His
tory
of
AoVE
t t
he f
irst 4
0 ye
ars
Jörg A Auerortrun PohlerMartina schlünderferenc KásaGerhilde KásaMarvin olmstead Björn von salisGustave E fackelman
2
Fig 1 Ancient Egyptian cat, 2700 years old (wood) (Museum rietberg, Zurich, switzerland).
Fig 2 trundholm sun Chariot, Denmark, 3400 years old. the horse and the wheels create the association of the rapid motion of the sun.
Since mythological, prehistoric times animals have been a
significant part of human culture and civilization. Historically,
it was an essential step forward in the development of man-
kind, when human beings learned how to tame, breed and
domesticate animals. A wooden Egyptian cat sculpture (Fig 1)
and a depiction of a horse transporting the sun (Fig 2) dem-
onstrate the artistic creation of animal sculptures in ancient
times. Throughout history animals have played different roles
and have had different functions: they were adored, used
for work, food and clothing, and utilized for their specific
skills, which were often considered superior to those of human
being. However, they have also been misused and neglected.
The history of AOVET tells of the unique development of
systematic orthopedic operative fracture treatment in the
veterinary medical discipline on the basis of—and in anal-
ogy to—the methodology developed by AO/ASIF to treat
systematic osteosynthesis in human patients. It shows that
large and small animal veterinary surgeons and ultimately
their patients profited from the clinical experience gained in
the treatment of human patients.
timeline of AoVEt 4
1 setting the field 7
2 How AoVEt started 19
3 the Waldenburg Circle 29
4 osteosynthesis in small animals 33
5 Maxlie the horse 41
6 institutionalizing the Waldenburg Circle:
the foundation of AoVEt and pioneering work 45
7 the hop over “the big pond” 59
8 spreading the word—AoVEt Center Waldenburg 69
9 Consolidating the achievements of the AoVEt founders 77
10 special events 85
11 Epilogue 91
List of AoVEt Presidents 93
references 94
Table of contents
3
4
1958
AO fo
unde
d in
Bie
l, Sw
itzer
land
1967
Björ
n vo
n Sa
lis m
eets
Frit
z St
raum
ann
1968
Wal
denb
urg
Circ
le s
tarts
wor
king
with
AO
ost
eosy
nthe
sis m
etho
ds
1968
1st t
itani
um 4
.5 m
m D
CPs
appl
ied
to a
McI
II os
teot
omy
in a
hor
se (N
ovem
ber)
1968
Mem
bers
of t
he W
alde
nbur
g Ci
rcle
par
ticip
ate
in th
e hu
man
AO
cou
rses
in D
avos
(Dec
embe
r)
1969
AOVE
T fo
unde
d in
Wal
denb
urg
(Aug
ust 3
1. 1
969)
with
Bjö
rn v
on S
alis
as 1
st P
resid
ent
1969
Key
Amer
ican
sur
geon
s pa
rtici
pate
in th
e hu
man
AO
cou
rses
in D
avos
(Dec
embe
r)
1970
1s
t AO
VET
cour
se in
Bet
tlach
, Sw
itzer
land
(Jan
uary
)
1970
1st A
OVE
T co
urse
at O
hio
Stat
e U
nive
rsiti
y in
Col
umbu
s, in
itiat
ed b
y Br
uce
Hoh
n (M
arch
)
1971
1st E
nglis
h AO
VET
cour
se in
Dav
os
1972
AOVE
T ac
cept
ed in
to A
O In
tern
atio
nal
1973
1st F
renc
h AO
VET
cour
se in
Dav
os (t
his
was
follo
wed
by
the
annu
al c
ours
es in
Cou
rche
vel f
rom
198
7 on
war
ds)
1974
1st s
mal
l ani
mal
vid
eos
deve
lope
d in
Dav
os a
nd C
olum
bus
1975
1st A
OVE
T Fo
ndue
Par
ty a
t the
Dav
os c
ours
es
1976
Die
ter P
rieur
take
s ov
er a
s Ex
ecut
ive
Secr
etar
y of
AO
VET
and
Dire
ctor
of t
he A
OVE
T Ce
nter
at t
he S
traum
ann
Inst
itute
in W
alde
nbur
g
1977
1st e
quin
e vi
deos
for p
ract
ical
exe
rcise
s de
velo
ped
in C
olum
bus
1982
1st G
erm
an A
OVE
T co
urse
in G
iess
en, G
erm
any
1982
1st E
quin
e AO
VET
Man
ual b
y G
usta
ve F
acke
lman
and
Dav
id N
unam
aker
is p
ublis
hed
tiM
ELin
E o
f Ao
VEt
5
1984
1st S
mal
l Ani
mal
AO
VET
Man
ual e
dite
d by
Wad
e Br
inke
r, Br
uce
Hoh
n, a
nd D
iete
r Prie
ur is
pub
lishe
d
1986
1s
t AO
VET
chap
ter e
stab
lishe
d in
Ger
man
y w
ith F
eren
c Ká
sa a
s ch
airp
erso
n1988
Fritz
Stra
uman
n di
es
1991
Die
ter P
rieur
retir
es a
s Ex
ecut
ive
Secr
etar
y of
AO
VET
and
Dire
ctor
of t
he A
OVE
T Ce
nter
1991
Mon
ika
Gut
sche
r sta
rts a
s Se
cret
ary
of th
e AO
VET
Cent
er in
Zür
ich
1992
The
AOVE
T Ce
nter
is m
oved
from
Wal
denb
urg
to th
e U
nive
rsity
of Z
üric
h un
der J
örg
Auer
, who
also
take
s ov
er a
s Ex
ecut
ive
Secr
etar
y of
AO
VET
1992
The
1st A
OVE
T m
embe
r is
elec
ted
to th
e Bo
ard
of T
rust
ees
of th
e AO
Fou
ndat
ion
(Jör
g Au
er)
1995
Th
e 1s
t ele
ctro
nic
AO M
anua
l inc
ludi
ng C
D-R
OM
is p
ublis
hed
by A
O P
ublis
hing
: AO
Prin
cipl
es o
f Equ
ine
Ost
eosy
nthe
sis1999
30-y
ear A
OVE
T ce
lebr
atio
n
2000
The
1st A
O M
anua
l is
publ
ished
by
AO P
ublis
hing
: AO
Prin
cipl
es o
f Equ
ine
Ost
eosy
nthe
sis
2003
AOVE
T re
ceiv
es th
e “D
istin
guish
ed E
duca
tor A
war
d” fr
om th
e Am
eric
an A
ssoc
iatio
n of
Equ
ine
Prac
titio
ners
2003
Brig
itte
von
Rech
enbe
rg re
ceiv
es th
e Re
cogn
ition
Priz
e fro
m A
OTK
2005
Synt
hesVET
is e
stab
lishe
d as
par
t of S
ynth
es In
c.
2008
AOVE
T be
com
es th
e 4t
h cl
inic
al d
ivisi
on w
ithin
the
AO F
ound
atio
n (J
une)
2008
Jörg
Aue
r rec
eive
s th
e Re
cogn
ition
Priz
e fro
m th
e AO
Fou
ndat
ion
(the
hig
hest
AO
aw
ard)
2008
50-y
ear f
estiv
ities
of t
he A
O F
ound
atio
n2009
40-y
ear c
eleb
ratio
n of
AO
VET
2009
Jean
-Pie
rre
Caba
ssu,
Pre
siden
t of A
OVE
T is
elec
ted
to th
e AO
VA
6
1 Setting the Field
7
sEtt
inG
tH
E fi
ELD
1
8
1 Setting the Field
Traditionally, in recent centuries in rural settings veterinar-
ians were mainly occupied with the treatment of horses and
cattle, which were mostly working and/or food-producing
animals. If necessary they also took care of “small animals”,
such as cats and dogs, as well as other domesticated animals.
Expensive treatments were not afforded to cats and dogs as
replacement was so natural and inexpensive. In the mid-
nineteenth century the disappearance of horses as working
animals and the advent of industrialization with increasing
introduction of machines, such as tractors, had a strong impact
on veterinarians not only regarding their professional iden-
tity but also economically [1–9]. Since then, horses have been
primarily used for pleasure riding or various sports activities,
such as racing, dressage, and show jumping, while cattle
have been kept as food and fiber-producing animals.
At the same time, particularly in the growing cities, small
animals increased in large numbers. These animals were kept
by their owners as pets, the most popular being cats and dogs
[10, 11]. The emotional attachment to these animals resulted
in the increasing commercialization of a pet’s life. Pets might
have been economically unimportant for their owners but
they had an economic value for breeders, the pet food
industry, and for veterinarians. While at the beginning of
the twentieth century small animal practitioners could be
found only in small numbers and only in large cities, their
numbers started to increase during the 1950s and 1960s and
now dominate veterinary medicine and surgery [1, 2, 12].
Because pet owners have been ready to spend an increasing
amount of time and money for their beloved, emotionally
highly valued animal companions, veterinarians have been
able to apply more demanding treatments.
9
The drastic modification of their patient population from
large animals to small animal pets confronted veterinarians
with new treatment regiments. Traditionally veterinarians
had been trained on the basis of the functional pragmatism
that ruled the lives of working animals [13–16]. In the context
of pet ownership, however, the veterinarian’s mission changed.
It was no longer about curing inexpensively or otherwise
killing the sick animal. The treatment of pets closely followed
the model of human medicine instead, something that was
increasingly expected by pet owners. Veterinarians thus
switched from a functional pragmatism to an “economy of
love” as a basis for their work. This change, however, con-
fronted veterinarians with the fact that they often did not
know how to treat an animal according to human medical
practice.
