‘I want to see the work’: Maud Forrester-Brown: inspiration and paradigm

Maud Forrester-Brown was born in 1885, three years after Robert Koch (1843–1910) isolated the tubercle bacillus and 10 years before Wilhelm Roentgen (1845–1923) reported ‘a new kind of ray’. When she died in 1970, total hip replacement had become an accepted surgical procedure.

Her professional life is a paradigm of developing orthopaedic surgery. Twenty years before her birth, there were already three orthopaedic hospitals in London and her life overlapped, by six years, those of two founding fathers of British orthopaedics, William John Little (1810–94) and Hugh Owen Thomas (1834–91). Two years after her birth, the American Orthopaedic Association was founded though it was to be a further seven years before the British Orthopaedic Society met first in 1894. It was to survive only until 1900, followed 17 years later by the founding of the British Orthopaedic Association. ¹ Only three years later, one of Forrester-Brown's earliest presentations to a meeting of the Association was greeted by markedly sceptical comments from two founder-members later to become doyens of the profession, Harry Platt (1896–1996) and Blundell Bankart (1879–1951). ² However, she was later to serve both as Honorary Secretary of the Association and as a member of its Executive Committee. She knew, visited and was mentored by both Robert Jones (1857–1933) and Gathorne Girdlestone (1881–1950), and incorporated their guidance and principles into building up the geographically huge network of children's orthopaedic clinics, which she personally ran in south-west England. ³

Maud Forrester-Brown was a true orthopaedist in the literal and original sense of the word. In 1929 her own book on the management of deformity in infants and children was published. ⁴ John Kirkup writes that she ‘dedicated her life to an emergent specialty', ³ yet in her work she remained the epitome of an orthopaedic generalist. Later were to come ‘orthopaedic specialists’. Now the anatomically restricted elective range of most orthopaedic surgeons has made them into super-specialists.

The breadth of Forrester-Brown's published work in content and time was remarkable. It extended over almost 50 years and included widely disparate topics in paediatric and adult orthopaedics, from the surgery of paralysis to the primary and secondary surgical management of trauma. Putting her name into Google-Scholar today will still produce more than 80 references and her work is quoted in major review articles in several fields. ^5,6

She was a pioneer in the surgery of nerve injury and of the effects of paralysis, published some of the earliest work on tendon transfers, described innovative sliding osteotomies for bone and joint deformities resulting from trauma, ⁷ and reported one of the earliest series of cases showing remodelling of the femoral head and neck after slipped upper femoral epiphysis. ⁸ She recognized and described the value of compression of cancellous bone surfaces in the acceleration of osseous union as early as 1939. ⁷ She was one of the earliest orthopaedic surgeons to take an active interest in ergonomic principles and in the importance of posture. Though best known for her splint for congenital dislocation of the hip, throughout her career she was an inventive originator of orthopaedic splints and appliances, and finally in her 82nd year published her experience with one of these, a flanged and perforated protective plastic dome for the conservative management of open myelomeningocoele. ⁹

Maud Forrester-Brown was an early exemplar of CPD (Continuing Professional Development) before the abbreviation or even the phrase was invented and given official status. She read and travelled widely, as John Kirkup's paper relates. ³

Early in his poetic career Ezra Pound (1885–1972), an exact contemporary of Forrester-Brown, born two weeks before her and who died two years after her, wrote in a poem about the painter Whistler (To Whistler, American): ¹⁰ You also, our first great, Had tried all ways; Tested and pried and worked in many fashions, And this much gives me heart to play the game. The first three lines could equally reflect the work and experience of Maud Forrester-Brown and perhaps even the last line would have appealed to such an amazingly versatile all-round sportswoman.

In 1963, still travelling and learning enthusiastically at 78, while visiting the Philippine National Orthopaedic Hospital she is reported ¹¹ to have said, ‘I do not just want to see the buildings; I want to see the work’.

Let us look again at her work, and be inspired.