Advertisement

International Orthopaedics

, Volume 43, Issue 2, pp 493–499 | Cite as

Hallmarks of amputation surgery

  • Konstantinos Markatos
  • Marianna Karamanou
  • Theodosios Saranteas
  • Andreas F. MavrogenisEmail author
Orthopaedic Heritage

Abstract

Purpose

To highlight the most important innovations and milestones in the historical evolution of amputation and disarticulation surgery through the ages, from the early antiquity until the modern era.

Method

A thorough search of the literature was undertaken in PubMed and Google Scholar as well as in physical books in libraries to summarize current and classic literature on the hallmarks of the history of amputation surgery in the course of medical history.

Results

Amputation of a limb is one of the oldest surgical procedures. Initially, it was fraught with complications and dismal outcome of the patients because of hemorrhage and infection. Due to lack of analgesics and narcotics the operation had to take only a few minutes. Obtaining experience, the surgeons evolved the operative technique and refined the procedure, anesthesia and perioperative analgesia was introduced, instruments were developed, and rehabilitation has enabled functional and social reintegration of amputees.

Conclusion

From the Hippocratic era until currently, the surgical approach to amputation has changed little. However, the indications for amputations have changed a lot and had been refined, especially in diabetic patients and in those with severe chronic peripheral vascular disease. An exponential decrease in mortality for an operation once fraught with complications was due to the development of the tourniquet, proper vessel ligation and repair, antisepsis, and anesthesia.

Keywords

Amputation History 

Notes

Compliance with ethical standards

Conflicts of interest

The authors declare that they have conflicts of interest.

