David H. Clements, III, MD
Historical Committee Member
Although bracing was begun for treating scoliosis in the 1950s, its efficacy and utility continue to be subjects of debate on the podium and in posters. The first brace to be developed and widely used was the Milwaukee Brace, named for the city of its inventors Walter P. Blount, MD and Albert C. Schmidt, MD. Dr. Blount’s name is still widely spoken, but Dr. Schmidt has undeservedly faded into obscurity. Thanks to David B. Levine, MD, Scoliosis Research Society Past President 1979 and Director of Hospital for Special Surgery Alumni Association, we are able to review Dr. Schmidt’s accomplishments and discuss his most important contribution.
Dr. Schmidt was an engineer before he was a surgeon. He trained at the Hospital for Special Surgery as a Fellow when John R. Cobb, MD was performing scoliosis surgery there using a technique of posterior fusion through a turnbuckle cast. The cast was used to obtain correction postoperatively and the patients were kept at bed rest for up to six months. Dr. Schmidt then went on to practice at the Milwaukee Children’s Hospital and the Medical College of Wisconsin. In 1945, he and Dr. Blount developed the brace as an alternative to the turnbuckle cast. At first the brace was used as postoperative immobilization only for thoracic curves, which were to be fused.
The brace was custom fitted to the patient who then wore it up to three weeks pre-operatively to “get used to it.” Then with adjustments of the brace pre-operative correction of the scoliosis occurred. The brace was removed prior to performing the posterior fusion, then reapplied postoperatively and subsequently lengthened for four weeks to obtain further correction. The patient was maintained at bed rest for five months to minimize pseudoarthrosis. Interestingly, Drs. Schmidt and Blount recommended using the brace sparingly in non-operative management, except near the end of growth or in chronic poliomyelitis. The brace continued to be developed and used into the seventies. Dr. Schmidt was one of the founding members of the SRS in 1966. He was elected to the American Orthopaedic Association (AOA) in 1952. He was president of the Hospital for Special Surgery (HSS) Alumni Association in 1955-56. He died in 1982.
Committee Chair: Behrooz A. Akbarnia, MD Committee Members: Nathan H. Lebwohl, MD, Past Chair; Vishal Sarwahi, MD; David H. Clements, III, MD; Azmi Hamzaoglu, MD; Reinhard D. Zeller, MD; Lawrence I. Karlin, MD.