Historical traumatology: The importance of historical knowledge of diseases in current clinical practice. The example of "crippling diseases".

INTRODUCTION/OBJECTIVES: This article highlights the importance of historical knowledge in current medical training and practice, particularly in specialties such as Traumatology and Orthopedic Surgery. It criticizes the increasing technologization of medicine and its growing disconnection from the humanities. The study argues that the historical study of diseases -especially so-called "crippling" diseases, like poliomyelitis and musculoskeletal tuberculosis- provides a deeper understanding of current clinical processes, enhances medical empathy, and promotes a more comprehensive and critical education.

METHODS: A historiographic study was conducted on 138 medical records from the San Juan de Dios Sanatorium in Seville, spanning the years 1943 to 1950. Thirty-two cases related to poliomyelitis and musculoskeletal tuberculosis were analyzed in depth, 9 of which underwent surgical intervention. Two cases involving subtalar arthrorisis were highlighted as examples to reinterpret past treatments using current orthopedic knowledge.

RESULTS: Patients with poliomyelitis treated in the past underwent aggressive surgical procedures that, although well-intentioned, often resulted in severe deforming sequelae. Many of these patients now present with osteoarthritis, chronic pain, or deformities. Techniques such as rib arch grafting (Grice's technique) were precursors to modern methods like the calcaneal stop screw. While some procedures had long-term functional success (over 90% positive outcomes), many failed to consider the emotional and psychosocial impact on the patient.

CONCLUSIONS: This study demonstrates that understanding the historical context of disease is essential for providing more humane, effective, and empathetic care. It advocates for the integration of the History of Medicine into the curricula of medical specialties, to avoid simplistic judgments of past practices and to recognize that medical treatments are also cultural products of their time. Historical training allows physicians to develop critical, humanistic thinking and a respectful approach to the patient's experience.