Educational Article

An American Innovator in Fracture Care Remembered

By Dr. Robert Martin

Leslie V. Rush MD has a serious problem. One of his patients had a severely comminuted fracture of one of the forearm bones, the ulna. It was the type of fracture that usually resulted in deformity with possible lifelong pain.

As the 31-year-old surgeon from Meridian, Miss, was attending church one Sunday in September 1936, his mind was more on his patient than the sermon. Suddenly, it occurred to him that he could put a sharpened metal pin through the bone marrow and wire the fragments together. The next day, Rush and his brother H. Lowry Rush, MD, attempted this pioneering procedure. Thus Kittie Bell Rembert became the first American to undergo intramedullary pinning for fracture fixation and her arm was restored.

It did not take long for Leslie V. Rush to understand the importance of his breakthrough. Soon he was using the pins in the femoral shaft (thighbone) fractures. The dynamic nature of the pin resisted the deforming force of the bone and allowed patients immediate weight bearing and cut healing time by weeks.

Rush’s experience with intramedullary pinning continued, and he dedicated his life to investigating various materials and designs to optimize the procedure making Leslie Rush one of the foremost American innovators in fracture fixation.

As with most concepts that challenge conventional thought, the intramedullary pinning technique took years to be accepted by the mid-century American surgical community. Rush first published on his experience with his pinning technique in 1937 and demonstrated it the same year at the Southern Medical Association (SMA) but few surgeons showed any interest. Twelve years later, however, at a meeting of the same SMA crowds of surgeons welcomed him.

Rush’s orthopaedic inspirational ideas emanated from a strong family tradition in the field. After graduating medical school in 1927, Rush followed his brother and joined the staff of his father’s hospital, the D. J. Rush Infirmary. The infirmary, precursor to Rush Memorial and today’s Rush Foundation Hospital, was Meridian’s first private hospital and was established in 1915.

Most of Rush’s patients came from the economically depressed farmlands of southern Mississippi. These patients had little money and could not afford to be hospitalized for long time periods for fracture care, as was the tradition then. This financial reality offered additional incentive for Rush to develop a method to stabilize severe fractures that would permit patients to be treated outside of the hospital.

Success continued for Rush and he established the Berivon Co. (named by combining his two children’s names, Beryl and Vaughan) to manufacture the pins. In 1951, the United States Department of Defense adopted Rush pins for treatment of femoral fractures. The use of intramedullary fracture stabilization advanced the care and rehabilitation of thousands of GIs during the Korean War by obviating the need for weeks and sometimes months in traction.

By the mid-1980’s, Berivon was producing 60,000 pins annually for distribution to 20 foreign countries. A true family-run business, Berivon usually operates with no more than nine employees and without a dedicated outside sales staff. The man behind the company has been described as a “creative dreamer” and a quiet, well-bred gentleman who was not comfortable in the spotlight. Dr. Rush died this week in 1987.

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