Bunnell. Colles. Dupuytren. Erb. These and countless other names litter the lexicon of orthopedic surgery. Eponyms abound from the moment one enters residency, providing prime “pimp” fodder for senior surgeons to accost trainees. Besides striking fear into the hearts of residents in morning conferences, eponyms do serve another purpose. They preserve our history. Contributions of giants in the field are immortalized, perpetuated every time one glimpses a characteristic X-ray or particular pathognomonic posture of a limb. Yet in orthopedic surgery, these eponyms share another commonality — they are nearly universally male. Much has been written about gender disparity in orthopedic surgery training and practice. From articles in the public domain, to manuscripts in the peer-reviewed literature, to calls for action by the American Academy of Orthopaedic Surgeons (AAOS), the gender bias is no secret. Women make up only 4 percent of AAOS members and 14 percent of orthopedic residents. In pursuing true equity within orthopedics, we must seek a better historical understanding of women’s names and contributions in our field. Eponyms should not favor gender. They stand as an homage to our academic ancestors, and it behooves us to learn of the life and work of both male and female predecessors that paved our path. Unsurprisingly, very little is written or elegantly cataloged about the influence of women in orthopedic surgery. This stands in stark contrast to the many repertoires of male orthopedic eponyms, which are often too numerous to count. Below are four women who made powerful contributions to the field of orthopedics and whose names should be remembered in kind. The very term “orthopedics” stems from Greek –— orthos means “to straighten or correct,” and paedion means “child.” As the name of our field arose from skeletal deformity correction in children, no repository of orthopedic history would be complete without mentioning Dr. Min Mehta (1926-2017). Few have made such monumental contributions to pediatric deformity correction as Dr. Mehta. Born in Iran and trained in India and the U.K., Dr. Mehta rose to prominence at a time of fierce challenge to women in surgery. In part motivated by her own struggle with deformity from severe juvenile scoliosis, Dr. Mehta pioneered the methodical assessment of infantile scoliosis and the body casting technique that bears her name. Her landmark 2005 treatise demonstrated that assessing rib-vertebral relationships and targeted cast molding with selective pressure along rib prominences can correct infantile scoliosis without spinal fusion surgery. Dr. Mehta received countless accolades and recognition throughout her career, fitting for an individual who devoted her life to the very definition of “orthopedics.” Another deformity that is familiar, at least in name, to every first-year medical student and beyond is that of Klumpke’s Palsy. Known also as Klumpke’s claw, or Klumpke’s hand, this condition was first described by the neuroanatomist Dr. Augusta Klumpke (1859-1927). She undertook extensive research on brachial plexopathy, associating the characteristic features of the now-eponymous Klumpke’s hand with that of lower trunk (C8-T1) plexus injuries, often associated with Horner’s Syndrome. In addition to the condition bearing her name, Dr. Klumpke was one of the first to describe heterotopic ossification following spinal cord trauma and the pathoanatomic features of lead neurotoxicity. She surmounted robust discrimination to produce the medical advances described, including from her dean of faculty, who stated, “The role of a woman is to create a home and to devote herself to her husband and her children.” Despite the constant barrage of misguided misogynism, Dr. Klumpke excelled. She received numerous awards and national honors, becoming the first female President of the Society of Neurology of Paris. Classification and scoring systems are common in orthopedics, and few are as ubiquitously recognized as the Beighton Score. Named after Greta Beighton (1939-2017) and her husband Peter, this system categorizes joint hypermobility across the body and is instrumental in the diagnosis and management of patients with conditions such as Ehlers-Danlos, Marfans, and Loeys-Dietz. Hypermobility is not confined to those with syndromes, and every orthopedic resident is well versed in calculating this score during the examination of patients with shoulder instability or patellar mal-tracking. Beighton was also a prolific geneticist and epidemiologist, studying diseases and inheritance in South African populations. Sadly, she was routinely excluded from authorship in publications despite major influence, as her husband feared perception of nepotism might arise. Her name and impact will live on as orthopedic surgeons the world over continue to calculate the Beighton Score in examination rooms to this day. When one considers the uniquely human trait of bipedal locomotion, no individual has left as indelible a mark on our understanding of ambulation and gait as Dr. Jacquelin Perry (1918-2013). Dr. Perry’s career began as a physical therapist, serving in the U.S. Army during World War II. She subsequently earned her medical degree and became one of the first women certified by the American Board of Orthopaedic Surgery. She then joined, and eventually led, the Rancho Los Amigos Rehabilitation Center in southern California. Through her care of patients with polio and spinal cord injury, she and Dr. Vernon Nickel pioneered the Halo frame, which is still used today for external stabilization and traction of cervical spine injuries. Dr. Perry struggled with health challenges of her own, and a diagnosis of cerebral artery stenosis put a halt to her surgical career. Yet this did not hold her back. Dr. Perry began her analysis of ambulation, founding the Gait Analysis Lab at Rancho and laying the foundation for similar laboratories across the world. Her work in this arena led to the authoritative text “Gait Analysis: Normal and Pathologic Function.” Despite struggling with Parkinson’s during her later years, Dr. Perry remained an avid mentor to thousands of aspiring doctors, engineers, and scientists. She was a founding member of the Scoliosis Research Society and the Ruth Jackson Orthopaedic Society. In 2009 the Perry Initiative was created, honoring her name and legacy, and providing a pipeline for women interested in science, technology and orthopedics. Next time you sit in the morning conference, sweating at the prospect of eponym interrogation by your attending, think beyond the name and its associated fracture pattern or surgical approach. Ponder the history of discovery and advancement. Ponder the reality of inequity, and understand that innovation is not the realm of one gender. Don’t just ask who was Sterling Bunnell or Abraham Colles. Ask who was Min Mehta and Augusta Klumpe. And ponder who are the countless others that will follow in their footsteps. Will it be you? Source
