Otto MADELUNG1846–1926

fellows, and residents to future orthopedic sur- geons as a viable continuation of his presence.

Ian Macnab died on November 25,1992, at the Toronto General Hospital, after a brief illness. He leaves behind his wife, who met Ian when she was a charge nurse in the orthopedic operating room at the Toronto General Hospital, and his three children.

and after a period under house arrest he retired to Gottingen.

Apart from his work on intestinal resections, intestinal typhoid, obstruction and so on, Madelung was one of the first advocates of early laparotomy for abdominal injuries. In 1909 he described arthrotomy of the shoulder from behind. His description of deformity at the wrist was not original, and only a little more complete than descriptions by Dupuytren and R.W. Smith, which had appeared many years previously.

It is difficult to give much impression of his personality—someone described him as a

“serious and conscientious man with powerful will” and this rather stern picture is supported by one of his sayings: “Every clinical lesson must be prepared and conducted in such a way that every student who contemplates missing the class must feel that he would miss something important.”

Madelung regarded the wrist deformity as a defect of growth of the wrist joint. It was not due to trauma or infection. Heavy work by young people produced more pressure on the anterior part of the distal radial epiphysis than the poste- rior part. In those with “primary weakness of bone” this degree of pressure may cause the ante- rior part of the epiphysis to stop growing. As a result, the lower end of the radius comes to be angulated forwards. The carpal bones are also compressed and show changes.

Treatment was not successful. Surgically replaced hands relapsed. However, Madelung noted that the pin disappeared after time, even when the subluxation was gross, and that the capacity for work was not impaired.

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Who’s Who in Orthopedics

Otto MADELUNG

1846–1926

Madelung was an abdominal surgeon—he flour- ished during the time that surgery was beginning to have something to offer the patient with abdominal disease. His orthopedic contributions, though they caused his name to decorate text- books, were slight.

He was born in Gotha, the son of a merchant,

and he studied at Bonn and Tubingen. After

serving in the Franco-Prussian war of 1871, he

settled in Bonn, and during this time he wrote his

paper on wrist deformity. He became assistant

professor of surgery at Bonn in 1881, then at

Rostock, before becoming professor at Strasburg

in 1894, where he was the youngest member of

the medical faculty. He built up the hospital at

Strasburg along German lines and continued to

work there until the city was recovered by the

French at the end of the First World War. Then all

the German professors were replaced by French