Who’s Who in Orthopedics

He developed the Leinbach screw for fractures

of the olecranon, modified the Gosset femoral
head–neck prosthesis for the treatment of defi-
ciencies of the femoral neck, and invented the
“femur jack,” an instrument that is very helpful in
exposing the femoral neck during reaming of the
medullary canal. He performed more than 3,000
primary and revision total hip arthroplasties.
He was a founding member of both the Hip
Society in the United States and the International
Hip Society. In 1966, he received the Governor’s
Award as Florida Physician of the Year, and he
was selected as Citizen of the Year by the St.
Petersburg City Council. In 1993, he received the
Lifetime Achievement Award from the Joint
Implant Surgery and Research Foundation, in
commemoration of 60 years of surgery.
Dr. Leinbach decided to study medicine
because it deals with human life, and he derived Emile LETOURNEL
a lot of pleasure from life. In his office hung a
small plaque with the inscription: “The funda- 1927–1994
mental principle of medicine is love.” Thousands
of patients benefited from his commitment and Professor Emile Letournel was the contemporary
dedication. icon of pelvic and acetabular surgery in the world
He died on January 12, 1994, after a brief and a great friend, teacher, instructor and member
illness, in St. Petersburg, Florida. He was 86 years of the AO family. The importance of this man and
old. He had been working regularly in the out- his monumental achievements in surgery of the
patient clinic of the Bay Pines Veterans Adminis- pelvis and acetabulum is unrivaled in modern
tration Hospital until a few days before his death. trauma surgery. Professor Letournel was recog-
Dr. Leinbach was survived by his wife, Alice; nized as the conclusive source of extensive
three daughters: Jenni Adams of Orlando, Judy experience and innovative techniques in the
Meserve of St. Petersburg, and Troy Kassing of management of severe pelvic and acetabular
Indianapolis; eight grandchildren; and five great- trauma. His lifelong contributions to the under-
grandchildren. His only son, Tyler, died in a tragic standing of the complex acetabular fractures and
cave-diving accident in 1960. Dr. Leinbach once techniques required to treat these difficult injuries
said: “I have flown high enough to enjoy looking have defined the predominant principles of surgi-
down on the clouds, and my great wife has been cal excellence of fracture surgery.
the wind beneath my wings.” Professor Letournel was the guest of honor at
the English-speaking, basic and advanced courses
in Davos, Switzerland in 1982. The presentation
of his experience in the development of diagno-
sis and surgical management of acetabular frac-
tures was extraordinary. It was given to a packed
audience in the advanced course upper lecture
room of the Kongress Halle in Davos. The par-
ticipants were in awe of his surgical technique and
ability to reduce difficult and extensive fractures.
His presentation included numerous examples of
anatomic reduction of complex associated acetab-
ular fractures with excellent 10–20 year results.
These radiographs demonstrated long, twisted
reconstruction plates curving around areas of the
pelvis (that the majority of the course participants
had never visualized), creating a singular educa-
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Who’s Who in Orthopedics
tional experience and a standing ovation. Emile These latter two textbooks are the primary
continued to be an immutable participant in the sources of information on surgery of the acetab-
advanced courses in Davos and participated in ulum in the English literature and are considered
countless AO courses throughout the United the “Bibles” of acetabular surgery. His work has
States, Europe and Canada. His unique personal- resulted in a complete transformation of our
ity and energy were legendary, and he was always understanding and treatment of fractures of the
available to answer the most trivial question from acetabulum.
any course participant. His passion and love of Emile Letournel was born on the French island
teaching extended worldwide as his results of St. Pierre et Miquelon, situated between New
became universally acknowledged. Emile’s per- Foundland and Nova Scotia, on December 4,
sonality and professional camaraderie were 1927. He never spoke English while growing up
quintessential Letournel, and his dedication to and after finishing secondary school in St. Pierre
teaching his techniques to conferences all over the he obtained a scholarship to the French Institute
world was the underlying virtue of this great man. in London. During this time period, the war
There are many instances in the history of in Europe was at a climax and for safety reasons
orthopedic surgery in which an individual the French Institute was moved to Hullswater
surgeon has made a significant contribution to a Lake, Cumberland Scotland, near Edinburgh for
particular area of surgery that has stood the test the duration of the war. Emile left St. Pierre
of time. There are very few instances of a sur- et Miquelon alone at the age of 16 on July 27,
geon contributing to the specialty of orthopedic 1944 to cross the Atlantic and attend school in
and trauma surgery in the complete and life- Scotland. At the time of his departure, he did not
long manner that was characteristic of Emile speak English and had never seen a train or a big
Letournel. His contributions began with descrip- city. He took a small boat from St. Pierre, “Le Cap
tion of the correct radiographic and anatomic Bleu,” to Nova Scotia (24 hours) and then to
diagnoses of acetabular fractures and progressed Montreal by train (36 hours). He left Montreal on
to a logical classification of these injuries into ele- August 7, 1944 in one of the largest convoys of
mentary and associated fracture types. This work the war consisting of over 200 ships. On his ship,
continued with development of two major surgi- “The Jamaica Planter,” no one spoke French and
cal exposures, reduction techniques, instruments all his personal belongings were confiscated until
and implant designs used in every operating the boat arrived in Scotland 28 days later. He
theater in the world today. Though there have studied for a year at the French Institute and
been refinements over time and contributions by received his Premier Bacalaureat. After the war
other authors in the field, Letournel’s original he left England for France, where he studied at
description, diagnosis, classification and surgical the Lycee Chaptal and received his Second
techniques have remained the ubiquitous standard Bacalaureat. He was admitted to the Faculty of
of care of acetabular fractures for the past 25 Medicine of Paris from 1946 to 1960 and became
years. Professor Letournel developed the base of a registrar in 1956.
