Lorenz

LORENZ Adolf (Adolf Lorenz, born in 1854), one of the creators of modern clinical orthopedics. He received his surgical training as a resident in Dumreicher's clinic in joint work with Nicoladoni; later he was an assistant to Albert. However, the brilliant career of L. on the field of clinical surgery was cut short. He became a victim of the then cruel antiseptic method of Lister and, due to severe carbolic acid poisoning of his hands, he was excluded from practice for a long time. Albert then directed the thought of his talented student toward the study of orthopedic problems. A series of major discoveries of a scientific and therapeutic-practical nature earned L. an authoritative name in this field. In the premises of the former hospital kitchen of the Vienna General Hospital, he set up an outpatient clinic, which later became a school of orthopedics for physicians of all countries. Having invented for his hands an alcohol disinfection instead of carbolic acid, he again began to perform bloody operations, placing patients in a ward that had only 4 beds and was expanded in the front part of another clinic. Following flatfoot, L. systematically studied the pathomorphology of scoliosis, in particular the phenomena of torsion, and pointed out the possibility, through hypercorrection and fixation of the lumbar curvature, to force patients to actively correct the overlying thoracic curve. In the struggle with clubfoot and other deformities, the method of "modeling reduction" developed by L. surpassed existing methods. His means for the prevention and treatment of spinal deformities, especially in tuberculous spondylitis, the plaster cot by L., also remained indispensable. During the general enthusiasm for resections and other operative interventions in bone and joint tuberculosis, L., having organized extensive outpatient assistance to these patients, proved the advantages and necessity of orthopedic treatment. The greatest success of L., which brought him worldwide fame, was the solution of the age-old problem of the treatment of congenital dislocation of the hip. Based on thorough patho-anatomical studies after checking on 200 cases of the "bloody," i.e., open method of Hoffa, L. decided in 1895 to proclaim his method of bloodless reduction as the best, more reliable, and relatively safe. Paying due tribute to the preparatory steps of Paci on the technique of reduction, L. created a whole method, which remained classic to this day, not only for the reposition of the hip but also for keeping the head in place with the sequential development of normal function. The victory cost a decade of stubborn, exhausting labor and intense struggle against merciless criticism from surgical leaders. In old age, Lorenz again took up this question, proving that what is congenital, strictly speaking, is not the dislocation of the hip but a predisposition to it, and that the task in the future should consist in the prevention of the manifestation of this defect. Furthermore, independently of Beyer, he pointed out the possibility in chronic cases, by means of "forking" (oblique subtrochanteric osteotomy) of the femur, to create a support for the pelvis, deprived of normal support from below due to dislocation of the head or fracture of the neck. The main works of Lorenz: "Die Lehre vom erworbenen Plattfusse" (Stuttgart, 1883); "Uber die operative Orthopadie des Klumpfusses" (Wien, 1884); "Pathologie u. Therapie der Skoliose" (Wien, 1885); "Pathologie und Therapie der angeborenen Hft-verrenkung auf Grundlage von 100 operativ behandelten Fallen" (Wien-Lpz., 1895); "Uber die Heilung der angeborenen Hftgelenks-verrenkung durch unblutige Einrenkung und funktionelle Belastung" (Wien-Lpz., 1900); "Uber die Behandlung der irreponiblen angeborenen Hftluxationen und der Schenkel-halspseudarthrosen mittels Gabelung" (Wien. klin. Wochenschr., 1919, No. 41). Lit.: &oclit H., Adolf Lorenz, Arch, fur ortho-padische u. Unfall-Chirurgie, Band XXIII, 1925; H a s s, Adolf Lorenz, Wien. med. Wochenschr., 1924, No. 24; Adolf Lorenz (Die Medizin der Gegenwart in SeHistdarstellungen, herausgegeben v. L. (Jrote, Band III, Leipzig, 1924).