Живојин Бумбаширевић : (1920–2008)

Abstract

Živojin Bumbaširević was born on July 26th, 1920, in Kruševac. He enrolled at the School of Medicine in Belgrade in 1938. Th e war interrupted his studies, so he worked as a medic instead. He continued the studies aft er the war and graduated in 1948. Aft er completing his internship, he was relocated to the Orthopaedic Trauma Clinic and in 1950 he commenced his specialisation studies. He passed t he Specialty Certifi cate Examinations (SCE) in 1955 with fl ying colours. In 1956, he was appointed the head of the department, between 1961 and 1971 he was assistant director, and between 1971 and 1980 the Director of the Clinic. Even aft er retiring in 1985, he continued working as a consultant at the Outpatient Department of the Clinic for several years. Dr Bumbaširević attended several professional training courses at orthopaedic and trauma clinics in Paris and Bordeaux. In 1952, he was elected as an assistant at the School of Medicine. In 1959 his habilitation internship was recognised so he was elected as a docent, and in 1969 he became a professor. He obtained his PhD in 1975, and in 1976 he was promoted to Full Professor. He taught orthopaedic and trauma surgery to physicians on specialist courses. Between 1980 and 1985, he was the Director of Postgraduate Studies in orthopaedics and traumatology. In 1964, he became a member and, in 1969, he presided over the speciality certifi cate examinations board for the candidates taking their SCEs in orthopaedic and trauma surgery. He was also a member of equivalent boards at Schools of Medicine in Novi Sad and Niš. Between 1967 and 1986, he was on the examination board for candidates taking exams in general and orthopaedic surgery at the Military Medical Academy (VMA). He was elected as a corresponding member of the Serbian Academy of Sciences and Arts (SANU) in 1983, and its full member in 1994. Academician Bumbaširević wrote two chapters for the textbook Surgery, edited by S. Petković and S. Bukurov, and one chapter for the monograph Diabetes mellitus, edited by D. Đurić (1982). He lectured a lot, by invitation, at national scientifi c gatherings and international congresses and symposia. He chaired sessions of the World Association of Orthopaedic Surgeons and Traumatologists (SIKOT) and may other congresses of national orthopaedic and trauma associations. His papers were cited in Campbell’s leading orthopaedic textbook Operative Orthopaedics- Surgical Techniques. Academician Bumbaširević was the head of several scientifi c research projects fi nanced by the Government of the Republic of Serbia, the SANU and the city of Belgrade. He mentored 29 candidates for doctoral and master’s degrees and was on the evaluation committee for the defence of 59 masters theses and doctoral dissertations at the schools of medicine in Belgrade, Novi Sad, Niš and Skopje, as well as at the Military Medical Academy in Belgrade. For a long time, he was a board member of the Serbian Archives of Medicine, Acta Orthopaedica Iugoslavica, Acta Biologiae et Medicinae Experimentalis. Since 1978, he was a member of the editorial board of the periodical Revie de Chirurgie Оrthopédique et Réparatrice de L’appareil Moteur (Masson Paris); an external editor of the periodical Beitrage zür Orthopaedie und Traumatologie and Orthopedia y Traumatologia (Harkov), formerly a prominent USSR journal but now Ukrainian, since 1993. Bumbaširević organised many scientifi c gatherings and congresses. Th e biggest was Th e East and West Combined Meeting, the world congress of orthopaedic and trauma surgeons, held in Belgrade in 1988. On the occasion of the celebrations of the 200th Anniversary of French Revolution in 1989, he organized a meeting of Serbian and French orthopaedic surgeons in Belgrade. He was a member of three sections of the Serbian Medical Society (SMS), the Yugoslav Association of Surgeons, the Yugoslav Association of Orthopaedic and Trauma Surgeons, a full member of the Medical Academy of the Serbian Medical Society, and a full and honorary member of orthopaedic and trauma associations in several countries. He was also a long-standing member of the Board of Directors of the Society for Cultural Cooperation between France and Yugoslavia and, since 1993, an honorary member of its Presidency. He received many honours from the SMS, schools of medicine in Belgrade, Zagreb and Niš, a Silver and Gold Tree diploma from JUOT (the Orthopaedic Trauma Association of Yugoslavia), various diplomas from the JUOT, the Association of Medical Societies of Yugoslavia, the City of Belgrade, SIKOT, University of Brno (Universitas Purkiniana), the Priorov Medal from the USSR Central Orthopaedic and Trauma Institute, a medal and diploma from the Medical Academy in Roma. He was also the recipient of the July 7th Award, Order of Labour with Golden Wreath, Order of Merits for the People with Silver Rays, the Knight of the Legion of Honour Medal, etc. He was a member of the Crown Council since its foundation. Professional and scientific contribution by academician Živojin Bumbaširević presents a mixture of clinical and surgical practices and scientifi c papers that resulted from many years of dedicated work. He was one of the fi rst orthopaedic surgeons in the country who applied a serious scientifi c approach to the treatment of synovial joint traumas, spinal cord injuries, haemophilic arthropathy, and bone tumours. Each of these areas benefi ted greatly from his expertise. He was the fi rst national author whose tumour treatment technique is quoted in Campbell’s Operative Orthopaedics, the “Bible” of orthopaedic surgeons. Prof. Bumbaširević understood the impact of trauma on synovial joints, the consequences and treatment methods. In his paper from 1953, he gave a detailed clinical and statistical work situation report at the Orthopaedic Trauma Clinic for the period between 1947 and 