10
1 Setting the Field
Insufficiency in operative fracture treatmentThese problems were of particular relevance for veterinary
surgery, especially in the field of trauma and orthopedic sur-
gery. Modernization and industrialization had led to a rapid
increase in the numbers of motor vehicles and, consequently,
to growing numbers of animals injured in traffic accidents
[19]. The injuries they suffered were more complicated than
those caused by a simple accident, fall, or kick by another
animal. Thus, the veterinarians were challenged quantita-
tively with more fractured bones and qualitatively with more
complicated fractures. Whereas previously the injured animals
would have been euthanatized, now their owners expected
effort to be made to heal and save the lives of their pets. In
the 1950s and 1960s, however, veterinarians’ knowledge
and treatment options for dogs, cats, and horses with broken
bones were limited, although certain adoptions from human
trauma surgery had been made [17–24]. For operative fracture
treatment in small animals, the most popular approach in
Germany and Switzerland (as well as in other countries) was
intramedullary nailing corresponding to the Küntscher tech-
nique (Fig 3a–d) [25, 26] and modifications thereof, like the
Rush-pin application and the stacked pin nailing. The use of
these elegant but somewhat tricky surgical methods was
relatively widespread during that era, even though they had
their limitations. In dogs intramedullary nailing was more
demanding than in humans, since the cortex of the dog bone
is thinner and more brittle, the diameter of the medullary
space more diverse than in humans. Instability and subse-
quent complications, such as nonunions, pseudarthroses,
and implant failures, were frequently the result. Also, the
anatomy of long bones varies considerably among different
breeds, making this technique difficult to standardize [27].
One of the German small animal surgeons of the 1950s, Dr
Heinrich Müller, who studied intramedullary nailing tech-
niques, blamed a blatant lack of accompanying scientific
research and the ensuing lack of knowledge flow between
the fields of human and animal fracture treatment for the
poor results [28, 29]. Joint and near-joint fractures are dif-
ficult to stabilize with nailing techniques or with pins and
cerclage techniques, except for some special methods that
have been developed over time. Conservative fracture care
with plaster of Paris casts and bandages as practiced in hu-
man medicine is rarely suitable for small animals, since the
11
Fig 3a–d a Mrs Willenegger’s dog named Kai.b suffered a mid-shaft femoral fracture.c in the 1940s, Drs Knoll and Willenegger assisted Dr. Jacques Jenny insert a Küntscher nail into the
medullary cavity, which led to complete healing of the fracture.d 14-week follow-up x-ray after complete fracture healing with the nail still in place (left) and x-rays
2 weeks later after nail removal (right).
a b
c d
patients usually destroy such applications. Thus, fracture
treatment in small animals during the 1950s and 1960s was
problematic and had many shortcomings.
12
1 Setting the Field
In large animals operative fracture treatment was extreme-
ly difficult, although occasionally attempts were undertaken.
Dieter Prieur refers to an early case [27] from 1891, in Cairo,
Egypt, where a city police horse that had suffered a broken jaw
was successfully treated with a drilled wire suture (cerclage).
After 10 months the horse was back to work. A publication
in 1966 [30] reports on the osteosyntheses of fractures of the
lower jaw in cattle by means of compression-plate applica-
tions, carried out in collaboration by a veterinary surgeon
together with an experienced human surgeon.
A brief look at human trauma surgery in the mid-1950s
indicates that at this time many unsolved problems existed
in the operative treatment of fractures. Many trauma surgeons
characterized their field as the “Cinderella of modern surgery”
[31, 32]. Trauma surgery and fracture care had not partici-
pated in the triumph of modern surgery in the late nineteenth
and early twentieth centuries. One reason why fracture treat-
ment was relatively unattractive to most surgeons was its
conservative character. Most patients with fractured bones
were treated with immobilizing techniques, such as plaster
casts and traction. Operative fracture care was extremely
demanding in terms of operative techniques, implant design
and quality and asepsis. The associated risk of bone infection
made it unsuitable for large-scale use. Complications occurred
frequently but their reasons were rarely analyzed or under-
stood. Only a few surgeons tried to make operative fracture
care a viable option. Even in human fracture surgery not
much systematic scientific research was conducted. Knowl-
edge was usually based on personal experience of individual
surgeons and not on larger systematic clinical or laboratory
research. Aside from Gerhard Küntscher, who improved and
expanded the intramedullary nailing technique, there were
the esteemed surgeons Albin Lambotte and Robert Danis
who applied their novel ideas to stabilize fractures with ex-
ternal transfixation devices and with screws and plates [33].
13
Systematic approach to osteosynthesis in human surgery developed by the AO group The breakthrough and spread of a systematic operative frac-
ture treatment occurred with the founding of the Arbeits-
gemeinschaft für Osteosynthesefragen (AO) that took place
on November 6, 1958, in Biel, Switzerland [1]. Based on
private individual interest and driven by the search for
improved and dependable osteosynthesis techniques, the five
surgeons of the core group who initiated the formation of
the AO (Maurice Müller, Martin Allgöwer, Hans Willenegger,
Robert Schneider, and Walter Bandi) (Fig 4a–e) had met
numerous times between 1952 and 1956 to exchange their
experiences, concerns, and new concepts [33]. They concen-
trated increasingly on collaboration, systematic work, and
the analysis of clinical problems. By 1957 they formulated
essential preconditions for successful operative fracture treat-
ment stressing the importance of a functional view of osteo-
synthesis. In December 1957 they decided on the formation
of an “Association pour Osteosynthèse” [33, 34]. At an inter-
nal meeting in March 1958 they demonstrated and evaluated
all osteosynthesis equipment available at that time. The results
were disappointing and the five surgeons decided to develop
their own instrument and implant systems and surgical methods
for the different fracture types and orthopedic interventions.
Professor Maurice Müller, the most highly motivated and
most active of the group, presented an overview of the “aims
and general principles of modern osteosynthesis in adults”
that sounded almost like an AO program [44]. Among other
aspects the following characteristic points were included:
Basic Principles:
• Continuity of asepsis from accident to healing;
postoperative wound drainage; careful anatomical
operation, reconstruction and reduction
• The fractured area should be transformed into a
stable block by the osteosynthesis
• Where possible fragments should be set under
compression for increased stability
• Pseudarthroses tend to heal quickly under
compression, but the source for the pseudarthroses
should be detected and treated if required. The
implant materials must be biocompatible
Aims:
• Early postoperative mobilization and activation of
near-fracture joints and muscles; this is very
effective but must not be forced too much
• Reconstruction of the anatomical conditions; this is
a precondition for functional results
14
1 Setting the Field
The various aims and concepts were followed up meticu-
lously, with astonishing momentum and personal engage-
ment. To implement the agreed development of instruments
and implants, Professor Müller visited Robert Mathys in spring
of 1958 in his production company in Bettlach where he was
working with stainless steel.
Mathys started immediately to design and manufacture pro-
totypes, so that the first samples of the 4.5 mm screws with
the corresponding (round-hole) plates and implantation
instruments were available already at the founding meeting
in November of the same year. Thus, Mathys was the first
manufacturer of AO implants and became the first exclusive
producer of AO products (later to become Synthes products)
and contributed substantially to the development of the
equipment.
The AO surgeons were highly successful because they ap-
proached operative fracture treatment on an unusually broad
and systematic basis and, at a point in time, when important
new techniques in various fields like metallurgy, physics,
aseptic surgical techniques, and perioperative antibiotic man-
agement were developed and became available to solve ma-
jor problems of bone surgery. They developed implants,
instruments, surgical techniques, and after-care protocols
simultaneously. They studied the biomechanics of the normal
skeleton and of the injured and treated bones, and they
investigated osteogenesis, and bone healing mechanisms
under various conditions histologically and metabolically.
In 1959 the AO Research Institute for Experimental Surgery
was established in Davos through the particular initiative of
Fig 4a–e the principal founders of Ao: (a) Martin Allgöwer, (b) Walter Bandi, (c) Maurice Müller, (d) Hans Willenegger, and (e) robert schneider.
a db ec
15
Professor Martin Allgöwer and supported by the financial
donations of the AO members. The Documentation Center
for the clinical cases of the AO members was moved there,
and a tissue culture laboratory was soon installed. This lab-
oratory also addressed the question of metal toxicity and led
to the early studies of biocompatibility of implant materials
and their components by Dr Lotte Hulliger and Ortrun Pohler
[35, 36]. Professor Herbert Fleisch led the AO Research
Institute during the early years. His special research interests
were bone biochemistry and metabolism, as well as bone
pathology and the development of medications for bone dis-
orders. From 1967 onwards Professor Stephan Perren led
the Research Institute as its director and constantly expand-
ed its facilities in addition to its organization, engagements,
and the subjects of research at the highest level. He imple-
mented biomechanical, biological, and mechanical testing
and analyses, histological and clinical research, cell and
organ culturing, and biocompatibility studies, as well as the
development of implants and instruments. The AO Research
Institute also provided enormous teaching and operative
support for the annual Davos courses. The accumulated
knowledge and expertise of the AO Research Institute con-
tributed tremendously to the success of the AO concepts and
the AO Foundation.
After the Straumann Institute in Waldenburg was contacted
by the AO in 1960 (see next chapter), it became instrumen-
tal in developing implant materials that possessed the required
biocompatibility, corrosion resistance, and variability in me-
chanical properties [32, 33]. Along with other developments,
the Straumann Institute became the second exclusive pro-
ducer in 1962 [34–36]. The collaboration of the surgeons with
the producers, engineers, physicists, metallurgists, biologists,
and scientists contributed to development and progress and
provided specific research techniques. Also, the availability of
antibiotics at that time and improved antiseptic management
reduced the risk of infection and supported the surgical success.