the statistical data of both immediate and long- As he developed an interest in orthopedic
term results of operative management of acetab- surgery, it became necessary for him to apply for
ular fractures. His thesis published in 1961, a postgraduate position to continue his education.
“Fractures du Cotyle. Etude d’une serie de 75 This process required the applicant to visit all
cas,” contained the initial description of the clas- professors who were offering training positions.
sification developed by Emile Letournel and Being from St. Pierre, Emile had no letters of
Robert Judet and has achieved worldwide accept- support to compete adequately for an orthopedic
ance. This system has greatly facilitated surgical position. A friend suggested he contact Professor
education in the understanding of the complex Robert Judet and he did this out of desperation
nature of acetabular fractures. He published three without any hope of obtaining a position. The
major textbooks on acetabular surgery, all with meeting with Robert Judet was very brief. Pro-
coauthor Robert Judet. fessor Judet asked Emile for his letters of recom-
The first of these textbooks was in French, mendation, of which he had none, but Emile
Fractures du Cotyle in 1974, the second was in indicated to him his sincere desire to train with
English, Fractures of the Acetabulum in 1981, Judet. Professor Judet asked him where he
and the third, Fractures of the Acetabulum in came from and Emile responded “St. Pierre et
1993, with Robert Judet as a posthumous author. Miquelon.” Judet looked in his agenda book and
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 Who’s Who in Orthopedics
offered Emile a 6-month opening the following is bestowed on a physician who has made pro-
year. The 6-month position lasted 12 months and found contributions to orthopedic surgery that
Emile subsequently became Judet’s assistant. have significantly altered the practice of the
Emile stayed with Robert Judet until his retire- specialty. This honor is customarily reserved
ment in 1978. During this period, Emile advanced for posthumous recognition. Professor Letournel
to associate professor and finally professor in qualified uniquely for this honor as he was still
1970. He became head of the Department of alive when the commission was given to pay
Orthopedic Surgery at the Centré Medico tribute to his life achievements in fracture surgery.
Chirurgical de la Port de Choisy in southeast Unfortunately, he died 2 weeks before this journal
Paris. He remained at the Choisy hospital until his was published with his dedication issue.
retirement from academic medicine in October Professor Letournel’s personality was robust,
1993. In addition to his interest in acetabular and rugged and energetic and he lived life with great
pelvic fractures, he performed over 6,000 total hip eagerness and excitement. His mere presence in
arthroplasties, developed implant designs and sur- the operating theater created movement. As he
gical techniques for management of calcaneal would scrub for surgery, his intensity to take on
fractures and had extensive expertise in the sur- his worthy fracture adversary would bubble forth
gical treatment of bone infection. His position at as he would review in his mind the preoperative
Choisy provided him an unlimited exposure to plan of surgical approach and internal fixation.
