Abstract
Ignacio V. Ponseti, Professor Emeritus of Orthopaedic Surgery at the University of Iowa, passed away on October 18, 2009, while preparing a lecture with the assistance of his beloved wife, Helena.
Professor Ponseti was born on June 3, 1914, in Ciudadela, a small town in Mallorca, the largest of the Balearic Islands. He received his Doctor of Medicine Degree in 1936 at the University of Barcelona, where one of his distinguished mentors in surgery was the renowned Professor Joseph Trueta.
From 1936 to 1939, he served as an officer in the Orthopaedic Department of the Spanish Army, where he contributed to the development of the modern treatment of war wounds and infected fractures. He worked under the direction of Professor Vidal, who had trained for several years in Vienna with Professor Lorenz Böhler. This afforded him the opportunity to learn the conservative treatment of fractures that was being popularised by Professor Böhler. At the end of the Spanish Civil War, he was persecuted for his republican beliefs by both the communists and fascists, and was obliged to leave Spain in 1939. He spent 2 years in Mexico and, after a short stay in Canada, moved to the University of Iowa, where Professor Arthur Steindler was the head of the Department of Orthopaedic Surgery. In 1944, Professor Ponseti completed his residency and embarked on his distinguished academic career, culminating in the position of full professor in 1957. Although he had decided to focus on congenital and developmental bone and joint disorders, his busy clinical practice covered the whole range of orthopaedic surgical conditions. His publications on idiopathic scoliosis, congenital dislocation of the hip and congenital clubfoot established his reputation worldwide as a leader in the orthopaedic community.
Professor Ponseti was not only an excellent clinician and surgeon, but an outstanding basic scientist as well, with particular interest in the molecular biology of the cartilage matrix and connective tissues. In the 1950s, he was the first to show that an enzymatic defect of collagen aggregation caused by α-amino acetonitrile (a molecule present in sweet peas) triggers a pathological condition of connective tissues known as lathyrism that, in turn, causes scoliosis and slipped capital femoral epiphysis in animals. During the same years, he became the first orthopaedic surgeon to found biochemistry and electron microscopy laboratories which were devoted to investigating the aetiology and pathogenesis of several genetic, congenital and developmental orthopaedic diseases. This strong background in the basic sciences made him a highly unique surgeon. At the end of a discussion on a very complex surgical case whose final result was not expected to be satisfactory, he would say: “This case cannot be solved in the operating room, but it should be studied in the laboratory!”
Both the clinical and the research activities of Professor Ponseti are documented by more than 100 papers, lectures at scientific meetings and monographs—many of which have become ‘classics’ in the field—as well as by numerous honours and awards. He received the Kappa Delta Award for Outstanding Orthopaedic Research in 1955, the Hektoen Gold Medal from the American Medical Association in 1960, the Alfred Shands Award from the American Academy of Orthopaedic Surgeons in 1975, the American Orthopaedic Association Award for Distinguished Contributions to Orthopaedics in 2003, the Paediatric Orthopaedic Society of North America Award for Distinguished Contributions in 2005 and EPOS’ most prestigious Maximis Meritis medal in 2006.
Professor Ponseti was also a renaissance teacher. I was privileged to benefit from his teaching skills, having been his student during my 2 years of fellowship at the University of Iowa. His dedication and patience were exemplary in the academic world.
In 1984, Professor Ponseti retired from clinical activities of the Department of Orthopaedic Surgery at the University of Iowa, and he became Professor Emeritus. Those who might have thought that he would reduce the amount of his research work as well as his clinical and teaching activities were not familiar with the scholar and surgeon that he was! Closure of his routine clinical activity opened the way to an even more active professional life. He was able to concentrate all of his energies on publishing his method of treating clubfoot, mainly based on his vast knowledge of the pathophysiology of this congenital deformity. His book on congenital clubfoot, published by the Oxford University Press in 1996, will remain a milestone in the history of that deformity. The Ponseti method of treating congenital clubfoot has become widespread during the past decade, and thousands of children who will never know his name will undergo this procedure. Their ability to run, jump and play will be the finest testimony and the greatest reward for his determination and dedication to grant them active, healthy lives.
Professor Ponseti will be remembered with admiration and respect. His legacy will be felt for generations to come. He will be sorely missed.