The AO, together with its producers, pursued a strategy of
standardization and quality control of instruments and im-
plants as well as teaching correct equipment handling and
corresponding operative techniques. For this purpose, the
AO established the Technical Commission (TK) in 1961 for
the guidance, testing, and acceptance of new developments
in AO surgical equipment and methods.
16
1 Setting the Field
In so doing, they had organized a system of quality control
and assurance, many years before today’s required interna-
tional quality-management standards (ISO).
The AO members obtained more and more requests from
their colleagues who wanted the AO equipment for their
own surgery. Since the operation techniques were subtle
and the risks of probable complications high, the AO de-
cided to sell the equipment only to surgeons who were well
trained and attended a special instruction course. At the same
time it was agreed with Dr Peter von Rechenberg of Synthes
AG, Chur, that earnings from the sale of the surgical equip-
ment would flow back into the research. In December 1960
The experimental clinical and histological research conducted
by Professor Hans Willenegger (Hospital Liestal near Basel)
and Professor Robert Schenk (University of Basel at that time)
demonstrated that with sufficiently stabilized osteotomies
primary direct bone healing occurs without callus formation
[37, 38]. Stephan Perren showed with his strain gauge mea-
surements on experimental compression osteosynthesis on
sheep in combination with related histological investigations
that no bone resorption occurred with the exerted compres-
sion [39]. These scientific findings, combined with the many
documented successful clinical cases, soon convinced the
surgical orthopedic community. Meticulous documentation
and critical evaluation of the clinical cases, as well as learn-
ing from complications, were important milestones of the
AO philosophy. The yearly spring and fall closed membership
meetings and open scientific sessions provided a forum
for information, exchange of experience, and coordinated
clinical projects.
However, with the propagation of the “compression-osteo-
synthesis technique” where screws and plates created reduc-
tion of the fracture gaps and axial compression at the end of
the bone fragments, the AO surgeons met with opposition
from their colleagues because the common opinion then was
that compression destroyed the bone. Another related con-
troversy arose surrounding the phenomenon of “callus-free
healing”, which was detected in connection with the stable
osteosynthesis techniques. At that time it was generally
accepted that callus formation should be interpreted as a sign
of progressive bone healing. Thus, surgeons concluded
wrongly that the missing callus with stable internal fixations
indicated a lack of bone healing.
17
the first AO course was offered in Davos with lectures and
practical exercises using original implants and instruments
on anatomical specimens. The Davos courses were then of-
fered on an annual basis and have grown in numbers and
diversity of their content. Additional courses expanded in-
ternationally. Corresponding teaching material was developed
and continually updated including videotapes for practical
exercises. The first AO manual with descriptions of the var-
ious operation techniques for typical fracture treatments and
general introductory information was published in 1963 [40].
This was followed by a series of updated editions of AO
manuals [41–44] in different languages (the third edition
contains sections on biomechanics, classifications of fractures,
soft-tissue injuries, and other interesting topics [43]).
The teaching, documentation, classification, interdisciplinary
research, specific surgical equipment and methodology, and
an international radius of action were the important corner-
stones of the AO’s development. However, the essential el-
ement was an unusual willingness to cooperate and exchange
information and experience, sustained by a sincere and
wholehearted human attitude characterized by responsibil-
ity, honesty, and tolerance of each other.
This specific characteristic of AO membership supported the
formation of an AOVET organization, about a decade after
its own founding. AO was generous in sharing its surgical
methodology and scientific knowledge with the fledgling
discipline of veterinary orthopedic surgery. In this way, a
group of veterinary surgeons enabled to develop efficient
and dependable osteosynthesis methods on a systematic
basis for small and large animal fracture treatment. Some of
the AO principles and equipment could be transferred directly
to veterinary surgery, some of them needed adjustment and
modification, and new solutions had to be developed as well.
In addition, the veterinarians had to learn many of the gen-
eral surgical preconditions and skills, which are standard
procedures in the treatment of human patients. Moreover,
the veterinarians had to undergo numerous experiences
similar to those of the AO founders.
18
2 How AOVET started
19
Ho
W A
oVE
t st
ArtE
D
2
20
2 How AOVET started
Several fortunate coincidences led to the formation of the
initial group of veterinarians, human trauma surgeons, and
scientists that eventually resulted in the founding of AOVET.
A horse shot deadWhen Dr Björn von Salis (Fig 5) was a teenager he was taken
to the local horse races. In the middle of a race one of the
horses fell with a broken leg and shot dead on the spot. This
was a crucial experience for the young visitor and it led him
to become a veterinarian. Von Salis told himself that such
things could not be tolerated, and dedicated the rest of his
life to finding solutions to this problem. When he worked as
a senior veterinarian at the Equine Hospital of the Univer-
sity of Bern in the 1950s, he noticed how underdeveloped
the facilities for equine surgery were. Neither adequate
instruments nor surgical techniques were available for equine
trauma surgery. Also, horses could not be anesthetized for
longer than 30 minutes. At that time horses were exclusively
anesthetized with intravenous chloral hydrate. Therefore,
von Salis decided to first examine the problem of anesthesia.
Veterinary anesthesia was more advanced in the UK, where
Leslie Hall was starting to use halothane for inhalation
anesthesia. Intrigued by this work, von Salis decided to go
there and study these new techniques. After returning to
Switzerland he introduced these techniques into the standard
procedures at the Equine Hospital of the University of Bern
and later published an article on equine anesthesia [45]. His
second goal for improving equine surgery was the development
of new transportation facilities for horses after an accident.
Since horses were typically put to death humanely, little
experience existed on how to transport an injured animal
and what kinds of devices were needed to load an injured
horse into a trailer, either in a standing or recumbent posi-
tion. This challenged him to construct an ambulance vehicle
equipped with an x-ray unit and first-aid facilities.
21
In the mid-1960s von Salis left the University of Bern and
moved on to work in a small animal practice in Basel so that
he could complete his specialization degree in small animal
surgery and medicine. There he became friends with Ferenc
(Feri) and Gerhilde (Geri) Kása, small animal veterinarians
who practiced and lived in Lörrach near Basel on the German
side of the Rhine river. Von Salis never forgot the need to look
for adequate implants and instruments for trauma surgery
in horses.
Fig 5 Björn and Cathrin von salis during an Ao function in Davos.
22
2 How AOVET started
Dr Guggenbühl’s huge dogs Before Dr August Urs Guggenbühl became the chief and
general surgeon at the Hospital in Grenchen (near Solothurn)
in 1957, he worked as chief resident at the Liestal Hospital
under Hans Willenegger, one of the AO Founding Fathers,
Guggenbühl was the youngest of the 13 AO founding members
in 1958.
Urs Guggenbühl was the proud owner of seven dogs (Irish
Wolfhounds, a Great Dane, a Bordeaux Dane, a Mastiff, as
well as a Greyhound) who used to accompany him almost
everywhere in his Jaguar convertible (Fig 6). He was renowned
for showing up with all of them in tow. Actually, he had
never planned to have so many (and such huge) dogs. He
had ended up with them by accident but he loved to live
with them. Of course, Guggenbühl was in contact with the
local veterinarian at that time but he was not impressed
by the techniques and equipment used for fracture care in
animals. Therefore, he started teaching the veterinarian the
AO Principles of osteosynthesis. Occasionally, Guggenbühl
himself carried out a surgical intervention with the veteri-
narian’s assistance.
Fig 6 Urs Guggenbühl in front of his house with four of his prize-winning giant dogs.
23
Afterward he discussed these animal cases with his AO
colleagues. Willenegger, who knew about the veterinary
activities in Waldenburg, introduced Guggenbühl to the
veterinarians, which led to his engagement as a veterinarian
teacher.
An animal owner and engineerIn 1954, Dr Fritz Straumann (Fig 7) and his father Professor
Reinhard Straumann established a private research institute
in Waldenburg (near Basel) to facilitate further development,
investigation, and testing of watch-spring materials and
watch-spring designs that the elder Straumann had invented.
The spring metal alloys were sophisticated and their produc-
tion processes required close attention and metallurgical
expertise. Since Fritz Straumann was very interested in all
natural sciences and technology, he expanded their research
beyond the watch industry into other areas as well. The
concept was to invest the earnings from their patents into
their research institute.
Fig 7 fritz straumann giving an address during an Ao function.
In 1960 Fritz Straumann was contacted by Willenegger, who
was seeking assistanceto improve the material quality of AO
implants because there were problems with the corrosion
and failure of plates and screws. Ortrun Pohler (Fig 8) analyzed
the defect implants and found that impurities and an insuf-
ficient composition of the stainless steel were the reason for
the corrosion. The breaking of the implants was caused by
material fatigue where a crack propagates with time through
the material under alternating bending stresses (cyclic load-
ing). Such critical local bending stresses can be generated
under the load bearing of the patient, in cases where bony
defects and instability of the osteosynthesis are present. With
time this phenomenon was studied in depth [46]. Straumann
developed of a stainless steel with high corrosion resistance
and variable mechanical properties that were particularly
suited for clinical applications. This material became the
model for the internationally standardized implant steel that
is currently used. Straumann volunteered to help to the AO
surgeons, and was able to assist in the development of various
techniques to resolve clinical biomedical problems.
Fig 8 ortrun Pohler a scientific member of Ao and an AoVEt member working on a publication.
24
2 How AOVET started
For example, he developed the first bone saw that was able
to cut thin undecalcified embedded bone sections for histo-
logical microscopy. This provided bone histology with a tech-
nique to obtain a more detailed and realistic visualization of
the microscopic bone structure and further understanding
of bone remodeling and healing.
