History of the AO

AO Foundation Education

History of the AO 1958−2008

Kevin Newman St Peter‘s Hospital, Chertsey, Surrey, UK

1944 The inspiration for AO Maurice Müller Bern, Switzerland (1918−) met a former soldier who had received a femoral nailing by Gerhard Küntscher Kiel, Germany (1900−1972) military surgeon

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1950 The early years Maurice Müller resident of Liestal, Switzerland (1918−) was on a fellowship in Holland with

Cornelis Pieter van Nes Leiden, Netherlands (1897−1972) who advised him to visit Robert Danis in Bruxelles

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1950 Compression plating Robert Danis Bruxelles, Belgium (1880−1962)

“Théorie et Pratique de l’Osteosynthèse” coapteur plate for rigid fixation

Compression for “per primam” healing Absence of callus “soudure autogène” 4

1951 First results of ORIF Maurice Müller Fribourg, Switzerland

• 75 patients • stable fixation • early mobilization • no complications

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1952 Old army friendships Robert Schneider

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Maurice Müller

1954 Documenting trauma Lorenz Böhler Wien, Austria (1885−1973)

241,000 trauma x-rays

Accident Hospital 7

1956 Five friends, eight more Müller

Patry

Brussatis Baumann

Willenegger

Allgöwer

Guggenbühl Ott

Schneider

Hunziker

Bandi

Schär Stähli

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1958 AO founded in Biel (Bienne) November 6, 1958, Hotel Elite Biel (Bienne), Switzerland

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1958 AO Founders Arbeitsgemeinschaft für Osteosynthesefragen

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Maurice Müller

Martin Allgöwer

Walter Bandi

Robert Schneider

Hans Willenegger

Zürich

Chur

Interlaken

Grosshöchstetten

Liestal

1918−

1917−2007

1912−1997

1912−1990

1910−1998

1958 Hex-head screw Maurice Müller Zürich, Switzerland (1918−)

Robert Mathys Bettlach, Switzerland (1921−2000)

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1959 AO Principles Hans Willenegger Maurice Müller Martin Allgöwer Robert Mathys

1 2 3 4 12

Documentation of all patients Development of implants and instruments Research of fracture healing and tissue cultures Teaching of osteosynthesis techniques

1959 AO Laboratory Davos Martin Allgöwer Davos, Switzerland (1917−2007)

AO Laboratory for Experimental Surgery Forschungsinstitut Obere Strasse 13

1959 AO Documentation Maurice Müller Davos, Switzerland (1918−)

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1960 1st AO Course in Davos Participants: 56 7 2 3 1

Maurice Müller teaches femoral nailing in the AO Lab. 15

1960 AO in Davos

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1960 AO Faculty in Davos Robert Schneider

Walter Ott

Walter Schär

Walter Bandi

Martin Allgöwer Fritz Brussatis

Willy Hunziker

August Guggenbühl

René Patry

Ernst Baumannn

(Fischer) 17

(Keller)

Hans Willenegger

Maurice Müller

Walter Stähli

(Bloch)

1961 AO TK founded Maurice Müller St Gallen, Switzerland (1918−)

Robert Mathys Bettlach, Switzerland (1921−2000)

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1961 AO Round hole plate Maurice Müller St Gallen, Switzerland

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1961 AO Compression device Maurice Müller St Gallen, Switzerland

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1961 2nd AO Course in Davos

John Charnley and Martin Allgöwer in the AO Davos Lab. 21

1963 AO Principles of ORIF Maurice Müller

Martin Allgöwer

Hans Willenegger

Robert Schneider

1 Atraumatic surgical technique 2 Anatomical reduction of fracture 3 Stable internal fixation 4 Early active pain free mobilization 22

1963 AO Plating

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1963 AO Instrument boxes Attendance at an official AO Course was mandatory for purchasing the six official AO Instrument boxes.

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1963 Teaching nurses

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1963 AO Tubular plates Maurice Müller Bern, Switzerland

1/2 tubular 1/3 tubular

1/4 tubular 26

1963 Primary bone healing Hans Willenegger Liestal (1910−1998)

Robert Schenk Basel (1923−)

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Fritz Straumann Waldenburg (1921−1988)

1965 AO Nailing Maurice Müller Bern, Switzerland

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1968 High-energy fractures Martin Allgöwer Basel, Switzerland

Thomas Rüedi Chur, Switzerland

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1969 AO VET (veterinary) Dog treated with Kuntscher nail by H Knoll, J Jenny and owner H Willenegger

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1969 Dynamic compression Martin Allgöwer Stephan Perren Max Russenberger

Dynamic Compression Plate Narrow: DCP 3.5

Broad: DCP 4.5 31

1969 AO Manual Maurice Müller Martin Allgöwer Robert Schneider Hans Willenegger

1970 Translated from German into English by by Joseph Schatzker

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1970 AO and Lorenz Böhler

Prof Willenegger presents Prof Böhler with AO book. 33

1972 AO International Hans Willenegger Liestal, Switzerland (1910−1998) 1st president of AOI

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1974 1st AO CMF course Joachim Prein Basel, Switzerland

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1978 Strain theory of healing Stephan Perren Davos, Switzerland Alexander Boitzy St Gallen, Switzerland

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1981 Biomechanical stability Bernhard Georg Weber St Gallen, Switzerland (1927−2002)

Minimax Fracture Fixation

Minimal amount of metal Maximum stability 37

1983 Soft-tissue injury Harald Tscherne Hannover, Germany

Tscherne classification of closed fractures 38

1984 AO Foundation

Peter von Rechenberg

Notary

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Martin Allgöwer

Thomas Peter Rüedi Matter

Maurice Müller

Robert Schneider

Fritz Straumann

Robert Mathys

Hans Willenegger

Stephan Perren

Hansjörg Wyss

1984 Four pillars of AO Martin Allgöwer Basel, Switzerland 1st AO Foundation president Four pillars of cooperation: • Documentation • Teaching • Research • Instrumentation

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1987 AO Classification Maurice Müller Peter Koch Serge Nazarian “A classification is useful only if it considers the severity of the bone lesion and serves as a basis for treatment and for evaluation of the results.”

