Oscar H. Allis, M.D.

   H. Augustus Wilson M.D.

   James T. Rugh, M.D.

   James R. Martin, M.D.

   Anthony F. DePalma, M.D.

   John J. Gartland, M.D.

   Richard H. Rothman, M.D., Ph.D.
Anthony F. DePalma, M.D. (1904-)
Fourth Chairman
Third James Edwards Professor (1950-1970)
With Martin's retirement in 1950, Anthony F. DePalma was appointed the third James Edwards Professor and Chairman of the Department. Three essential ingredients were in place that could promise further growth and development for orthopaedic surgery at Jefferson. Wilson had provided Departmental status, Rugh pioneered the surgical emphasis for the specialty, and Martin initiated the Residency program. The appointment of a full-time faculty in orthopaedics, however, was still 20 years away. Drs. Wilson, Rugh, Martin, and DePalma all engaged actively in the private practice of their specialty from off-campus offices. They also did their clinical work in other local hospitals in addition to Jefferson Hospital. They contributed time to Jefferson for teaching and managing the administrative details of the Department.

DePalma soon proved himself to be a forceful teacher and a busy clinical orthopaedic surgeon. He was a skillful surgical technician and his practice eventually grew to huge proportions as his reputation spread beyond the confines of Jefferson. A sense of excitement was returned to orthopaedics by DePalma's surgical experience and dynamic teaching style. The students were stimulated, and DePalma influenced many to seek careers in orthopaedic surgery. Many Jefferson students who later held orthopaedic faculty appointments at Jefferson received their graduate orthopaedic education under him. Among the group were Drs. Gerald E. Callery (Jefferson, 1943), John J. Dowling (Jefferson, 1947), Hal E. Snedden (Jefferson, 1950), Jerome M. Cotler (Jefferson, 1952), James M. Hunter (Jefferson, 1953), J. David Hoffman (Jefferson, 1956), Phillip J. Marone (Jefferson, 1957), Richard A. Camilli (Jefferson, 1958), and John M. Fenlin (Jefferson, 1963). Richard H. Rothman, later destined to become the fifth James Edwards Professor of Orthopaedic Surgery and Chairman of the Department in 1986, completed his orthopaedic residency with DePalma in 1968.

DePalma proved to be a tireless worker both in his own clinical practice and in academic pursuits. He was a prolific writer, and his orthopaedic texts are still considered classics. They appeared as follows: Surgery of the Shoulder (1950) in three editions; Diseases of the Knee (1954); Degenerative Changes in the Sternoclavicular and Acromioclavicular Joints in Various Decades (1957); The Management of Fractures and Dislocations (1959), in two volumes; and The Intervertebral Disc, co-authored with Richard H. Rothman (1970). He also edited Clinical Orthopaedics a series of volumes in symposium form produced under the auspices of the Association of Bone and Joint Surgeons. Because of his constant productivity, Jefferson's national prominence in orthopaedics gradually enlarged.

If DePalma had a weak spot, it was his tendency to be too much of a "one-man show." It was difficult for younger faculty members to develop academically and clinically in this environment at Jefferson during those days, and many left to develop their own services elsewhere. DePalma tended to be somewhat arbitrary and brusque when he believed he was correct on a point. As a consequence he did not enjoy a great personal popularity with the other Philadelphia orthopaedic professors. This attitude also tended to hurt him nationally, where he was regarded with respect but, at the same time, considered somewhat controversial. These mixed reviews from his colleagues undoubtedly played some role in delaying his election to membership in the American Orthopaedic Association until 1965.

During his chairmanship, DePalma established an orthopaedic research laboratory in the space formerly occupied by the Department of Pathology on the fifth floor of the College building. In 1953 he became founding editor of Clinical Orthopaedics, a respected series of volumes in symposium form still published eight times yearly by J.B. Lippincott Company. The original editorial office for this publication was a small room in the space occupied by the orthopaedic outpatient clinic on the sixth floor of the Curtis Clinic Building. In 1970 this orthopaedic outpatient clinic space was converted into administrative offices for the Department. From 1970 until 1985, this same small room functioned as the administrative office for the senior orthopaedic resident. DePalma founded the Jefferson Orthopaedic Society in 1960, with membership offered to former residents and all Jefferson alumni who had elected careers in orthopaedic surgery. The Society has remained active and holds a two-day scientific meeting on the Jefferson campus yearly. It celebrated its twenty-fifth anniversary with a special meeting in Puerto Rico during November, 1984.