Fritz Straumann was also a passionate horseman. He owned
a number of horses and kept them at stables and an indoor-
riding arena close to a nearby castle called Bechburg
(Fig 9), a place also used for occasional veterinary activities.
Straumann also owned dogs (blood hounds and bassets). In
1967, when one of the dogs became sick, Fritz Straumann
took it to Dr Christoph Uehlinger, a small animal practitioner
in Basel, and there he met Björn von Salis.
25
Fig 9 Bechburg, near Waldenburg, the place where AoVEt was founded.
26
2 How AOVET started
Getting togetherChristoph Uehlinger told von Salis about Straumann’s in-
volvement in the development of instruments and implants
for fracture care in humans, and von Salis immediately rec-
ognized that Straumann could be instrumental in solving his
third problem concerning trauma surgery in horses: the de-
sign of appropriate instruments and implants. Von Salis helped
treat Straumann’s dog and started visiting the dog and its
owner at their home in Waldenburg. He had prepared him-
self very well for his first visit. He took his publications on
horse anesthesia and a Dutch book by Verhaar on operative
fracture management in large animals with him to Walden-
burg [47]. In those days fracture treatment in horses was in
its infancy. The two men got along very well from the start.
Indeed, their first conversation lasted until 3:00 am in the
morning. When von Salis asked Straumann at the end of
their meeting if he could help him with the instrumentation
problem, the engineer promised every kind of help and sup-
port, including the offer to use his laboratories. As a first step
Straumann set his metallurgist, Dr Ortrun Pohler, to work
on the “animal-project”. She was already experienced in the
research and development of AO implants and was in close
collaboration with the AO Research Institute in Davos. They
agreed to meet every Wednesday afternoon at the Institute
in Waldenburg to explore the conditions under which the
AO techniques and equipment could be applied to fracture
management in animals. Björn von Salis attempted to involve
Christoph Uehlinger in the devlopment of implants for the
veterinarians. When he declined, von Salis asked Feri and
Geri Kása (Fig 10a–b) who jumped at the chance because they
previously had a frustrating experience treating a radioulnar
fracture without proper instrumentation and implants. A week
later they joined Björn von Salis on his visit to Waldenburg
as they were searching for more efficient internal fixation
methods to overcome the limitations of the common nailing,
pin, and cerclage techniques they were using so far. Although
they had developed particular skills in nailing fractures in
small birds (Fig 11a–c) [48], this was the start of intense work
on veterinary osteosynthesis in large and small animals.
Fig 10a–b ferenc (a) and Gerhilde (b) Kása, the first small animal surgeons working with Ao techniques.
a
b
27
Fig 11a–c a Preoperative x-rays of a fracture of the distal metaphysis of the tibiatarsus in a canary bird; treated by feri and Geri Kása.b intraoperative picture showing the incision. c Postoperative x-rays following intramedullary pinning of the fracture with a straight needle.
a
b c
28
3 The Waldenburg Circle
29
tHE
WAL
DEn
BUrG
Cir
CLE
3
30
3 The Waldenburg Circle
Studies of osteosynthesis in large animalsThe experimental work on horse bones in the Straumann
laboratories began immediately after the key meeting between
Drs Björn von Salis and Fritz Straumann. The primary ques-
tions to be answered were: (1) what type of fractures actu-
ally occur in horses; (2) how could such fractures be stabilized
with already existing AO implants, and what specific implants
and instruments needed to be developed; (3) would such
fixations remain stable under the heavy weight-bearing load
of an adult horse; and (4) would the fracture eventually heal
with the help of internal fixation, and would the attainable
stability suffice?
For this work von Salis collected horse bones from animals
that had to be slaughtered because they had suffered a frac-
ture. X-rays of the bones were taken with the mobile x-ray
unit from his Equine Ambulance. Very soon it became clear
that on the large bones, such as the adult femur and hu-
merus, osteosynthesis would be almost impossible from a
biomechanical point of view. For the other bones of the limbs
there seemed to be possibilities for internal fixation, given
the fractures were not too complicated. With the largest type
of existing AO plates and screws, some of the actual fractures
could be well stabilized. Interestingly, the mechanical load-
ing tests that followed demonstrated that it was extremely
important to apply the compression plates and screws in a
biomechanically optimal way as taught by the AO principles
for human surgery. Also the most precise anatomical fracture
reduction was necessary to achieve sufficient postoperative
stability and immediately allow full weight bearing on the
fractured leg.
Some of the instruments had to be modified because of the
big diameters of the horse bones. The first explorations were
encouraging and suggested that there might be certain types
of common fracture configurations that could be treated
surgically. It appeared that the largest, the 4.5 mm cortex
screw and plate system, would be suitable for the major
applications and other already available implants seemed
useful too. But some new implants and instruments would
have to be developed and others adapted to the dimensions
of the horse bones (Fig 12). Later on, a 5.5 mm large animal
cortex screw was developed by Pohler with improved strength
and good holding resistance in cortical and cancellous bone
[49]. However, the major question remained: would such
31
stabilized fractures really heal, and how long would the healing
process take? How could the horse be placed on and taken
off the surgical table and back on its legs again? This meant
that a substantial amount of research had to be conducted.
Von Salis worked on this project systematically every Wednes-
day afternoon and evening at the Straumann Institute. Dur-
ing more demanding surgery on cadaveric bones and horses
he was assisted by Guggenbühl and another human surgeon,
his friend Dr Peter Dätwyler (Fig 13).
Fig 12 A special fragment distractor developed for Björn von salis by Beat schenk, the son of Professor robert schenk, for equine fracture repair. Each of the two pins for each main fragment had a diameter of 6 mm. the distractor was solidly built and allowed movement of the fragments in any direction. However, it was too heavy and the pinholes too large to be used in clinical work.
Fig 13 Peter Dätwyler, a human surgeon very instrumental in exploratory large animal surgery during the initial organizational period of AoVEt.
The exchange of knowledge The group members complemented each other in an advan-
tageous way. Von Salis was mainly interested in horses and
the development of large animal surgery, even though he
was a small animal veterinarian too. His friends and colleagues
Feri and Geri Kása were specialists in small animal surgery.
In addition, Geri Kása was a veterinary anatomist. However,
none of the veterinarians had the sophisticated surgical skills
needed in the field of osteosynthesis as developed by the AO.
It was the experienced surgeon Urs Guggenbühl who con-
tributed these skills. Straumann and Pohler had worked
together with the human AO surgeons for several years and
were experienced in instrument and implant design, material
development, and research. However, what they all had in
common was a deep and passionate interest in animals and
the desire to heal injured animals and to improve the fate of
the increasing number of animal accident victims. One of
their main goals was to reduce the number of animals that
had to be humanely destroyed because of the lack of viable
fracture treatment techniques.
32
4 Osteosynthesis in small animals
33
ost
Eosy
ntH
Esis
in s
MAL
L An
iMAL
s
4
34
4 Osteosynthesis in small animals
After the Kásas joined the Waldenburg Group in 1968, Urs
Guggenbühl started to systematically instruct veterinarians in
surgical techniques (Fig 14). At that time aseptic techniques
were taught at university clinics but not universally applied in
veterinary surgery because the risks of infection were regarded
by many as negligible; an attitude detrimental to bone surgery.
The duration of a surgical intervention had to be recognized
also as a factor contributing to infection risks. In the same way
atraumatic surgical techniques had to be introduced to avoid
additional damage to bone, blood vessels, nerves, and soft tissues
that in turn could cause complications and delayed healing.
Precise anatomical reconstruction of broken bones and joints
had to be learned, as well as how to use the specific reduction
instruments. All these parameters were prerequisites for
successful bone surgery and for achieving the specific goals of
the AO:
Guggenbühl instructed veterinarians in how to read x-rays
of the fractures, how to generate a strategic plan for the
impending surgical procedure, and how to select the ap-
propriate fixation method for each individual case. The AO
had developed different kinds of implants and application
methods for the various types of fractures occurring at the
specific human anatomical locations. Now the veterinarians
had to find out which techniques suited best the particular
fracture problems they experienced with their different
animal patients. One considerable issue was the huge variety
in the sizes of their patients (Fig 15). Analysis of preoperative
x-rays of clinical cases and the selection of suitable fixation
techniques and operative procedures in connection with the
critical evaluation of the operative outcome and the healing
results became important cornerstones in veterinary educa-
tion in osteonsynthesis and the spreading of the AO tech-
niques across the globe. The Kásas were active very early
and generous in communicating their acquired experiences
and knowledge to their colleagues, helping them to learn
the methods of AO fracture treatment.
“optimal anatomical and functional reconstruction of bone and
joints and early pain free motion.”
35
Fig 14 Urs Guggenbühl teaching equine veterinarians during a laboratory session on the management of a third metacarpal bone fracture. Left to right: Urs Jenny, chief assistant at the surgery Clinic of the University of Zurich, a Belgian veterinarian, Dr forr, the assistant of Björn von salis.
Fig 15 Dogs of different sizes: a great dane and a chihuahua.
36
4 Osteosynthesis in small animals
Guggenbühl often assisted in the osteosynthesis of actual
clinical cases of cats and dogs to demonstrate procedures and
also gave helpful advice for the postoperative care. All treated
clinical cases were closely followed up clinically and radio-
graphically and usually turned out to be successful (Fig 16a–c).
The time required for bone healing appeared to be much
shorter in small animals than in adult human patients. This
was seen as a welcome compensation for the problematic
fact that these animals apply full weight on the operated leg
immediately after operation. At the same time it explains
why the concept of stable internal fixation rapidly became
so successful in veterinary surgery. Unfortunately, these
animals also love to lick and destroy their bandages, a prob-
lem that required some ingenuity from the veterinarians if
it was to be overcome.
