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History of Traumatology

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Medicine in ancient times

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A dressing used for the immobilisation of condylar process fractures of the mandible similar to a headcap has been described as early as 1500 BC in the papers of Edwin Smith.

The first therapeutic guidelines were found in the time of transition from the fifth to the fourth century in recordings of Hippocratic physicians. Hippocrates of Kos (ca. 460-370 BC) is certainly the most famous ancient physician.
In 400 BC, Hippocrates introduced the leather collar that was also used for immobilisation and is referred to as "Funda hippocratis".

Jaw dislocation and fractures were usually treated by headcap-like fixation with wax salves and linen bandages (perhaps similar to the chin holder described by Soranus of Ephesus in his book "On bandages").
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936 013: Abu al Qasim (Albucasis)

One of the most important Islamic physicians of the tenth and eleventh century from a surgical point of view is Abu al Qasim who lived in Spain, then under Arab rule. He was born in Cordoba where he worked and eventually died in 1013. He continued the traditional Hippocratic treatment of fractures.

12th century: Abbess Hildegard of Bingen (1098-1179)

The complete breakdown of the Roman Empire at the beginning of the 5th century and the division of its ancient Western hemisphere into new areas of government represented significant impediments to cultural and scientific development, if not the final collapse of ancient cultures.
Herbal tinctures are used as a universal remedy.
Examples of maxillofacial procedures are only given by Abbess Hildegard of Bingen who recommends an incision into the tongue in case of an abscess to let the pus drain.

11th and 12th century

Founding of the Medical School of Salerno for surgeons with the respective surgical procedures.

The Medical School of Salerno was characterised by a variety of medical texts translated from Arabic to Latin.

Council of Tours (1163)

The separation of the fields of surgery and internal medicine introduced by the Council of Tours in 1163 had serious consequences noticeable for several centuries. It was tantamount to the destruction of a unity that had been beneficial for the two disciplines and had been undisputed in antiquity. Surgery was no longer taught by professionals at medical universities but was considered a craft for which the responsibility lay with barber surgeons, herniotomists, lithotomists, and oculists. The Council of Tours in 1162/63 was, in this respect, characterised by the Church's declaration "Ecclesia abhorret a sanguine" (the Church abhors shedding blood) which prohibited the performance of surgery by physicians.

In Italy and France, there were movements against this senseless division.

Founding of a surgical guild in Paris in 1258

Louis XIV establishes the dental surgeon (Chirurgien dentiste) as a sub-discipline of the "barber surgeon".

1738–1818: Andreas Bonn

Illustration of mandibular fractures in an atlas of bone disease.

1865: Weber

Introduction of India-rubber splints by Weber, a dentist from Paris.
Intermaxillary fixation for the treatment of bone fractures used for the first time. Paris dentist J.A.C. Weber demonstrated the first European India-rubber splint in 1865 at a dentists' reunion in Leipzig. He took the impression while trying to maintain the fracture parts in the most favourable position.
His splint was only applied to the lower teeth; complete healing was supposed to occur within three weeks. Furthermore, the splint enabled the patient after only a short time to chew carefully since the incisal edges and occlusal surfaces were not covered, contrary to the interdental splint (Hoffmann-Axthelm 1995).

1890: Prof. Robert Baume (Berlin)

In his complete works, Prof. Robert Baume dedicated only 12 pages to the topic of traumatology.
A headcap is still used for the immobilisation of fractures.

1901: Julius Wieting

The "Funda hippocratis" is still a treatment of choice.
Additionally, surgical procedures with wire are introduced by Julius Wieting.

1869–1951: René Le Fort

René Le Fort introduces a three-level classification system for maxillary fractures.

1892–1956: Martin Wassmund

In 1927, Martin Wassmund, maxillofacial surgeon from Berlin, introduces a classification of fractures.

1907 - Perthes, and 1927 - Wassmund

Perthes Georg, 1869-1927
Perthes 1907: Trauma to and diseases of the jaw
Perthes and Wassmund support primary surgical treatment procedures for temporomandibular joint (TMJ) fractures.

1928: Ruedi

Ruedi favours conservative treatment procedures for TMJ fractures using prolonged immobilisation. This treatment approach was used until the beginning of the 1960s.

1958: AO Foundation

Four leading Swiss surgeons (Martin Allgoewer, Maurice E. Mueller, Robert Schneider and Hans Willenegger) founded the AO Foundation (specialising in osteosynthesis) establishing guidelines for the surgical treatment of fractures.