Chapter 10. Orthopedics in the Russian Empire and the USSR

Orthopedics in Russia originated in St. Petersburg at the Medical and surgical Academy. Particularly noteworthy for Russian orthopedics and traumatology is 1806, when the book «The first principles of bone science» by Professor E. O. Mukhin of Moscow University (1756–1850) was published, which gave an impetus to the development of surgical treatment of diseases of the organs of movement in Russia.

Fig. 10.1. Efrem Osipovich Mukhin (1766–1850) — Professor at Moscow University

In the first half of the 19th century, thanks to the works of I.F. Bush, E.O. Mukhin, I.V. Buyalsky, N.I. Pirogov and their students, general principles of treatment of patients with bone fractures were developed in Russia, based both on the centuries-old experience of providing medical care to victims and on the achievements of world scientific medicine. These included: matching broken bone fragments (reposition); immobilizing the injured limb (immobilization) to hold the matched fragments for the period necessary for the fracture to heal; prevention of complications and treatment aimed at restoring limb function.

Fig. 10.2. Title page of the book by E.O. Mukhin «First beginnings bone science»

Fig. 10.3. Nikolai Ivanovich Pirogov (1810–1881)

Surgeon and anatomist, naturalist and teacher, Professor, Creator of the first Atlas of topographic anatomy, founder of the Russian military field surgery, founder of the Russian school of anesthesia.

The simplicity and accessibility of the method, the reliability of immobilization of broken bone fragments made it the main medical aid for surgeons in the clinical practice of peace and, especially, wartime.

For the wounded with gunshot fractures of the limb bones and wounds of large joints, it became an alternative to the amputations and exarticulations that were inevitable in those years, which allowed N.I. Pirogov to call it a saving method of treating the wounded. The famous surgeon was a pioneer in the use of anesthesia in operations. He had the idea to apply plaster for fractures, before that, doctors used a wooden splint. N.I. Pirogov’s contribution to the development of topographic anatomy is significant. Still relevant are his works on the anatomy of the arterial trunks and of fascia, and Pirogov cuts of frozen corpses, «ice sculpture» formed the basis of modern clinical methods of visual studies (CT, MRI, etc.). So he was the first among the Russian scientists came up with the idea of plastic surgery and among the first in the world that put forward the idea of bone grafting, published in 1854, 21 work «Osteoplastic elongation of the bones, disarticulation of the foot». The principles of sorting the wounded, evacuation «on themselves» are still part of the modern military medical doctrine of different countries. N.I. Pirogov played a significant role in the development of asepsis and antiseptics.

Fig. 10.4. «Ice anatomy» of N.I. Pirogov — prototype of CT and MRI

In the 80s of the 19th century, the Medical and surgical Academy created an independent Department of desmurgy and mechanurgy, which was headed by I.G. Karpinsky. In 1894, the head of this Department was Henry Ivanovich Turner — a pioneer and founder of Russian orthopedics. Having organized the first Department and clinic of orthopedics in Russia in 1900, H.I. Turner laid the scientific and clinical foundations of this most important branch of surgery, and created the national school of orthopedists.

Fig. 10.5. Henri Ivanovich Turner (1858–1941) — doctor, orthopedic surgeon. Full councilor. Honored scientist of the RSFSR (1927)

In 1906, a new orthopedic institution was opened — Russian Orthopedic Institute. It was founded thanks to the initiative and great perseverance of one of the major orthopedists of that time, doctor of medicine Karl Khristianovich horn. Further, the Director of the orthopedic Institute was appointed an official of special assignments of the VII class at the Main Military Medical Department, doctor of medicine, state Councilor Roman Romanovich Vreden. The Institute performed arthrotomies, arthroplastics, arthrodeses, tendon and bone grafting, osteotomies, bloody dislocations, resections and other operations.

Fig. 10.6. Roman Roma­novich Vreden (1867–1934) — Russian and Soviet doctor, military field surgeon, orthopedic surgeon

R.R. Vreden is rightfully the founder of operative orthopedics in Russia. He suggested 21 method of surgeries: arthroplasty of the hip and knee joints, tendon and bone grafting, fixation of the lumbar spine, osteotomy, open reduction of the hip dislocation, etc.

In November 1918 in Kazan, Professor M.O. Fridland organized orthopedic facility orthopedic hospital with 40 beds, which in 1920 became part of Kazan state clinical Institute for improvement of doctors as the Department of orthopedics.

In 1921, at the initiative of Professor V.N. Rozanov, a Medical and prosthetic Institute was established in Moscow under the leadership of Nikolai Nikolaevich Priorov.

Fig. 10.7. Nikolai Niko­laevich Priorov (1885–1961) — Soviet orthopedic traumatologist, academician of the USSR Academy of medical Sciences

After the end of the Great Patriotic war in 1945–1946, research institutes were organized in Nizhny Novgorod, Irkutsk, Novosibirsk, Saratov, Prokopyevsk (Kuzbass research Institute), and later in Kurgan.

Literature

1. Мухин Е.О. Первые начала костоправной науки в 2 книгах, в 5 частях, с приложением 37 чертежей. М., 1806.
2. Травматология и ортопедия: Учебник / Под ред. Н.В. Корнилова. 3-е изд., доп. и перераб. 2011. 592 с.