Besides the encouraging experience of successful cases, it
became obvious very soon that the smaller bones of dogs
and their variable sizes among different breeds required more
variety in implant size than were available in the human
implant sets at that point in time. The proportionally thin
cortices of dog bones with some brittle quality and the rela-
tively wide medullary canals called for certain modifications
in surgical techniques. The Straumann Institute with its flex-
ibility in technical improvisations and problem solving was
the ideal partner to develop prototypes and to adapt human
AO instrumentation and techniques quickly to veterinary
requirements. With time, specific implant designs and dimen-
sions were developed for the animal patients. The develop-
ment of a “broad” dynamic compression plate (DCP) 3.5 in
addition to the standard DCP 3.5 serves as example because
it was particularly helpful in the treatment of certain com-
mon sizes of dogs (see Appendix in Small Animal Maual 2nd
ed) [69]. The broad DCP 3.5 has a cross section like the nor-
row DCP 4.5 and is considerably stronger. Often the smaller
versions of implants were also welcomed by the human AO
surgeons, such as the special 3.5 mm cortex screw with
finer threads and a thicker core, that was developed for dogs
and became the conventional Synthes 3.5 mm cortex screw
of today [49, 68] (see chapter 8).
37
Fig 16a–c one of the first documented cases treated (february 3, 1969) with Ao implants. the owner of this spitz dog returned home from a party and threw the dog out of the window because it had diarrhea and messed up the house. a it broke its femur and its scapula from the fall. the woman drove immediately to the Kása’ small animal
clinic where she encountered Geri Kása–feri was at a meeting and missed this action. in the morning they treated the femur with a four-hole 4.5 mm round-hole plate and the scapula with a five-hole L-plate (not shown here).
b 2-week postoperative x-ray of the treated leg).c 23-week follow-up x-rays of the healed fracture with the plate still in place (left), following plate removal
(middle) and a few weeks later after the drill holes had healed (right).
a
c
b
38
4 Osteosynthesis in small animals
Furthermore, the veterinarians realized that it was necessary
to develop an optimal and reproducible positioning technique,
with standardized x-rays of small animals. The Kásas imme-
diately devoted their attention to this problem and worked
out certain standard procedures [50]. They also worked on
the problems of postoperative care and generated correspond-
ing techniques. The surgical approaches to the fractured bones
had to be studied and An Atlas of the Surgical Approaches to the
Bones of the Dog and the Cat by Don Piermattei and Gordon
Greeley provided invaluable help [51].
The first osteosynthesis cases were shown at veterinary meet-
ings, and soon some nearby veterinarians joined the small
initial study group on Wednesdays, bringing along their
problem cases (Fig 17a–c). Guggenbühl never tired of helping
and explaining. Often operations took place in the evenings
and on weekends in one or the other of the regional veterinary
practices. Up until today all group members still remember
this period—more than 40 years ago—as a time when they
were fascinated by their explorations and the free and suc-
cessful friendship-based collaboration.
39
Fig 17a–c some small animal veterinarians were particularly active in AoVEt during the initial phase: (a) Peter Weber, Biel, involved in a conversation with Cathrin von salis; (b) Pierre and Annie Hauser, Lausanne; (c) Janos Komáromy, Zurich.
b c
a
40
5 Maxlie the horses
41
MAx
LiE
tHE
Ho
rsE
5
42
5 Maxlie the horses
In November 1968 after many preliminary investigations on
isolated cadaveric horse bones conducted by von Salis, it was
time to explore whether an osteotomized bone of a horse
would heal without complications after an internal fixation
had been carried out. Maxlie, a horse saved from the slaugh-
terhouse by Fritz Straumann was chosen to demonstrate it.
Maxlie was anesthetized and maintained in anesthesia with
the first BOC “to and fro” portable anesthesia machine used
on horses, a novel practice at that time. A transverse oste-
otomy was performed on the third metacarpal bone with the
special atraumatic, oscillating AO bone saw developed by
the Straumann Institute. The application of this device, which
avoids soft-tissue damage, appeared as useful in large and
small animal surgery as when performed on human patients.
Although surgical intervention on Maxlie was carried out in
a horse barn (Fig 18a), the preparations of the surgeons, the
patient, and the surgical field with its surroundings were
similar to those applied in human surgery. At that time
Stephan Perren was studying the feasibility of titanium plates
for use in human fracture management at the AO Research
Institute in Davos. Implanting these plates in a horse was
therefore a welcome test. The osteotomy was performed by
Professor Stephan Perren, Peter Dätwyler, Urs Guggenbühl,
Björn von Salis, and Fritz Straumann. Paul Gysin and Jacques
Furrer, employees at the Straumann Institute assisted as
“operating room” personnel. Maxlie recovered rapidly and
after the bone had healed all the implants were removed
(Fig 18b−c). Upon investigation, the implants showed neither
damage nor wear and tear. Maxlie spent the rest of his life
healthy and without any negative effects. This successful
osteosynthesis paved the way for internal fixation in the first
clinical equine cases in von Salis’ recently opened equine
clinic in Frauenfeld (Fig 19a–b). (At that time there were no
equine clinics in Switzerland aside from the equine hospitals
at the veterinary schools at the Universities of Zurich and
Bern). The surgical interventions had to always be conducted
in the evenings or over holidays because during the day the
two assisting human surgeons, Guggenbühl and Dätwyler,
had to take care of their human patients. One night when
lightning struck an electrical distribution center in the area
causing loss of electricity in the whole region, the final sutures
of a surgical intervention on a horse had to be performed
with the help of automobile headlights.
43
Fig 18a–c the first osteotomy on a live horse, Maxlie, carried out in a barn. a intraoperative x-rays of the osteotomy. b immediate postoperative photograph of Maxlie, following recovery from anesthesia.c 35-week postoperative x-ray showing the healed osteotomy with the plates still in place.
Fig 19a–b one of the first clinical equine cases treated by Björn von salis with internal fixation according to Ao principles.a Dorsopalmar (left) and lateromedial (right) x-rays of a nondisplaced,
biarticular, sagittal fracture of the proximal phalanx. b 14-week postoperative, dorsopalmar radiograph of the healed
fracture, which was treated with three interfragmentary cortex screws inserted in lag fashion (compression).
a
a
b
b
c
44
6 Institutionalizing the Waldenburg Circle: the foundation of AOVET and pioneering work
45
inst
itU
tio
nAL
iZin
G t
HE
WAL
DEn
BUrG
Cir
CLE
:
tHE
foU
nD
Atio
n o
f Ao
VEt
AnD
Pio
nEE
rin
G
Wo
rK
6
46
6 Institutionalizing the Waldenburg Circle: the foundation of AOVET and pioneering work
The founding of AOVETShortly after the successful osteosynthesis on Maxlie and on
a series of small animals, members of the Waldenburg Circle
participated in the human AO courses in Davos in December
1968. During those courses, a proposal began to take shape
for the formation of an AO group for veterinarians with the
aim to study and introduce osteosynthesis corresponding to
AO principles into veterinary medicine. After reviewing the
work done thus far by the Waldenburg Circle and recognizing
the generally poor state of bone surgery in veterinary med-
icine, the AO board agreed to form an AO veterinary group,
and transfer AO techniques and knowledge to the veterinary
discipline.
On August 31, 1969, AOVET was founded at an official
ceremony carried out by Hans Willenegger in the city hall
of Waldenburg (Fig 20). In addition to the founding members
(Fig 21) a number of Swiss, German, French, Dutch, and US
veterinarians were present, together with some friends from
the AO and the Straumann Institute. Björn von Salis became
the first president of AOVET. Ortrun Pohler was asked to act
as secretary. The constitution of the AO was adopted by
AOVET with certain modifications, in particular regarding
the criteria for membership. The AOVET group intensified
and systemized their work enthusiastically. The clinical
cases treated by the AOVET members were documented in
Waldenburg on cards with pertinent data and copies of the
x-rays. The surgeons obtained copies of those cards from
their cases. Similiar to the AO, spring and autumn meetings
were organized each year with clinical and administrative
membership sessions. Maurice Müller asked Urs Guggenbühl
officially to take over the responsibility that the veterinarians
carry out their osteosyntheses properly in accordance with
the AO principles. Fritz Straumann continued to provide
support and access to the laboratories of his institute. Pohler
worked systematically with other employees for the internal
and external organization of AOVET, the development of
implants and instruments for large and small animals, the
performance of testing and research, and preparation of teach-
ing aids. Through her, AOVET was also–first indirectly, later
directly–represented in the Technical Commission (TK) of
the AO.
47
Fig 20a–b festivities following the opening ceremony of AoVEt on August 31, 1969, at the restaurant Bechburg near Waldenburg.
