology specialty in France may raise a number of problems.
在整个19世纪直至1945年,骨外科主要专注于矫正儿童畸形。成人损伤相关骨病变(复合骨折和脱位)的治疗在1970年左右之前一直属于普通外科医生的范畴。里昂在18世纪和19世纪发挥了独特作用,原因有三。1)“矫形外科学”(意为“矫正儿童”或“使儿童变直”)一词由里昂圣尼济埃教区一位80岁的居民尼古拉·安德里或安德烈于1743年创造,他曾是巴黎医学院院长。该词在全世界被采用。2)第一位法国矫形外科医生是加布里埃尔·普拉瓦,他来自里昂的博沃辛桥街区。他在位于埃特鲁瓦码头的矫形和气动研究所治疗“有待直立的儿童”,并且是第一个成功复位先天性髋关节脱位(1850年之前)的人。3)1897年,最著名的骨外科医生是奥利耶,他出色地将克劳德·贝尔纳开发的方法应用于骨膜作用的实验研究。他观察到在对感染的骨或关节组织进行“骨膜下切除”后会形成新骨。他的技术极大地减少了因感染而进行的肢体截肢数量。1897年,除了奥利耶(他于1900年去世)之外,许多来自里昂的杰出外科医生也对骨外科表现出兴趣。大约在1897年,雅布莱(以血管和移植外科医生而闻名)成功地在骨盆中部进行了截肢手术。同样在这一时期,冈戈尔夫使用截骨术矫正肢体畸形,并且也进行了骨移植。1897年至1910年间,在里昂迪厄医院工作的放射科医生E. 德索托出版了两本关于骨折分类的书籍,《腕部》和《足部》,这两本书很快被翻译成英文。迪厄医院的里昂学派在19世纪展现出卓越,在20世纪催生了一所儿童骨外科学派,1894年至1937年由G. 诺韦 - 若瑟兰领导,1937年至1947年由L. 塔维尼耶领导。塔维尼耶是一位体育爱好者,不仅精通小儿外科,还擅长半月板损伤和骨肿瘤领域。他之后由吉耶米内(1947 - 1962年)接任,然后是约瑟夫·马里昂。创建了两个成人矫形外科教学医院科室,一个由阿尔贝·特里拉特领导,他与H. 德茹尔和A. 穆尼耶 - 昆一起,作为杰出的运动损伤外科医生在欧洲闻名,另一个由让·克雷塞尔领导,他与G. 德莫尔格斯合作,在法国将创伤相关损伤(传统上由普通外科医生治疗)引入矫形外科领域发挥了重要作用。第一批成功的全髋关节置换手术大约在1966年完成。矫形外科学和创伤学在1969年成为一个独立的专科,在此变化之后,创建了许多仅专注或优先专注于身体某一部位(例如手和上肢、膝盖或臀部)的科室。在过去的一个世纪里,里昂外科学会在发表骨外科发现以及传播该领域知识方面发挥了关键作用。尽管现在存在髋关节、膝关节、脊柱、手部、足部等外科学会,但里昂骨外科学会的会议仍然很有用,因为新的想法和技术有时源于在其他领域获得的经验。值得注意的是,在其他欧洲国家,创伤学本身就是一个专科,包括内脏和骨创伤学。可以预见,协调德国的创伤学专科和法国的矫形外科与创伤学专科可能会引发一些问题。