he lived with his maternal uncle, Dr. Hudson J.
Winnett, a busy general practitioner. He entered the University of Michigan School of Medicine in 1895 and graduated 4 years later. He then spent some time in New York at the Bellevue Hospital before returning to Lincoln and joining his uncle’s practice. He became dissatisfied with his life as a general practitioner, and in 1904 went to Chicago where he fell under the spell of Dr. John Ridlon, the Professor of Orthopedic Surgery at North- western University. After spending a summer in Chicago working with Dr. Ridlon, Orr returned to Lincoln filled with enthusiasm for his new specialty.
He then joined a group of individuals already lobbying for a crippled children’s hospital. In 1905 the legislature provided funds to open the State Hospital for the Crippled and Deformed.
This was only the third state-supported hospital of its type in the United States. Orr was intimately associated with the work of this hospital, later called the Nebraska Orthopedic Hospital, for 50 years.
During World War I, Orr was a member of the Goldthwait Unit of Young American Orthopedic Surgeons assembled by Dr. Goldthwait, and was sent to England for training under the aegis of Sir Robert Jones in preparation for service to American forces in France. Later, Orr was in charge of a base hospital in Savenay, France, where he was responsible for the care of thou- sands of patients with open fractures. It was his exposure to Dr. Ridlon and Sir Robert Jones that gave Orr an appreciation of the work of Hugh Owen Thomas and his principle of rest, enforced, uninterrupted and prolonged, and it was his expe- rience with large numbers of open, contaminated fractures, that led him to develop his method of treatment. At the end of the war, Orr was dis- charged with the rank of Lieutenant Colonel. He was always very proud of his army service, and after his death he was buried in Arlington ceme- tery in Virginia. After his return to civilian life, Orr perfected his method and applied it to cases of acute hematogenous osteomyelitis and open fractures. He wrote and lectured to promote its use. During the Spanish Civil War, Trueta used with great success the Orr method, with some modification, in the treatment of open fractures.
The use of the Orr and Trueta method has been eclipsed by the introduction of antibiotics and the emphasis on delayed primary or early secondary closure of wounds, coupled with effective inter-
nal fixation. It remains, however, a viable option for treatment in less than optimal conditions.
As early as 1903, Orr was lecturing on the history of medicine at the University of Nebraska.
He pursued his interest in medical history for the rest of his life. He was a collector of rare medical books. He gave his collection of more than 2,600 items to the American College of Surgeons, and it is now on permanent loan to the University of Nebraska College of Medicine. A second collec- tion of books on Anne of Brittany and her era was given to the Love Library at the University of Nebraska.
Orr had extensive experience as an editor, including a short stint as editor of the progenitor of The Journal of Bone and Joint Surgery, and as an author of numerous papers and several books.
He was president of the American Orthopedic Association in 1936. Orr was a well-known figure in Lincoln, NE, where it was common knowledge among the children that if your parents took you to see Dr. Orr, he would put you in a cast.
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Who’s Who in Orthopedics
Marino ORTOLANI
1904–1983
Very few non-orthopedic surgeons have con-
tributed as much to the study of congenital hip
pathology as Professor Marino Ortolani. He was
born in 1904, studied medicine in Bologna, Italy,
and became a pediatrician, opening his practice in
1929 in Ferrara, Italy. It is interesting how a single case completely changed the scientific interest and career of Professor Ortolani.
In 1935, a 5-month-old baby was brought to Professor Ortolani with a diagnosis of Cooley’s anemia. The child’s mother was worried because, since birth, she had felt a click every time the per- ineal region of the baby was washed. Professor Ortolani became very interested in this fact, asking the mother to reproduce this click. He carefully examined the baby and found that during abduction–adduction motion of the thigh, the click was clearly audible and palpable. He took an x-ray of the hips and congenital hip pathology was clearly recognized. From that day, Professor Ortolani started examining the hips in all newborn children born in his hospital and all babies brought to his clinic, and was amazed at the number of newborns with positive “click”
signs. He started treating these children in abduc- tion and external rotation of thighs, holding them loosely with three diapers. (It is a well-known fact that the province of Ferrara has one of the highest incidences of congenital dislocation of the hips in all of Italy.)
The young pediatrician Ortolani wrote his first paper in 1936 (in Atti Accademia Medica-
Ferrara) entitled, “A Very Little Known Sign andits Importance in the Early Diagnosis of Con- genital Hip Predislocation.” In that paper he described in detail the click, which later became known all over the world as Ortolani’s sign.
In 1938, Professor Ortolani became director of the Children’s Hospital, but his special interest remained the hips in newborn children and babies. In those years he contributed much to the very early diagnosis and treatment of congenital hip pathology in the province and town of Ferrara, and in 1946 the Italian government opened the
“Center for the Diagnosis, Prophylaxis and Treat- ment of Congenital Hip Dislocation,” which was the first of its kind in the world. Professor Ortolani became the director of this new center.
Professor Ortolani has diagnosed and treated personally over 8,000 children with congenital hip pathology. Since the opening of the Center for the Diagnosis, Prophylaxis and Treatment of Con- genital Hip Dislocation, Professor Ortolani had dedicated all of his professional and scientific activity to the congenital hip problem. His energy, organizational capabilities and his love of teach- ing were endless. He educated his nurses on the examination and treatment of congenital hip
pathology in the newborn and sent his nurses to the homes (in Italy not all children are born in the hospitals) of farmers to examine newborns and to treat the hips in the event of positive findings. (In many cases the nurses have to travel many hours on a bicycle to reach the most remote areas of the province of Ferrara.)
Professor Ortolani became interested in anatomical pathology of the congenital hip in 1938 and dissected numerous hips in very young babies who died from unrelated causes. He col- lected many excellent specimens of congenital hip pathology in the fetuses at all stages of intrauterine development, proving that congenital hip pathology already exists in the fetus. Profes- sor Ortolani was a pioneer of the very early diag- nosis and treatment of congenital hip pathology.
He had written 31 papers and one book on this subject. He had presented the papers at numerous pediatric and orthopedic meetings in Italy and all over Europe, and was an active participant at all SICOT meetings in the post-war period, present- ing papers on this subject.
Professor Ortolani was a very fine gentleman, whose kindness, generous hospitality, humility and endless patience were proverbial and well known to the numerous visitors from all over the world. The immense love and patience in treating these small children who came to walk normally after completion of his treatment and the gratitude of their parents became the compelling purpose of Professor Ortolani’s life and work.
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