Fig 21a–h the founding Members of AoVEt; top row left to right: Björn von salis, fritz straumann †, ortrun Pohler, Hans Willenegger †; bottom row: Urs Guggenbühl†, Peter Dätwyler†, Geri Kása, feri Kása.
a
a
e
b
f
c
g
d
h
b
48
6 Institutionalizing the Waldenburg Circle: the foundation of AOVET and pioneering work
Pioneering work of AOVETLater in 1969 small instruction workshops started, offering
lectures and practical exercises with implants and instruments
(Fig 22). In the years that followed, veterinary workshops were
also offered abroad and during the AO course weeks held
every year in December in Davos. Guggenbühl expanded on
his instructions and developed a whole lecture series on var-
ious surgical and clinical topics (in time these lectures were
also given in French and English). Von Salis and the Kásas
started to present lectures on AO techniques at professional
veterinary meetings and AOVET courses. In October 1969 at
the veterinary school of the University of Zürich during a
German Veterinary Medical Society (DVG) convention two
lectures were given: one by Guggenbühl and von Salis on AO
osteosynthesis, and one by the Kásas and Paul Hutzschenreuter,
on osteosynthesis in small animal medicine. Following these
lectures there were heated discussions about compression
osteosynthesis because at that time their colleagues believed,
as did human surgeons 10 years before, that compression
causes bone resorption. However, the results of the AO re-
search, and the successful and well-documented clinical small
animal cases of the AOVET members, refuted these doubts
within a short period of time. In December 1969, some AOVET
members attended the human AO course in Davos and met
a group of veterinarians, Wade Brinker, Hugh Butler, Bruce
Hohn, Jacques Jenny, and Don Piermattei, who came from
the US and were very interested in osteosynthesis. An exchange
of experiences and ideas took place, and the ground was paved
for an extensive cooperation. More details on the AOVET
development in the US are given in chapter 7.
In January 1970, a Swiss AOVET course took place in Bettlach
(Fig 23). In the same month the Kásas gave a lecture during
the annual meeting of the DVG in Duisburg in which they
showed a series of AO osteosyntheses on small animals. This
caught the attention of the German veterinarians and they
started participating in AOVET events. Inspired through the
attendance of the recent human AO course in December,
Professor Bruce Hohn (Fig 24) organized the first course on
the internal fixation of fractures and nonunion at Ohio State
University (OSU) in Columbus, Ohio in March 1970. In the
same year the AO TK accepted the first veterinary small
animal equipment set with round-hole plates of particularly
small dimensions for the small screws. Later on those plates
were also integrated in the human standard sets.
49
Fig 22 feri and Geri Kása teach-ing small animal veterinarians the technique of axial compression of a fracture on cadaver legs, with the help of the tension device.
Fig 23 Participants of the first AoVEt course organized in January 1970 in Bettlach, home of Mathys AG. some of the participants are identified by numbers, left to right. (a) 1: Jan Gajenthan, 2: Arnold Müller, 3: Herbert Post, 4: Prof Paul Hutzschenreuter, 5: Urs Jenny, 6: reto scartazzini, 7: robert schenk, 8: Karl Gabrisch, 9: Peter Dätwyler, 10: Peter Bartels, 11: Geri Kása, 12: Margrit Jaques, 13: feri Kása, 14: Pierre Gonin, 15:Pierre Hauser, 16: Gianpietro togni, 17: Urs Guggenbühl, 18:Axel Bubloz, 19:Gottfried Ueltschi, 20: “Arco” von salis, 21: Margrit Diehl, 22: György Halmos, 23: freek Meutstege, 24: Christoph Uehlinger, 25: Janos Komáromy, 26: Mario ferrari, 27: thomas David, 28: Laszlo Lakatos; 29: Hans-Georg niemand, 30: unidentified; 31: rudolf Zeller, Hannover; 32: Hans-Georg stihl; 33: ortrun Pohler, 34: Carsten rosenhagen, 35: oswald Padrutt; 36: Liesbeth Mathys, 37: fridolin séquin, 38: robert Mathys; (b) 39: Jacques furrer, straumann institute; 30: Björn von salis.
50
6 Institutionalizing the Waldenburg Circle: the foundation of AOVET and pioneering work
In January 1971 AOVET held its first veterinary course in
English, in Davos along with the human courses. Parts of
the scientific human lectures were included in the veterinary
program. Professors Hohn and Jenny, a Swiss veterinarian
teaching at the University of Pennsylvania, (Fig 25) were fac-
ulty members. Professor Sakki Paatsama, a well-known small
animal surgeon (Fig 26) from Finland, was a guest lecturer.
From then on AOVET courses were offered annually in Davos
in parallel with the human courses in December. In March
1971 Hohn again organized a course at OSU which led to
the creation of the present-day courses in Columbus, tradi-
tionally held each year.
Fig 24 Professor Bruce Hohn of ohio state University during the first small Animal Course in Davos, December 1970. Practical exercises on cadaveric dog bones in the basement of the Congress Center.
Fig 25 Professor Jacques Jenny, University of Pennsylvania (left), and Howard rosen, Clinical Professor of orthopedic surgery at the nyU school of Medicine/Mount sinai school of Medicine in new york City, a treasured friend of the veterinarians (right).
Fig 26 Professor sakki Paatsama of the University of Helsinki during an early Ao function.
51
Fig 27 Professor Ulrike Matis, Director of the Veterinary surgery Clinic at the University of Munich, the first female chairperson of AoVEt.
Fig 28 Professor roberto Köstlin of the University of Munich was of particular help as a faculty member with spanish language skills at AoVEt courses during the early days.
In spring 1972 an instruction course again took place at the
Mathys company in Bettlach. At the Medical-Technology
Congress 1972 in Stuttgart two AOVET lectures were
presented: one by Feri Kása on “Frakturbehandlung und
Korrekturosteotomy beim Kleintier” (Fracture management
and corrective osteotomy in small animals), and one by von
Salis on “Frakturbehandlung und Arthrodese beim Grosstier”
(Fracture management and arthrodeses in large animals). In
the same year von Salis gave a lecture on his findings and
experiences on operative AO techniques in horses at the
annual Convention of the American Association of Equine
Practitioners in San Francisco [52]. In 1973 an AOVET pub-
lication on stable internal fixations on dogs [53] was published
and in 1974 at the DVG Annual Meeting in Mannheim the
Kásas lectured on the treatment of humeral fractures. In the
same year, Professors Ulrike Matis (Fig 27) and Roberto Köstlin
(Fig 28) of the University of Munich published a paper on
compression osteosynthesis on the femur of cats and dogs
[54]. The expansion of the different osteosynthesis treatments
during the second half of the 1970s is reflected in two
publications by Ulrike Matis, who performed small animal
osteosyntheses in a wide range of applications [55, 56]; and
in two papers by Geri and Feri Kása, [57, 58] the latter was
given at a human AO course. Further papers on the applica-
tions of osteosynthesis in small animals were published in
the 1980s [59–62]. In 1986 the Kásas published a series of
toy breed cases, which because of their very delicate small
bones represent a special challenge in small animal fracture
management [63].
52
6 Institutionalizing the Waldenburg Circle: the foundation of AOVET and pioneering work
Many members of the AO were very generous and supportive
in contributing lectures on special topics at the various vet-
erinary courses. Robert Schenk (Fig 29), scientific AO mem-
ber and director of an excellent histological laboratory at the
University of Basel, later vice-director of the Anatomical
Institute of the University in Bern, became a very valued
and good friend of the verterinarians. He was always ready
to lecture on subjects of bone structure—metabolism, and
bone healing. In time, interesting research projects were
developed with him. For decades he lectured at the veterinary
courses in Columbus, and Davos. Stephan Perren (Fig 30)
always had an open ear for the problems of the AOVET mem-
bers and was a supportive friend, accommodating their
courses in Davos as well as scientific projects. He appreci-
ated the veterinarians’ common sense and quick realization
of AO concepts and new research results. Until his death,
Hans Willenegger was a staunch supporter of AOVET in
various aspects. He was a tireless lecturer on AO principles
and developed several slide presentations for these one-on-one
teaching sessions (Fig 31). After these sessions he presented
the slides to the recipients of these lectures.
Increasingly, the veterinarians learned to treat all the relevant
bone injuries and skeletal corrections [64, 68–70] in small
animals in much the same way as in human patients, although
they frequently had to improvise. They also acquired the
skills to apply their operation techniques to injured exotic
animals like birds or polar bears (Fig 32a–e) [65]. In large
animals, osteosynthesis was also performed with astonishing
results; however, possibilities remained restricted because
of the large size of the animals, as well as their anatomical
and biomechanical conditions.
During AOVETs pioneering days, one practical aspect that
had to be kept in mind was the financial costs. When the
veterinary activities on AO osteosynthesis started, private
practices, even university clinics were not equipped for the
performance of osteosynthesis corresponding to AO human
clinical standards. Decisions to include such AO open fracture
treatment techniques into the clinical routine of veterinary
practices or clinics required considerable investment in tech-
nology (eg, high- quality x-ray and sterilization equipment),
implants and instruments, and probable additions of rooms
and assisting personnel. Thus osteosynthesis appeared to
veterinarians like an expensive hobby. Also, performing the
Fig 29 Professor robert schenk, a true friend of the veterinarians, with one of his favorite stress releases, his “schwiizer Örgeli”—a special swiss accordion.
53
Fig 30 Professor stephan Perren, since 1967, Director of the Ao research institute Davos. He supported the veterinarians strongly.
Fig 31 Professor Hans Willenegger and his long-term secretary Elisabeth spicher during one of their frequent slide sorting sessions at his home in schauenburg near Liestal, 4 weeks before his death in 1998.
Fig 32a–e A female polar bear at the Karlsruhe Zoo broke its maxilla. the Kása’s repaired it with two 3.5 mm DCPs and a reconstruction plate 2.7. the plates were removed after the fractures had healed. a Preoperative picture of the polar bear’s head.b intraoperative picture during the repair (the commercially available drill shown here was gas sterilized, a novelty at
that time.c 16-week intraoral postoperative x-ray of the repaired maxilla showing the implants used. d the still anesthetized patient was transported with the help of a fork lift back into its cage. e the the patient shortly after recovering from anesthesia, still slightly uncoordinated in its cage.
a
d
b
e
c
54
6 Institutionalizing the Waldenburg Circle: the foundation of AOVET and pioneering work
surgical interventions was still very time-consuming because
an economic routine was yet lacking. Furthermore, there were
no reimbursements from health insurance plans—neither
for small nor large animals—unlike the insurance policies
for human patients, and so the animal owners could not be
asked to pay for the actual costs. Consequently, veterinarians
had to try to carry on their practices with other clinical treat-
ments. Only slowly, with the increase in successful osteo-
syntheses and the growing attitude of animal owners to
consider their pets as members of the family with the re-
sponsibility to provide them with the best possible medical
treatment were veterinarians able to obtain adequate reim-
bursement for their work. There exists some trade-off in so
far as the stable internal fixation techniques allow very
early postoperative discharge of the animal patients from the
clinics, which reduced some treatment costs.
