Paul Randall Harrington

Paul Randall Harrington

Paul Randall Harrington (born September 27, 1911 in Kansas City ; died November 29, 1980 in Houston , Texas) was an American orthopedic surgeon . He became known as the developer of the Harrington rod for straightening crooked spine . The implant became commonplace in the 1960s and remained the gold standard of surgical scoliosis treatment until the late 1990s . During this period, Harrington's method of treatment was used in approximately one million patients.

Early years

Harrington went through the local school system to graduation in 1930 and was named one of the 15 Outstanding High School Graduates in Kansas State . He did not plan to take up a degree at first, but changed his mind after he was offered a sports scholarship as a basketball player from the University of Kansas . During his time at this university he was a member of the basketball team that won the "Big Eight Conference", a tournament of the eight most important universities, three times in a row. In his senior year of college, he was elected team captain .

His original interest in sports education turned into an interest in medicine . He graduated from the University of Kansas Medical School and graduated in 1939. He financed his education as a semi-professional basketball player. In 1936 he sought membership in the American Olympic team and won the regional javelin championship , but could not take part in the final in Chicago for financial reasons.

His residency training began Harrington at Roper Hospital, Charleston , South Carolina and closed it in 1942 at St. Luke's Hospital in Kansas City from. He then joined the United States Army .

During his military service in World War II from May 1942 to November 1945 Harrington served in the "77th Evacuation Hospital" as chief physician of the orthopedic department. The staff of this unit consisted mainly of trainee doctors and nurses from the University of Kansas and was deployed primarily in Europe and Africa. During this time Harrington came into contact with well-known military figures such as General George S. Patton .

After the war, Harrington went to Texas and worked as a surgeon at Jefferson Davis County Hospital in Houston . In the post-war years a dramatic epidemic of poliomyelitis developed , which became his main field of work. During this time he worked with Baylor College of Medicine and established the Southwest Respiratory Foundation of the National Infantile Paralysis Association, the first such organization in the United States.

Poliomyelitis patients tend to develop scoliosis , i.e. a curvature and twist of the spine . Harrington realized that the usual treatment for scoliosis, which relied primarily on physical therapy, was not working in poliomyelitis patients, so he began to explore new treatments. His first attempts consisted of the operative manual correction of the scoliotic deformity with internal fixation of individual vertebral joints. This treatment resulted in some improvement for the patients, but Harrington saw that the fixation was not permanent. The hooks and highly stressed bars corroded and broke, causing the spine to return to its original misalignment. Two patients died. Without being put off, Harrington continued to work on what later became known as the Harrington Rod through the late 1940s and 1950s .

Harrington staff

Thoracic scoliosis

Harrington spinal fusion

The Harrington rod is a device developed by Harrington for straightening the back of the spine. The device consists of a rod made of stainless steel , which is hooked above and below the bend of the spine. The spine is pulled apart and straightened with ratchet teeth. After the surgical insertion of the rod, the patient wears a plaster cast or a corset for a few months until the stiffening of the vertebrae is visible in the X-ray image. When the device, later known as the Harrington rod, was first used, new surgical instruments had to be made the evening before each operation. Harrington subsequently modified these instruments based on his perception of the current surgical success. Satisfied with the basic design, Harrington had his instruments tested at the Engineering Department at Rice University in Houston and at a commercial testing facility in Chicago.

Harrington publicly presented his method for the first time at the annual meeting of the American Academy of Orthopedic Surgeons in Chicago in 1958, where it was noted with astonishment and deep skepticism . Nevertheless, the process slowly gained acceptance. In 1959, Harrington signed a contract with the medical technology manufacturer Zimmer , which made its instruments available to other doctors. However, he insisted that no one be allowed to use his implant until he demonstrated the procedure himself. The Time magazine reported in 1960: "Some sufferings seem to be almost better to endure than their treatment. An example is scoliosis, an abnormal curvature of the spine that occurs in childhood. The [previous] treatment seems so stressful that parents can hardly be convinced to allow it, even if it results in a lifelong deformity. Last week Paul Harrington, a Houston surgeon, did some persuasion for a new and happier method. "

The main disadvantage of the Harringon Bar is that it straightens the normal curvature of the spine in the areas that are being stiffened. This leads to a flat back deformity in some patients . The current advances in surgical technology in the late 1990s make it possible in many cases to correct the scoliosis without creating a flat back. This gradually led to the withdrawal of the Harrington rod treatment.

