Sir William Arbuthnot Lane, 1856–1943
This biographical sketch on William Arbuthnot Lane corresponds to the historic text, The Classic: The Operative Treatment of Fractures, available at DOI 10.1007/s11999-009-0860-4.
Sir William Arbuthnot Lane was born July 4, 1856, in Fort George, Inverness, Scotland [2, 7]. His early education was in Scotland. His father, a military officer, moved the family about. Owing to matters of convenience and finances at the time, his father arranged for him to enter Guy’s Hospital at the age of 16 for medical training. He was apparently shy  and had a youthful appearance even for his young age, a point that created some problems for him with his fellow students, who nonetheless soon realized his exceptional abilities . He qualified at Guy’s Hospital and as a member of the Royal College of Surgeons in 1877 at the age of 21 (becoming a Fellow in 1883). He subsequently received Bachelor of Medicine and Master of Surgery degrees from the University of London . He procured an appointment at Great Ormand Street in 1883 but returned to Guy’s in 1888 at the age of 32 and spent most of his career there.
“In one morning at Guy’s I saw him do an unusually difficult palatoplasty for cleft palate in a small child, a resection of the lower jaw for malignant disease, an open reduction and plating of both bones of the forearm for fracture, and a total colectomy, from cecum to sigmoid, with a terminal ileosigmoidostomy, by his method of anastomosis—for the relief of what is still known as “Lane’s disease.” Upon all these operations he stamped the seal of his personality by the originality of his procedures and the smoothness, ease, and perfection of technic that proclaimed a real master, a master who dared where others quailed and who succeeded where others would have failed without his skill, his precision, and the confidence with which he planned and executed his operations” .
Lane traveled extensively, developing international friendships and colleagues and frequently visited the United States . He retired from practice at Guy’s Hospital in 1920, but continued a practice out of his home office . He often held strong opinions and in fact after retirement “asked to have his name removed from the Medical Register, in order to promote the New Health Society (the first organised body to deal with social medicine), to avoid being disciplined by the General Medical Council. He had founded the New Health Society in 1925 to publicise his views on healthy diet and life” .
“A careful inquiry into the results of the treatment of fractures by splints and manipulation confirmed the experiences of the dissecting room and showed that the consequent joint changes meant depreciation in physique and the wage-earning capacity of those who had to engage in laborious pursuits” .
“These views met with violent opposition till the discovery of X-rays proved that the first contention (the high rate of nonunion of displaced fractures) was true, while the law courts are steadily impressing on the profession, in a costly manner, the disabilities which are associated with the imperfect restoration in the form of broken bones” .
“…his operating on simple fractures raised a storm of criticism and even abuse. In his hands the operation was performed under strict asepsis but some other surgeons less meticulous in their technique failed to obtain union of the fracture owing to sepsis. This led to a tendency to blame the operation rather than the manner in which it was performed” .
“It is well to remember that it is never perfectly safe to operate on a compound fracture, even though the wound has been healed for months, and there be no evidence whatever of the presence of any inflammation process about the fracture. It would be possible for organisms introduced at the time of injury to remain latent for long periods of time, and to light up into activity when a large foreign body is introduced” .
The apparent success of his approach to internal fixation no doubt attests to his meticulous aseptic and surgical technique and Lane likely had as much or more influence on the introduction of the internal fixation of fractures as any of the other early pioneers such as Lambotte and later Sherman.
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