International activities of AOVETAOVET enjoyed an immediate international response. In the
early 1970s, in addition to the courses in the US and Davos,
courses were offered in Sweden—encouraged by Harry Pet-
tersson—Finland, and England, as well as in France—encour-
aged by Pierre Hauser. These courses offered the same con-
tent because the course faculties (lecturers and instructors)
remained almost the same in Europe and in North America.
The course faculties soon realized the importance of their
united approach. They organized meetings throughout the
year where the courses were prepared, critical discussions
took place, and new concepts for courses were planned. An-
nual AOVET membership meetings were held in connection
with the Davos courses and provided further opportunities
for organizational activities and planning. In the US the an-
nual meetings of the Veterinary Orthopedic Society (VOS)
were also events where AOVET members met and organized
their own additional workshops. The basis for this type of
cooperation was the supporting structure of the AO organi-
zation as well as the friendship and loyalty among the vet-
erinarians themselves, who had a common goal in develop-
ing systematic operative fracture treatment in veterinary
medicine. Elaboration of the multitude of surgical treatments
for different fracture types and orthopedic corrective inter-
ventions in different anatomical areas as they are shown in
the small and large animal manuals [66–70] are the result of
this fruitful cooperation.
55
In the US the veterinarians had no intention to form a na-
tional AOVET group. Therefore they became individual mem-
bers of the existing AOVET organization. The same type of
individual AOVET membership was arranged for members
from other countries. In 1972 AO International (AOI) was
established with Hans Willenegger acting as president. Already
nominated in 1977, AOVET was confirmed as an official AOI
member in 1979. Certain national groups or smaller circles
were also active. For example, Professor Freek Meutstege
(Fig 33) led a working circle in the Netherlands. In the early
1970s the French AOVET members began offering an an-
nual veterinary course in France in (Fig 34). In 2004 the
courses were moved to different locations in the French Alps,
such as Les Deux Alpes. The organization of parallel courses
in diagnostic imaging filled quickly and attracted many par-
ticipants, exhibitors and sponsors. Professor Klaus Bonath
(Fig 35) offered successful AOVET courses at the University
in Giessen, Germany, beginning in 1982. From the start the
Swiss and German AOVET members undertook joint pro-
grams. In 1986 a German AOVET group was established with
Feri Kása as president who had very good connections to the
AOVET group and the AO in Germany. The Austrian AOVET
members together with the Swiss members cooperate close-
ly with the German AOVET group and organize joint an-
nual meetings. Annual 1-day student workshops have been
organized at the University of Vienna by Dr Norbert Kopf
(Universitätsdozent) (Fig 36) since 1997. In cooperation Dr
Günther Schwarz offers every second year an AOVET course
for veterinary practitioners in Salzburg, Austria. In Berlin,
Professor Leo Brunnberg (Fig 37) has offered student work-
schops since 1998. From 1972 on, Feri Kása was active at
the Veterinary Medical University of Budapest, Hungary,
establishing operative fracture treatment corresponding to
AO principles. In 1991 he was awarded an honorary profes-
sorship in recognition of his teaching.
Fig 33 Professor freek Meutstege, University of Utrecht, third AoVEt President and a dedicated faculty member of AoVEt courses from the beginning.
56
6 Institutionalizing the Waldenburg Circle: the foundation of AOVET and pioneering work
Fig 34 four prominent members of the organizing committee of the french AoVEt Courses, left to right: Michel Baron, a past president of AoVEt; Jacques Drapé, La rochelle; Didier fontaine, nantes; Jean-Pierre Cabassu, Marseille, france. not shown yves Latte, Grenoble, france.
Fig 35 Professor Klaus Bonath of Giessen, the organizer of the first German AoVEt Courses and student workshops at his university.
Fig 36 Professor norbert Kopf of the University Vienna, one of the first Austrian small animal veterinarians involved in AoVEt.
Fig 37 Professor Leo Brunnberg of the University of Berlin, an early collaborator of AoVEt.
a b
57
Bruce Hohn of the Veterinary School of OSU established a
nucleus of AOVET activities in the US. Human surgeons from
the local hospitals liked to participate in veterinary courses.
The AO research appeared to inspire a wave of clinical stud-
ies at different veterinary schools and human medical insti-
tutions in the US. In turn, surgeons and scientists from Eu-
rope enjoyed meeting and collaborating with their colleagues
in the US. Schenk introduced histological research techniques
to the laboratories at OSU. Straumann sponsored a surgery
unit at the Veterinary Clinics of OSU to enable clinical re-
search independent of routine clinical work. In the following
chapter a short review is given of the development of AOVET
on the other side of the Atlantic Ocean, in the US. Again,
the search for improved operative fracture treatment in
animals, a series of special circumstances—a hidden network
of correlations—and human openness led to the introduction
of systematic AO osteosynthesis in the US.
58
7 The hop over “the big pond”
59
tHE
Ho
P o
VEr
“tH
E Bi
G P
on
D”
7
60
7 The hop over “the big pond”
Dr Bruce Hohn was engaged in a private mixed practice for
much of his early career in Minnesota. In a life-changing
event, he was able to secure a 1-year fellowship in orthope-
dic surgery at the Mayo Clinic in Rochester, Minnesota. In
the mid-1960s he left private practice to become head of
Small Animal Surgery at the Animal Medical Center (AMC)
in New York. Hohn’s connection with the AO started the
day a Saint Bernard was presented to him with a commi-
nuted fracture of the femur. He had heard about a certain
Dr Howard Rosen in New York, who was using metal plates
and screws to stabilize fractures in people with great success.
Howard Rosen heard about the techniques the “crazy Swiss
surgeons” (as the AO founders were called in the US) were
promoting to manage fractures. Intrigued by these techniques,
he wanted to purchase the equipment. However, at that time
the instruments and implants were only sold to doctors that
participated in a special course in Switzerland, where their
proper use was instructed by the founders. Howard Rosen
didn’t wait long, signed up for the next course and returned
to the US with all the instruments and as many implants as
available at that time—everything packed into his suitcase.
Rosen at that time was the only MD surgeon in North Amer-
ica who applied AO principles and soon became one of the
course instructors in Davos. At that time, there were no such
courses taught to MDs in North America.
Bruce Hohn contacted Rosen and asked him if he could bor-
row this marvelous equipment to repair the dog’s fracture.
Howard Rosen asked if he knew anything about using plates.
Of course Hohn had never seen a plate before but he was
sure he could figure it out. So Rosen suggested to Hohn that
he would bring his equipment to the AMC and they could
work on the fracture together. That was, as they say, the
start of a lifelong friendship. Throughout the rest of his life,
Howard Rosen, a soft spoken gentleman and one of the most
prolific, charismatic and distinguished teachers of AO tech-
niques maintained a special interest in AOVET members and
their patients. He was invited to numerous AOVET courses
and meetings of the Veterinary Orthopedic Society (VOS) to
speak on his favorite topic “Complications”. He cherished
his contacts with the veterinary group and inspired many
young residents to pursue a career in veterinary orthopedic
surgery.
61
In December 1969 Bruce Hohn and four other veterinarians
from North America went to Davos to a human AO course.
Professor Wade Brinker (Fig 38), who would later become
the second President of AOVET and the first North American
President, was a member of that group. Another distinguished
member of the group was Professor Jacques Jenny, actually
a Swiss expatriate, who was teaching equine surgery at the
University of Pennsylvania at the New Bolton Center. Previ-
ously in 1943, as a resident at the University of Zürich, Jacques
Jenny assisted Dr Knoll and Dr Willenegger in the first clinical
intramedullary nailing in a dog (see Fig 3). Unfortunately,
Jacques Jenny died after the Davos course in 1972, much
too early. However, before his death, Professor Jenny had
established the use of AO techniques at his school. The last
horse Jenny performed surgery on before he died was “Hoist
the Flag”, who broke its proximal phalanx (comminuted
fracture) and the adjacent third metatarsal bone (condylar
fracture) of the right hind leg. The surgery took 6 hours with
Dr Delahanty of Cornell University assisting. At the end of
the surgery the first ever fiberglass cast was applied to the
injured limb. John Alexander and David Nunamaker did the
cast changes and the horse survived. Unfortunately “Hoist
the Flag” bit off its grooms thumb in their presence—it was
not a nice, well-mannered horse.
Fig 38 Professor Wade Brinker of Michigan state University served as the second AoVEt President. He promoted the systematic internal fixation technique in small animals. He was an avid downhill skier.
During the Davos courses in 1969 Bruce Hohn met Fritz
Straumann and Ortrun Pohler. At that time, Hohn had left
the AMC and was a professor at OSU in Columbus, Ohio. He
left Davos knowing that he wanted to organize and chair an
AO course at OSU, so in March 1970, 99 veterinarians and
faculty were present at the first annual course on “Internal
Fixation of Fractures and Non-unions.” This course was co-
sponsored by OSU and AO. The following year the veterinary
course was combined with a human AO course—the first
human AO course to be offered in the US. An equine course
was also added to the event with the help of Professor Jenny.
