Dallas B. Phemister

REPAIR OF BONE IN THE PRESENCE OF ASEPTIC NECROSIS RESULTING FROM FRACTURES, TRANSPLANTATIONS, AND VASCULAR OBSTRUCTION

Aseptic necrosis of bone may result from a number of causes—as vascular disturbances, injuries, the action of chemicals, and the application of radium in the treatment of malignant disease. The process of repair of the damaged area differs with the causative agent and with the amount of functional stimulation to which the part is subjected during the reparative period. It also differs from that seen in cases of necrosis produced by infection. Necrosis en masse produced by severe infection is nearly always followed by a fibroblastic and fixed tissue phagocytic reaction which usually results in complete absorption of the dead bone, if the area is small, or in sequestration, if it is large. However, mild inflammatory reactions, particularly when associated with embolic or thrombotic processes and due to low grade micro-organisms, may sometimes result in necrosis which is followed by simultaneous absorption of dead bone and incomplete, irregular replacement by new bone (creeping substitution).

The Classic: Repair of Bone in the Presence of Aseptic Necrosis Resulting from Fractures, Transplantations, and Vascular Obstruction

Dr. Dallas Burton Phemister is shown. Figure is ©1952 by the Journal of Bone and Joint Surgery, Inc. and is reprinted with permission from Dallas Burton Phemister 1882–1951. J Bone Joint Surg Am. 1952;34:746–747.

Conservative Bone Surgery in the Treatment of Bone Tumors

Dallas Burton Phemister ( 1882195 1) was born in Carbondale, a small town in southern Illinois. After two years at Valpamiso College he transferred to the University of Chicago, where he graduated in 1900. His medical degree was gained at Rush Medical College. This was followed by an internship at the Cook County Hospital. After this he entered the private practice of medicine in suburban Chicago. In 1908 he obtained a teaching appointment in the Dept. of Surgery of Rush Medical College. His desire to further his education took him abroad for two years of study in Berlin, Paris, and Vienna. On his return he continued to teach and limited his practice to surgery. Service in France during World War I broadened his experience. His reputation as a surgeon and teacher was responsible for his appointment as the first Chairman of the Department of Surgery of the new Medical School of the University of Chicago in 1926. He held this position for the next 22 years, during which he gained national and international attention for his research. His contributions to the field of orthopedic surgery resulted in his election to membership in the American Academy of Orthopaedic Surgeons. He became president of the American Surgical Association and the American College of Surgeons. He is remembered for his work on bone tumors, aseptic necrosis, and fracture healing, as well as the pathogenesis of traumatic shock. At a time when there is great interest in limb sparing operations for malignant bone and soft tissue tumors of the extremities, it seems appropriate to recall Phemister’s paper on this subject published almost 50 years ago.