Management of fractures of the humerus in Ancient Egypt, Greece, and Rome: an historical review.

Abstract

Fractures of the humerus have challenged medical practitioners since the beginning of recorded medical history. In the earliest known surgical text, The Edwin Smith Papyrus (copied circa 1600 BC), three cases of humeral fractures were described. Reduction by traction followed by bandaging with linen was recommended. In Corpus Hippocraticum (circa 440-340 BC), the maneuver of reduction was fully described: bandages of linen soaked in cerate and oil were applied followed by splinting after a week. In The Alexandrian School of Medicine (third century BC), shoulder dislocations complicated with fractures of the humerus were mentioned and the author discussed whether the dislocation should be reduced before or after the fracture. Celsus (25 BC-AD 50) distinguished shaft fractures from proximal and distal humeral fractures. He described different fracture patterns, including transverse, oblique, and multifragmented fractures. In Late Antiquity, complications from powerful traction or tight bandaging were described by Paul of Aegina (circa AD 625-690). Illustrations from sixteenth and seventeenth century surgical texts are included to show the ancient methods of reduction and bandaging. The richness of written sources points toward a multifaceted approach to the diagnosis, reduction, and bandaging of humeral fracture in Ancient Egypt, Greece, and Rome.