orthopedic disease and created the environment to His silhouette completely covered from head to
further his investigation of acetabular fractures. foot in his French blue surgical gown was a rare
The Choisy Medical Center is a nonprofit hospi- sight to observe and revere. His distinctive vocal
tal, and Professor Letournel never charged a commentary (always in French) on a particularly
surgeon’s fee to any patient throughout his entire stubborn fragment reduction or repeated failed
career at Choisy for his services. He was admit- surgical maneuver or the worthlessness of a par-
ted to the French Academie de Medicine et ticular instrument to perform its function would
Chirurgie in 1981 and received the “Legion create absolute silence from the operating theater
d’Honneur” from President Mitterrand of France staff until a universal sigh of relief would resound
in 1988. These honors were very special to Emile throughout the room when he was finally satisfied
and were public recognition of his stature in with his reduction. Of special mention is Profes-
French medicine and his accomplishments in the sor Letournel’s most trusted medical assistant,
field of orthopedic trauma surgery. Following Remy Ser, who was the master of the Judet frac-
his death, the elected officials of St. Pierre et ture table. He could position any extremity on the
Miquelon passed a resolution naming a street on fracture table into the desired position during the
the island of his birth, “Emile Letournel.” most critical time of a procedure and always
Professor Letournel organized the first acetab- underneath all the sterile surgical drapes. His
ular fracture educational course in Paris in 1984. routine response to any request from Professor
His Paris courses were famous for the exposure Letournel was “Oui, Messier.” He was the
participants received to his wealth of surgical “Charge d’affaires” of Letournel’s operating suite
knowledge and skill, his superb hands-on cadav- and was primarily responsible for patient problem
eric dissection and above all his boundless enthu- solving before, during and after the surgical pro-
siasm and energy. The few fortunate surgeons cedure. Remy Ser was an extremely dedicated
who have been able to study with him at the professional and stayed with Emile for over 15
“Letournel School of Acetabular Surgery” gained years until the day he died. He was an integral
tremendous insight into his diagnostic and surgi- part of the Letournel team perpetuating the
cal acumen and the steadfastness with which he excellence that was the hallmark of Professor
pursued every acetabular fracture to obtain “the Letournel’s surgery.
perfect reduction.” He was acknowledged as Professor Letournel never used a depth gauge.
the most skillful acetabular fracture surgeon in the He would merely place his finger on the drill bit
world and shortly before his death, he completed at the appropriate length of penetration, show the
his 1,050th surgically treated acetabular fracture. drill bit to his scrub nurse and promptly receive
A symposium was published in August 1994 in the correct length of screw. He would continually
Clinical Orthopedics and Related Research, ded- vocalize to himself all the possibilities and con-
icated to Professor Letournel and his significant sequences of his technique while performing his
contributions to orthopedic surgery. This tribute surgical maneuvers. His genius had an enormous
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Who’s Who in Orthopedics
ability to comprehend spacial relationships,
leading him to understand quickly the complexi-
ties of a particular fracture and develop a plan of
reduction based on his extensive experience. He
was a masterful surgeon who knew well his abil-
ities and limitations. His brilliance as a technician
was evident in his surgical results. His personal-
ity was always warm and endearing.
He lived for the difficult trial, whether it was in
the operating room or performing the ritualistic
decapitation of a bottle of Dom Perignon with a
saber, he was always the same wonderful man.
His admirers encompassed the entire world of
orthopedic and trauma surgery. His presentations
were legendary and as uncommonly entertain-
ing as his own form of English (an ingenious
Letournel dialect), which created within the
audience a profound awareness of the complexity Jacques LEVEUF
of acetabular fractures and the importance of his
pioneering original and lifelong contributions to
1886–1948
acetabular fracture surgery.
This remarkable individual was not enormous Leveuf was born in Limoges and studied in the
in physical stature, but he was immense in per- School of Medicine in Paris. After the usual junior
sonality and had no equal in his field. He was hap- intern appointments he was for many years an
piest in the operating theater struggling with a assistant in the surgical clinic of Pierre Delbet. He
difficult fracture or enjoying personal moments worked with Delbet in the early attempts to nail
with his loved ones and close friends. He espe- fractures of the femoral neck under x-ray control.
cially enjoyed entertaining the participants of This experience no doubt largely determined his
his Parisien acetabular courses at the evening choice of the surgery of bones and joints as his
banquet by singing his favorite boyhood song life work. In due course he achieved the coveted
“Les Prunes” escorted by his “band” playing status of “surgeon to the hospitals of Paris” and
champagne bottle instruments. His patient list became surgeon-in-chief at the Bretonneau
read as a “Who’s Who Directory” of French Hospital. In 1942, on the retirement of Professor
society, yet he would treat the most common Ombrédanne, Leveuf was chosen as his successor
citizen with the same respect and care as any at the Clinique des Enfants Malades and in the
high-profile patient. Chair of “Infantile and Orthopedic Surgery”—the
Professor Emile Letournel died unexpectedly blue riband of Paris orthopedics. In the new
after a brief illness on August 16, 1994, at his surgical clinic designed by Ombrédanne, Leveuf
home in Paris, France. began to work with ever-increasing intensity on
the problem of the treatment of congenital dislo-
cation of the hip by open reduction. Before the
war he had carried out a survey of the late results
of manipulative reduction in the province of
Brittany, where the deformity was exceedingly
common, and had been impressed by the high
proportion of poor results. During the last 2 years
he had established a center in Brittany for the
diagnosis and treatment of this deformity.
Arthrography, a technique in which he was a
master, was practiced on the newly born, and
many interesting observations had already come
to light. His aim was to recognize those disloca-
tions in which an interposition of soft tissues
existed that would prevent concentric reposition
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