Leg-braces - their history

In the mid twentieth century when the polio epidemics were at their zenith, leather and steel leg-braces were quite a common sight. When did they first appear? Who invented them? This is a brief history of the leg-brace based on the information I've managed to glean from various books and internet sources. It is very hard to find a clear history of the leg-brace as such and I am not aware of a single book on its history, which is perhaps surprising when one considers how important they have been in the last century or more.

There are several articles on the history of orthopaedics in general including that by Vlasios Brakoulias [1].  I claim no originality for what is written here and recommend you look to the references for more detailed data.  Should you spot errors, please let me know.

The leg-brace timeline

A Persian called Abu Mansur Muwaffak first described the coating of plaster for fractures and other bony injuries of the limb. 

A 16th century Frenchman, Ambroise Pare, designed a wide variety of braces and artificial limbs as well as a scoliosis corset and a clubfoot boot.

The word "Orthopaedics" was first used by a French physician, Nicolas Andry, in 1741 at a time when the term was largely used in connection with the correction of childhood deformities such as rickets. It is derived from the two Greek Words orthos meaning straight and paedios meaning child [2].

The 18th century Swiss physician Jean-Andre Venel specialised in the treatment of deformities in crippled children. He is known as the father of orthopaedics, making various braces and appliances at his institute.

The 19th century Dutchman, Antonius Mathysen,invented the plaster of Paris bandage for the immobilisation of fractures.

A British doctor from Liverpool, Hugh Owen Thomas, is reknown as the father of British orthopaedics. He was a qualified doctor from a family of "bone setters". Wandering in the beautiful Welsh countryside, Thomas acquired the art of splinting birds and animals with broken bones.  At odds with other common methods of his time, he invented several types of splints, with rigid steel bars, to allow rest and immobilisation in the treatment of fractures and tuberculosis. These splints were manufactured in his own workshop by a blacksmith and a saddler. The Thomas Splint is still used today. Thomas's splints are probably the true starting point of the orthopaedic leg-brace that we know today [3].

Thomas's nephew Sir Robert Jones promoted orthopaedics training as a speciality in Liverpool and he has a spinal brace named after him, the Robert Jones brace [4].

It was not until the 20th century when the most significant contributions to orthotic sciences were made, stimulated by the aftermath of the first and second world wars and the polio epidemics of the late 1940’s and early 1950s [6]. 

After graduation in 1952, Ronald Huckstep worked in Africa mainly on the treatment of polio. He developed many splints and other useful devices, including the Huckstep Nail. He became Professor of Orthopaedic Surgery at the University of New South Wales in 1973.

For about 100 years the basic design of the leg-brace has hardly changed although leather buckles and straps have been replaced increasingly by velco fastenings. The steel uprights have also been replaced by lighter weight, but stronger, metals. In the last 20 years the design of the leg-brace has moved on somewhat with more use of cosmetic stylings. These are considered more user-friendly and less "orthopaedic" in appearance. They are usually made with materials such as thermoplastics with velcro fastenings and are designed to blend in more with the contours of the legs. Many users still prefer the conventional leather and steel or other more lightweight metal designs, especially for use in hot climates, where the plastic designs can be uncomfortable.

    REFERENCES

    [1] The History of Orthopaedics
           
    by Vlasios Brakoulias
    [2] "L'orthopédie ou l'art de prevenir et de corriger dans les enfans, les difformités du corps"
        
      by Nicolas Andry. Published in 1741.
    [3]
    Hugh Owen Thomas biography (available at Surgical-tutor.org.uk)
    [4] "Orthopaedic Surgery"
          
    by Robert Jones
    [5] "
    Muscle recovery in poliomyelitis. Journal of Bone and Joint Surgery (American)"
         by W.J.W Sharrard. Published in 1955
    [6] "Diseases of the hip, knee and ankle joints, with there deformities treated by a new and efficient method"
         by Hugh Owen Thomas. Published in 1857 
    [7]  "Poliomyelitis: A guide for developing countries including appliances and rehabilitation"
          
    by R.Huckstep. Published 1975.