Scoliosis always involves twisting the vertebral bodies, i.e. that is, it is a three-dimensional problem; however, the Harrington method can only correct two-dimensionally - the curvature in the frontal plane. Another disadvantage is the rigid straight rod. Only two hooks at the ends take the entire load on the vertebral arches. The development of derotating systems with flexible rods and several hooks (Cotrel-Dubousset) was inevitable. Klaus Zielke developed the ventral derotation spondylodesis as the most powerful procedure. The Harrington rod still has its place in paralysis colioses, which are not uncommon as a consequence of poliomyelitis in developing countries.

The late years

From the late 1950s onwards, Harrington made many trips to demonstrate his surgical technique and the Harrington rod. During this time he also developed an interest in ships, which led to the development and construction of a 54-foot catamaran , and he also worked as a hobby in photography and hi-fi systems .

In 1966 Harrington was one of the founding members of the Scoliosis Research Society , of which he was president in 1972 and 1973. He also served as an orthopedic consultant to the United States Air Force and Army in San Antonio, Texas. At Baylor College of Medicine, he was Professor of the Department of Orthopedic Surgery and the Department of Rehabilitation. During these years he was awarded several prizes. From 1972 Harrington worked with Marc Addason Asher and institutionalized the "Mary Alice and Paul R. Harrington Distinguished Professorship of Molecular Orthopedics at Kansas University Medical College".

Death and legacy

Paul Randall Harrington died on November 29, 1980 in Houston , Texas .

In an obituary, the Journal of Bone & Joint Surgery wrote : “Paul will be remembered not only for the development of the Harrington instruments, but for his straightforward frankness, his bowties, his par golf, his smile, his trumpet, and above all for being a nice person. "

In his will, Harrington left all of his professional materials to the University of Kansas Medical Center , where they are now known as the Harrington Archives. The archive contains all writings, photographs, publications, manuscripts, blueprints, drawings and examples relating to the Harrington baton, as well as biographical information, presentations, professional and personal correspondence, personal photographs, films and video tapes. Case studies with photographs, documents and other artifacts depicting Harrington's story are also available.

In 1992, Harrington's collected writings (compiled by Nancy J. Hulston and Marc A. Asher) were published by Lowell Press under the title The Collected Writings of Paul Randall Harrington, MD .

Baylor College of Medicine has announced an award for "Excellence in Orthopedic Research" in memory of Harrington's contribution to spinal surgery.

Individual evidence

1. ^ National Scoliosis Foundation: Instrumentation Systems For Scoliosis Surgery . National Scoliosis Foundation. Retrieved February 11, 2010.
2. ↑ ^{a b} Who's Who In Orthopedic Surgery . Springer London. Retrieved February 11, 2010.
3. ↑ ^{a b} Nancy Hulston: History and Philosophy of Medicine Newsletter # 1 . Kansas University Medical College. Archived from the original on December 4, 2008. Info: The archive link was automatically inserted and not yet checked. Please check the original and archive link according to the instructions and then remove this notice. Retrieved February 12, 2010. 
4. ↑ ^{a b c d e f g h i j k l m} Paul Randall Harrington, MD, 1911–1980 . The Journal of Bone & Joint Surgery . Retrieved on February 11, 2010.  ( Page no longer available , search in web archives )  Info: The link was automatically marked as defective. Please check the link according to the instructions and then remove this notice.  
5. ^ ^{A b c} American Academy of Orthopedic Surgeons: Arresting Development - Dr Paul Harrington MD . American Academy of Orthopedic Surgeons. Archived from the original on July 24, 2011. Info: The archive link was automatically inserted and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. Retrieved February 11, 2010. 
6. ^ Flat Back Syndrome . In: iScoliosis.com . Medtronic. July 11, 2008. Retrieved February 15, 2010.
7. ^ Native Sons and Daughters of Kansas - Marc Addason Asher MD, 2007 Distinguished Kansan . www.ksnativesonsanddaughters.org. Archived from the original on October 29, 2010. Info: The archive link was automatically inserted and not yet checked. Please check the original and archive link according to the instructions and then remove this notice. Retrieved February 12, 2010. 
8. ^ National Scoliosis Foundation: Thirty-Fourth Harrington Guest Lecture, SRS, 2008 Harrington's Contributions in Perspective . Spine. Retrieved February 12, 2010.
9. ↑ Nancy J. Hulston, Dr Marc A. Asher: The Collected Writings of Paul Randall Harrington, MD . Lowell Press, 1992.