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1987 Indications for ORIF Joseph Schatzker

Toronto, Canada

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Marvin Tile

Toronto, Canada

1988 Periosteal blood supply (plates) Stephan Perren Davos, Switzerland

Osteoporosis under plate is caused by bone necrosis and not by stress protection 43

1988 AO Plastic bones Stephan Perren Davos, Switzerland

“Synthes bones” = SYNBONE 44

Thomas Rüedi Chur, Switzerland

1989 AO Founders reunited

Hans Willenegger

Robert Schneider

Maurice Müller

Peter von Rechenberg CEO

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Martin Allgöwer

Walter Bandi

1989 AO Alumni Association 56 local chapters in 6 AO Regions in 2008

Europe North America

Middle East Asia Pacific

Latin America

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Africa

1989 Indirect reduction Jeff Mast

Roland Jakob

Reinhold Ganz

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1990 “Bio-logical” fixation Alexander Boitzy Bern, Switzerland

Reinhold Ganz Bern, Switzerland

Soft-tissue injury determines the type of fracture fixation. Three stages of tissue damage: 1. Compromised (careful standard fixation possible) 2. Partial degloving (indirect reduction required) 3. Soft tissues destroyed (reconstruction essential) 48

1990 Endosteal blood supply (nails) Stephan Perren Davos, Switzerland

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1990 Small footprint LC-DCP Stephan Perren Davos, Switzerland

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Emanuel Gautier Chur, Switzerland

L

Limited

C

Contact

D

Dynamic

C

Compression

P

Plate

1990 Robert Schneider passes away

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1992 AO North America

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1992 AO Center Davos Spring

Fall

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Summer

Winter

1993 Internal fixator PC-Fix Stephan Perren Davos, Switzerland

Slobodan Tepic ???, Switzerland

PC-Fix Point Contact Fixator

Monocortical locking 54

1994 AO East Asia Suthorn Bavonratanavech Chiangmai, Thailand 1st president of AOEA Hong Kong Indonesia Malaysia Philippines Singapore

South Korea Taiwan/Chinese Taipei Thailand

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1995 LISS Robert Frigg Bettlach, Switzerland

Less Invasive Stabilization System

Locking head screws 56

1997 Walter Bandi passes away

57

1997 Mini incisions (MIPO) Christian Krettek

Harald Tscherne

Minimally Invasive Plate Osteosynthesis 58

1998 AO Latin America AOLAT • • • • • • • • • 59

Argentina Bolivia Brazil Chile Colombia Ecuador México Perú Uruguay

1998 Hans Willenegger passes away

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1999 AO Clinical investigation Ruedi Moser 1999−2003

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Beate Hanson 2003−

Surgeon of the 20th century

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2000 AO Principles of Fracture Management Thomas Rüedi

Chur, Switzerland 63

Liam Murphy

Surrey, England

2000 Howard Rosen passes away

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2000 Robert Mathys passes away

65

2000 Locking compression plates Robert Frigg Michael Wagner Robert Schavan

Bettlach, Switzerland Wien, Austria Willich Anrath, Germany

Combination hole Osteoporotic bone

Nonunions 66

2000 AO Plate technology 1961 1963 1970

Round hole plates Tubular plates Dynamic compression plates

Maurice Müller Maurice Müller Stephan Perren

1989 1990 1990

Indirect reduction techniques Biological fixation Limited contact (DC) plates

Jeff Mast Reinhold Ganz Stephan Perren

1993 1997 1995 2000

PC-Fix MIPO LISS Locking compression plates (LCP)

Stephan Perren Christian Krettek Robert Frigg Robert Frigg

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2001 Anatomical plates Preshaped locking plates for MIPO techniques

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2001 AO Portal on the Internet

69

2002 Hardi Weber passes away

70

2002 StarDrive screws Stephan Perren Davos, Switzerland

71

2003 AOSpine is formed John Webb

Max Aebi

Paul Pavlov

Nottingham, England

Montreal, Canada

Nijmegen, Netherlands

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2003 Strain theory and LCP Michael Wagner Wien, Austria

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Christoph Sommer Chur, Switzerland

2004 AO CAS and BrainLAB Christian Krettek Hannover, Germany

C A S 74

Computer Aided Surgery

2005 AO Expert nails

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2006 AO Trauma Asia Pacific AOTAP

Australia China Hong Kong Indonesia Japan Malaysia

New Zealand Philippines Singapore South Korea Taiwan Thailand

India joins AOTAP in 2007 76

2006 AO LCP Manual Michael Wagner Wien, Austria

Robert Frigg Bettlach, Switzerland

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2006 AO Surgery reference

Editors: Chris Colton Peter Trafton Joseph Schatzker Ernst Raaymakers

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2007 AOSpine Manual John Webb

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Vincent Arlet

Max Aebi

2007 AO Principles of Fracture Management─2nd edition Thomas Rüedi Chur, Switzerland

Richard Buckley Calgary, Canada

Christopher Moran Nottingham, England 80

2007 Pediatric classification Theddy Slongo Bern, Switzerland

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Laurent Audigé Dübendorf, Switzerland

2007 Martin Allgöwer passes away

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2008 AO 50th anniversary Professor Maurice Müller

on his 90th birthday March 28, 2008 unveils a plaque in Hotel Elite. Biel (Bienne) Switzerland 83

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Transforming Surgery

Changing Lives 85