Medicine: Breakbones, Bonesetters

As the foremost cripple in the world, the American Academy of Orthopedic Surgeons wanted President Roosevelt to attend their banquet in Manhattan last week. They asked one of their colleagues. Dr. Michael Hoke. the President's good friend and surgeon-in-chief of Georgia

Warm Springs Foundation, to extend the banquet invitation. President Roosevelt regretted that he could not leave Washington, "but I do want to tell you . . . that [your] aim happens to be one of the undertakings closest to my own heart. It is largely through the work of some men who have practiced your specialty that America and the world have progressed so far in the prevention of deformity and in the bringing up of 'straight' children."

Orthopedist Philip Duncan Wilson of Manhattan, president of the Academy, read the message, called off the names of other famed cripples—,Æsop. Richard III, Alexander Pope, Lord Byron, Sir Walter Scott—and pointed to one-legged Dramatist Laurence Stallings who was at the speakers' table of the banquet. From their successes Dr. Wilson drew a moral: "The orthopedic surgeons have the duty not only of relieving the patient of physical deformity, but of watching over his mental training during the long periods of hospitalization. The cripple must be made to understand that while his disability can be greatly relieved, he will always carry some slight defect and his chances of success in life can be greatly helped by proper psychological preparation."

With these preliminaries out of the way, the orthopedists listened to promising means of preventing and remedying bodily deformities, as follows:

Corset Patterns, At Georgia's Warm Springs Surgeon Michael Hoke invented a clever pattern for the steel-framed corsets which some victims of infantile paralysis wear to keep their spines from growing crooked. Dr. Hoke molds strips of lead to the patient's body, then fashions steel corset "bones"' to duplicate the lead patterns exactly.

Spiked Hips. The unshapely knob at the top of the thigh bone (femur) is the hip bone. When a person, especially if elderly, falls the knob is apt to break off from the thigh bone. Healing has been a tremendously difficult and painful process. Last year Dr. David Robert Telson of Brooklyn suggested piercing the knob and shaft and lacing them together with stout piano wire. This procedure works to a degree. But the stoutest piano wire gives a little. Last week Dr. Frederick J. Gaenslen of Milwaukee said that he got dependable cures of broken hips by nailing the knob and shaft together with steel spikes about half the thickness of a lead pencil.

Shelved Hips. Dislocation of the hip is apt to recur when the muscles which hold the hip bone into the shallow hip socket have been weakened. Injury or infantile paralysis will do this. Dr. Marion Beckett Howorth of Manhattan invented a way of overcoming the slipping of the joint. He cuts through the flesh at the hip, lays bare the joint. Then he carefully breaks the part of the pelvic bone which forms the upper edge of the hip socket. The loosened piece of bone he bends down and wedges securely with bone grafts. After healing, the downturned chunk of pelvis acts like a claw to hold the hip bone within its socket. The new grip is just tight enough to let the leg swing at the hip.