1950. Th is was the fi rst time that a systematic description of epidemiology and management of limb injuries was provided in former Yugoslavia. For over 50 years and with a great commitment, Bumbaširević studied trauma injuries, especially those sustained in traffi c accidents, through clinical and scientifi c work, research projects and scientifi c publications. In the early 1950s, he recognized the importance of understanding road traffi c traumas and polytraumas from surgical as well as psychological points of view, and the propensity to cause accidents, which was labelled as such much later and the term accident prone persons introduced. Bumbaširević noticed the problem of femoral neck fracture in the early 1950s when he published a study of 81 patients treated with compression osteosynthesis, reporting only 4 fatalities – an impressive result even by today’s standards. Th e work of prof. Bumbaširević, including his own observations regarding the treatment of femoral neck fractures with hip (Austin Moore) prosthesis and transtrochanteric fractures, was a pioneering undertaking. Prof. Bumbaširević was one of the few authors who, in 1965, published papers on injuries and fractures of amputees. He also described radiographic signs of bone healing aft er injuries sustained by athletes, wrestlers and height jumpers, the area not suffi ciently researched up until then, for which he won acclaim, and still does nowadays, and whose results are acknowledged through work of many of today’s orthopaedists. Prof. Bumbaširević was particularly interested in spinal injuries. Together with engineers from the Faculty of Electrical Engineering and the Serbian Academy of Sciences and Arts, he demonstrated treatment of paralysed patients with exoskeletons. Th e latest model of the exoskeleton (Phoenix) weighs only 12 kilograms and has clinical applications, which proves that this was not a utopian idea. Prof. Bumbaširević was one of our first scientists to describe hyperextension injuries of the spine while studying cases of his patients in 1964, at the time when there was very little knowledge of such conditions. In 1962, he described the successful operative treatment of unstable spinal fractures, which represented a pioneering work in spinal surgery of that time. He published the results of the treatment of, and prognosis for, 225 patients with spinal cord injuries in his paper entitled Analysis of the neurological results in 225 cases of traumatic tetraplegia and paraplegia (Analyse des résultats neurologiques chez 225 cas de paraplégie et tétraplégie traumatique) published in the Revue de Chirurgie Orthopédique. Another research area to which Prof. Bumbaširević contributed greatly was haemophilic arthropathy. In 1961, he gave a precise description of the clinical and radiological picture of haemophilia and haemophilic arthropathy. However, bone tumours were the largest and perhaps the most important area which prof. Bumbaširević researched throughout his career. It was an area of special signifi cance at the time, bearing in mind that bone tumours are diffi cult to diagnose and treat which is a challenge even today, in the era of modern technologies. In the 1950s, it was a ground-breaking mission. Th e greatest tribute to his understanding of bone tumour pathology is the fact that he is quoted in the most important textbook for orthopaedic surgeons Campbell’s Operative Orthopaedics (1990). In 1955 already, he described a case of the chondrosarcoma of the scapula in the Serbian Archives while in 1957 he produced the fi rst outline of the tumour registry in former Yugoslavia, emphasizing the importance of a comprehensive overview of this issue, and not simply observations regarding the treatment of only one isolated case. He also explained the treatment of malignant tumours of the humeroscapular areas and preservation of upper limb function following radical removals of a tumour. Th is kind of approach to the preservation of extremities in orthopaedic oncology was publicised 20 years after the publication of the text Limb Salvage Procedures. In the treatment of osteoclasts, surgeons applied radical resection – a modern form of treatment of tumours – repairing bone defect by inserting a bone plug or by endoprosthetic replacement while localising tumour in the proximity of the femur. Th ey indicate that no clinical diagnosis can be made on the basis of clinical and radiological images (a widely spread notion at the time), and stipulate that a tumour biopsy is required prior to the treatment. A large study of 75 patients at the Orthopaedic Trauma Clinic, during the period 1950–1955 and 1961– 1970, presented the achieved results and the guidelines for the treatment of bone tumours. Prof. Bumbaširević also described osteoid osteomas, benign types of a tumour, and gave a detailed description of the tumour localisation, age and the clinical picture of the patients, a precise radiological description by which this entity is characterised. In an article published in 1968, six patients diagnosed with eosinophilic granuloma were described, as well as diff erent localisations of granuloma and pathohistological verifi cations of their clinical diagnosis. Solitary xanthomatous tumours were also explicated. Tumour resection treatment was described in the articles Diaphyseal Epiphyseal Resection in Bone Tumours of the Knee, and in Résection en bloc et reconstruction dans le cas de la tumeur des cellules géantes – grade II, in 1977. He also introduced computers and ultraviolet light in orthopaedic surgery and arteriography in bone tumour diagnosis; novel diagnostic and treatment methods in those days. In 1958, Prof. Bumbaširević established a bone marrow bank for compensation of bone defects, described fractures and changes in epileptic patients, and the use of electromagnetic fi elds in the treatment of fractures and stimulation of bone growth.