References

  1. 1.
    Paré A (1840–1841) Oeuvres d’Ambroise Paré. Paris, France: J-B BaillièreGoogle Scholar
  2. 2.
    Renner C (2014) The tourniquet of Jean-Louis Petit [in French]. Hist Sci Med 48:125–130Google Scholar
  3. 3.
    Lister J (1870) On the effects of the antiseptic system of treatment upon the salubrity of a surgical hospital. Lancet 1:84–101Google Scholar
  4. 4.
    Petit J-L (1741) D’un nouvel instrument de chirurgie. Mémoires de l’Academie Royale des Sciences (Paris). In: Histoire de l’Academie Royale des Sciences (Paris) 1718. Avec les mémoires de mathématique et de physique pour la même année. Paris, L’Imprimerie Royale, 199–202Google Scholar
  5. 5.
    Verduin PA (1697) Nouvelle Méthode pour Amputer les Membres (translated by J. Vergiol).Amsterdam. J Wolters 4–24Google Scholar
  6. 6.
    Ravaton H (1770) Pratique moderne de la chirurgie. L’Imprimerie Royale, Paris, pp 217–238Google Scholar
  7. 7.
    Sachs M, Jorg B, Encke A (1999) Historical evolution of limb amputation. World J Surg 23:1088–1093CrossRefGoogle Scholar
  8. 8.
    Kirkup J (2007) A history of limb amputation. Springer-Verlag, LondonGoogle Scholar
  9. 9.
    Mavroforou A, Koustia S, Fafoulakis F, Balogiannis I, Stamatiou G, Giannoukas AD (2007) The evolution of lower limb amputation through the ages: historical note. Int Angiol 26(4):385–389Google Scholar
  10. 10.
    Samzun A, Durand S, Nicolle F (2006) Le site néolithique de Buthiers et Boulancourt «Le Chemin de Malesherbes» (Seine-et-Marne): résultats préliminaires. In: Internéo 6 Journées d’ information du 18 novembre 2006, Paris, ouvrage publié par l’Association pour les Etudes Interrégionales sur le Néolithique (INTERNEO) et la Société Préhistorique Française: 45–54Google Scholar
  11. 11.
    Buquet-Marcon C, Philippe C, Samzun A (2007) The oldest amputation on a Neolithic human skeleton in France. Nature Precedings 1–14Google Scholar
  12. 12.
    Magee R (1998) Amputation through the ages: the oldest major surgical operation. Austr NZ J Surg 68:675–678CrossRefGoogle Scholar
  13. 13.
    Kennedy MT (2004) A brief history of disease, science and medicine. Asklepiad Press, Mission ViejoGoogle Scholar
  14. 14.
    Sullivan R (1996) The identity and work of the ancient Egyptian surgeon. J R Soc Med 89(8):469CrossRefGoogle Scholar
  15. 15.
    Porter R (1999) The greatest benefit to mankind: a medical history of humanity. WW Norton, New YorkGoogle Scholar
  16. 16.
    Hippocrates (2004) Vol. I: Ancient Medicine. Airs, Waters, Places. Epidemics 1 and 3. The Oath. Precepts. Nutriment (No. 147; translated by W.H.S. Jones); Vol. II: Prognostic. Prognostic. Regimen in Acute Diseases. The Sacred Disease. The Art. Breaths. Law. Decorum. Physician (Ch. 1). Dentition (No. 148; translated by W.H.S. Jones); Vol. III: On Wounds in the Head. In the Surgery. On Fractures. On Joints. Mochlicon (No. 149; translated by E.T. Withington); Vol. IV: Nature of Man. Regimen in Health. Humours.Aphorisms. Regimen 1-3. Dreams. Heracleitus: On the Universe (No. 150; translated by W.H.S. Jones); Vol. V: Affections. Diseases 1. Diseases 2 (No. 472; translated by P. Potter); Vol. VI: Diseases 3. Internal Affections. Regimen in Acute Diseases (No. 473; translated by P. Potter); Vol. VII: Epidemics 2, 4-7 (No. 477; translated by W.D. Smith); Vol. VIII: Places in Man. Glands. Fleshes. Prorrhetic 1-2. Physician. Use of Liquids. Ulcers. Haemorrhoids and Fistulas (No. 482; translated by P. Potter). Loeb Classical Library, Harvard University PressGoogle Scholar
  17. 17.
    Lichtenthaeler C (1975) Geschichte Der Medezin. Deutscher Arzte-Verlag GmbH, Koln-LovenichGoogle Scholar
  18. 18.
    Robinson KP (1991) Historical aspects of amputation. Ann R Coll Surg Engl 73:134–136Google Scholar
  19. 19.
    Ellis H (2001) A history of surgery. Greenwich Medical Media Ltd, LondonGoogle Scholar
  20. 20.
    Celsus AC (1838) Della medicina di Aulo Cornelio Celso libri otto. Dalla tip. di Giuseppe Antonelli, VeneziaGoogle Scholar
  21. 21.
    Hernigou P (2013) Ambroise Paré IV: the early history of artificial limbs (from robotic to prostheses). Int Orthop 37(6):1195–1197CrossRefGoogle Scholar
  22. 22.
    Padula PA, Friedman LW (1987) Acquired amputation and prosthesis before the sixteenth century. Angiology 38:133–141CrossRefGoogle Scholar
  23. 23.
    Lascaratos J, Voros D, Tsiamis C (2003) Paul of Aegina: landmark in surgical progress. World J Surg 27(12):1336CrossRefGoogle Scholar
  24. 24.
    von Gersdorff H (1967) Feldbuch der Wundarznei. Ed. Wissenschaftliche Buchgesellschaft, DarmstadtGoogle Scholar
  25. 25.
    Di Matteo B, Tarabella V, Filardo G, Viganò A, Tomba P, Marcacci M (2013) The traumatologist and the battlefield: the book that changed the history of traumatology. J Trauma Acute Care Surg 74(1):339–343CrossRefGoogle Scholar
  26. 26.
    Hernigou P (2013) Ambroise Paré II: Paré's contributions to amputation and ligature. Int Orthop 37(4):769–772CrossRefGoogle Scholar
  27. 27.
    Markatos K, Tzivra A, Tsoutsos S, Tsourouflis G, Karamanou M, Androutsos G (2018) AmbroiseParé (1510-1590) and His Innovative Work on the Treatment of War Injuries. Surg Innov 25(2):183–186Google Scholar

Copyright information

© SICOT aisbl 2018

Authors and Affiliations

  1. 1.Biomedical Research Foundation of the Academy of AthensAthensGreece
  2. 2.Department of History of MedicineUniversity of Crete, School of MedicineHerakleionGreece
  3. 3.Second Department of AnesthesiologyNational and Kapodistrian University of Athens, School of MedicineAthensGreece
  4. 4.First Department of OrthopaedicsNational and Kapodistrian University of Athens, School of MedicineAthensGreece

Personalised recommendations