It was also during DePalma's tenure as Chairman that Jefferson developed a specific presence in the important orthopaedic subspecialty of hand surgery. After James M. Hunter (Jefferson, 1953) completed his orthopaedic residency under DePalma, he took a one-year fellowship in hand surgery with Dr. Robert E. Carroll at Columbia-Presbyterian Medical Center in New York. He returned to Jefferson and became the first Philadelphia orthopaedic surgeon to confine his practice totally to surgery of the hand. He originally began practice in association with DePalma but later opened his own office. He was joined by his first associate, Dr. Lawrence H. Schneider, in 1969. As noted previously, Jefferson had no full-time orthopaedic faculty as yet, and all members supported themselves by a private practice conducted in outside offices. From the outset, Hunter was considered Jefferson's hand surgeon, and he responded by keeping his office close to the Jefferson campus and by doing almost all of his surgical work in Jefferson Hospital. Hunter was a hard worker and innovative researcher in both the basic and clinical spheres. His research led, ultimately, to the development of the "Hunter tendon" in 1965, the first successful artificial tendon for use in reconstructing severely damaged hands.
Hunter's reputation as a hand surgeon grew over the years, progressing from a local to an international stature. In 1978 he coauthored Rehabilitation of the Hand with Lawrence H. Schneider, M.D., Evelyn J. Mackin, L.PT, and Judith A. Bell, O.T.R. A second edition with additional collaborators appeared in 1984. His clinical load grew proportionately, requiring him progressively to increase his professional and support staff. By 1985 this group totalled four hand surgeons, four hand fellows and a support staff of approximately 50 persons, all housed in a building at Ninth and Walnut Streets known as the Hand Rehabilitation Center. Although hand surgery at Jefferson began and remains an essentially private practice, this group officially accepted the designation of Division of Hand Surgery of the Department of Orthopaedic Surgery when the Department was later reorganized by Dr. John J. Gartland, the fourth James Edwards Professor. This reorganization gave administrative structure to hand surgery and allowed participation in the organized educational programs of the Department without forcing a change in their financial arrangements by acceptance of full-time status within the Department.

DePalma was the busiest orthopaedic clinician Jefferson ever had or, possibly, ever will have. His clinical practice was enormous, with a huge surgical caseload. As pleasant as this appeared to be to hospital administrators, a price had to be paid. The price was a gradual lessening of the effort put into educational programs for students and residents. Although DePalma tried hard, it was simply impossible for one person to do it all. As a consequence, he delegated much of the responsibility for conducting the educational programs to junior faculty but without giving them authority to make needed changes. At first this seemed to work well, as many junior faculty appeared stimulated by the challenge to teach. Unfortunately, their enthusiasm waned as they gradually realized there was little chance to develop a clinical practice at Jefferson as long as DePalma remained so busy. He incorporated many of the junior faculty into his office as "Associates" and between 1952 and 1970 there were at least ten such associates. The bulk of responsibility for student teaching fell to Dr. John J. Dowling. He accomplished the assignment so well that the Jefferson Class of 1974 honored him by presenting his portrait to the College. He also served as President of the Alunmi Association in 1984.

Between 1950 and 1970 the residency program had been gradually enlarged to a total of 24 Residents basically as a response to the large clinical volume. During this period the hospitals used for resident education in orthopaedics were Jefferson, Philadelphia General, Methodist, and the State Hospital for Crippled Children at Elizabethtown. Unfortunately, the Philadelphia General Hospital was approaching the end of its unique history as a Philadelphia institution, and orthopaedic attending coverage for the residents was sparse. In 1969 the Residency Review Committee for Orthopaedic Surgery noted the imbalance of the Jefferson program toward service demands as compared to educational commitments and strongly suggested the program be reorganized with a larger educational base.

DePalma was a very active participant in Jefferson affairs and chaired many important faculty and medical staff committees. He served as President of the Altunni Association in 1959. He made many lasting and significant contributions to the growth and development of orthopaedic surgery at Jefferson. Although intangible, perhaps, his most important contribution was a legacy of Departmental strength, vitality, and professionalism. He inherited a Department that was admittedly weak in staff members, clinical volume, and faculty influence. His tireless energy and enthusiasm achieved an enlarged clinical volume, enhanced the teaching programs, and commanded faculty respect. He retired as Chairman in 1970 and was followed by Dr. John J. Gartland (Jefferson, 51944) as the fourth James Edwards Professor. At the time of DePalma's retirement, the Department of Orthopaedic Surgery, although still small by most faculty standards, was generally agreed to be one of the stronger Departments of the institution. The Class of 1962 presented his portrait to the College. In 1975, five years after his retirement as Chairman, Dr. DePalma was awarded Jefferson's Alumni Achievement Award.

John J. Gartland, M.D.

Thomas Jefferson University Hospital Department of Orthopaedic Surgery.