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General Orthopaedics

TRAUMA ADVANCES IN THE LAST HALF-CENTURY

Australian Orthopaedic Association Limited (AOA)



Abstract

In 1788, a significant date for Australia, and also for Sir Percival Pott and us, as it was the year Sir Pott fractured his ankle. Wars, as well as individuals like Sir Pott, play a strong role in trauma technique advancement, exemplified by the Thomas splint and the Kuntscher nail. Over the 50 years of my clinical lifetime, a significant period of rapid advancement in knowledge and technology very fortunately occurred and with which I was involved in.

In the 1960s, the strong and long ingrained conservative influence of the British Orthopaedic school of trauma care was challenged by the equally long-established but more aggressive European school, in the form of the Swiss AO Foundation (Arbeitsgemeinschaft für Osteosynthesefragen). Australia was ‘a ham in the sandwich’. Which way to go? The pilgrimage to Davos produced some early converts. Phillip Segelov and I were among those and we returned three times to become educators and trainers for the AO Foundation.

We convened AO courses in Australia, with our St George-made colour videos (before the Swiss). In 1980 the St George Skills Laboratory was born and became the venue for ongoing technique education. This became known (by some, and not always as a compliment) as the ‘Phil and Bill show’. Almost all who underwent this early training, including Phil and Bill, experienced an initial phase of doubt and rejection. This was metallic madness. However, we had new teachers, new parents, and we learnt to respect them. Interesting and controversial days were to follow.

Unfortunately, a number of our very senior Australian colleagues clearly felt deeply confronted. They clinically rejected and in open meeting condemned these aggressive concepts. We were very concerned. This unfortunate circumstance subsided only slowly over time and in concert with the decline of their influence.

Interestingly, today, successful trauma unit bed administration and outcomes depend significantly on our use of these concepts and methods. We could not practice modern traumas care without them.