As previously mentioned he passed away a year later and
could therefore not reap the full harvest of his work.
62
7 The hop over “the big pond”
Fig 39
faculty of the Colum
bus Courses 197
7; left to right, back row (standing): M
olm
stead, unidentified, D M
cLean, P Call,
W B
etts, G C
ormack, t D
ueland, D Pierm
attei, unidentified, M H
erron, L Wallace, W
reed; fourth row (standing): t Lenahan,
s turner, A van de Water (Johnson), G
sumner-sm
ith, P Call, f r
heinlander, H B
uttler, G fackelm
an, t Braden, B
Hull, W
Daily,
C n
ewton, C
Knecht; third row
(sitting): unidentified, unidentified, W B
rinker, unidentified, W r
iddle, H rosen, B
Hohn, D
rudy, J stoyak, r G
urevitch, s Crain, D
Crow
, unidentified; second row (stitting): t turner, B
Buttler, s stoll, E trotter, r shank, B
slocum,
B H
orne, M D
eAngelis, Jt A
lexander, W H
oeffle, E Craig, unidentified; front row
(standing): D Prieur, A G
uggenbühl, t rüedi, H
Willenegger, o
Pohler, r schenk, B von salis, and B
rahn.
63
Fig 40 Professor Marvin olmstead, of the ohio state University, co-chairperson of the ohio Courses. After Bruce Hohn passed away, olmstead succeeded him as General Program Chairperson.
Fig 41 Professor Gustave (Bud) fackelman of the University of Pennsylvania was a strong and avid promoter of the application of Ao techniques in large animals. to his right Andi Kása, the son of feri and Geri, who eventually took over responsibilities at the small animal clinic in Lörrach, Germany.
Fig 42 Jörg Auer, at that time of texas A&M University in College station, tx, together with Len Langlands, a small animal veterinarian from Johannesburg, south Africa, who organized the first small animal AoVEt courses in his home country and attended the Davos Courses every year just to be with the AoVEt group.
These were different times, when lectures were given with
old-fashioned slide projectors. Text slides were white letters
on a solid blue background and not multicolored with inter-
esting backgrounds as they are today. In the early 1970s
Bruce Hohn and Marvin Olmstead were responsible for de-
veloping teaching videos for practical exercises in the small
animal courses following the AO guidelines. In 1977 Profes-
sor Gustave (Bud) Fackelman (Fig 41) took his young resident
Dr Joerg Auer (Fig 42) to Columbus before the courses to
prepare the first teaching videos for the equine course.
From then on the courses in Columbus were offered annually
(Fig 39) with Bruce Hohn as General Program Chairperson
(see Fig 24); in 1997 Professor Marvin Olmstead (Fig 40) be-
came co-chairperson. The equine courses were chaired by
Professor Al Gabel with Dr Larry Bramlage as co-chairperson.
64
7 The hop over “the big pond”
The Veterinary College at OSU established itself as the center
for AOVET activities in North America, with Bruce Hohn as
the leader. On the small animal side, Hohn was supported
by Professors Wade Brinker and Terry Braden of Michigan
State University, Professor Geoff Sumner-Smith, Professor
Don Piermattei of Colorado State University (Figs 43 and 44),
Professor Larry Wallace of the University of Minnesota (see
Fig 33), Professor Robert Leighton of the University of Cali-
fornia Davis, Professor Tass Dueland of the University of
Minnesota, and Professor David Nunamaker of the Univer-
sity of Pennsylvania (Fig 45). The equine side of AOVET in
North America was mainly promoted by Al Gabel of OSU,
and Gustave Fackelman of University of Pennsylvania. In
time younger faculty emerged among whom Marvin Olm-
stead, Larry Bramlage (Fig 46), and Jörg Auer followed in the
footsteps of their teachers.
In 1979 the human AO course was moved to Sun Valley,
Idaho, a location near a ski resort. This allowed the veterinary
course to increase the number of participants and expand
from basic small animal and equine courses to advanced
courses in each discipline. These courses grew over the years
to annually host between 350 and 400 veterinarians and
an international faculty of over 50 veterinarians, medical
doctors, and scientists. Following Bruce Hohn’s untimely
death in 1986, Marvin Olmstead became General Program
Chairperson and shortly after Larry Bramlage was named
co-chairperson for the equine courses. Olmstead remained
in that position until just before retirement from OSU in
2002. From these courses, veterinary fracture management
according to AO techniques spread throughout the US to all
university veterinary schools and colleges. The courses are
now a standard element in the education of veterinary stu-
dents, interns, and residents. Every spring from 1970 until
1988 AOVET courses were taught at OSU in Columbus in
their continuing education facility, the Fawcett Center for
Tomorrow (Fig 47). From 1989 onward the courses were
moved first to the Hyatt Regency Hotel in downtown
Columbus and in 2005 to the Hilton Easton Mall, still in
Columbus. For years the Continuing Education Credits were
provided by OSU. Since 2002, Kenneth Johnson (Fig 48) of
Sydney, Australia (former professor at OSU), acts as small
animal chairperson and Larry Bramlage, together with Alan
Ruggles (Fig 49) of Rood & Riddle Equine Hospital, Lexington,
65
Fig 45 Professors David nunamaker of the University of Pennsylvania (the second equine specialist past AoVEt President), Larry Wallace of the University of Minnesota, Minneapolis, and freek Meutstege of the University of Utrecht (third past AoVEt President). in the background Len Langlands during an AoVEt function in Davos.
Fig 46 Dr Larry Bramlage, co-chairperson of the Columbus Equine Courses, here addressing the AAEP audience after he became President-Elect in 2003— one of the key large animal surgeons who was instrumental in the progression of equine fracture repair.
Fig 43 Professor Geoff sumner-smith, a past AoVEt President, in deep discussion on Ao teaching videos with Geri Kása during a Davos Course dinner.
Fig 44 Professor Don Piermattei, a past president.
66
7 The hop over “the big pond”
Fig 47 faculty of the Columbus courses 1985, left to right, back row: t turner, r Kaderli, W Hoeffle, L Wallace, J Auer, G fackelman, D Prieur, D nunamaker, r Vannini, r Boudrieau, r fingland, D Deyoung, W Betts; third row: J Dee, D rudy, s roe, r ringwald, B Hohn, M olmstead, A van de Water (Johnson), t fossum, M shamis, L shamis; second row: r Copeland, s Payne, W read; front row: t Lenahan, t Braden, CW Mcilrwaith, o turner, f Meutstege, s stevenson, L Bramlage, r schenk, A Gabel, o Pohler, W Brinker, D Piermattei, r schneider, P Montavon, and r Emberson.
Fig 48 Professor Kenneth Johnson, presently of the University of sydney, took over as chairperson of the Columbus small Animal Courses from Marvin olmstead.
Fig 49 Dr Alan ruggles, co-chairperson of the Columbus Equine Courses.
67
Kentucky (former OSU faculty members), serve as co-chair-
persons of the equine courses. These are now run by the
Education Division of AO North America, which also provides
the CME credits. Recently, additional Small Animal Basic,
Advanced, and Master courses were organized in San Diego,
California, during the summer months. Also, in alternate
years, an Equine Master Course was added, resulting in a total
of six to seven AOVET courses being organized annually in
the US. Workshops dealing with specific AOVET applications
are frequently organized at national and regional meetings
throughout the US.
It was Bruce Hohn’s idea to establish an AOVET Residency
Program at OSU. Willenegger supported this idea and was
helpful in establishing a special fund at OSU for the purpose
of financially supporting this residency. Money was donated
from different sources. The three surviving AO founders,
Professors Müller, Allgöwer, and Willenegger, donated part
of the prize money received with the prestigious 1987 Swiss
“Benoist Prize,” to the Hans Willenegger Residency Fund.
AOVET also supported the fund with a free membership
account. The endowment supported a 2 to 3-year residency
at OSU for a European veterinarian, interested in orthopedic
surgery, enabling the resident to acquire expertise not read-
ily available in Europe. It was planned that these residents
would then return to Europe to teach what they had learned
in the US. As increasing inflation reduced the value of the
fund, it was clear that the initial capital provided was not
enough to sustain a 3-year residency. Additional funds were
provided by OSU for some time.
Every 3 years the AOVET board received applications from
a number of European candidates, who were preselected by
the faculty at OSU. All residents had specialized in small
animal surgery, with the exception of two special equine
(1-year fellowship) recipients. The residency is still offered;
however, as most of the money comes from OSU, its faculty
now makes the final selection decision.
68
8 Spreading the word—AOVET Center Waldenburg
69
sPrE
ADin
G t
HE
Wo
rD—
AoVE
t C
EntE
r W
ALD
EnBU
rG
8
70
8 Spreading the word—AOVET Center Waldenburg
To support the expansion of AOVET, an AOVET Center was
established in Waldenburg in 1976 and Dr Dieter Prieur
(Fig 50) was asked to lead it. Ortrun Pohler (appointed as
scientific member of the human AO in 1973) transferred
responsibilities for the organization of the AOVET secretariat
to Prieur since she had started to work at the Metallurgical
Institute and with the Veterinary School at OSU and with
other US-based technical organizations, commuting between
Switzerland and the US. The Straumann Institute provided
office space for the AOVET Center with assistants, infrastructure,
working materials, and other help, while other parts of the
budget were supplemented by the AO. Dieter Prieur became
the first executive secretary of the AOVET organization. He
prepared the official and educational meetings, coordinated,
and organized the increasing numbers of local and interna-
tional AOVET courses. He taught and lectured at interna-
tional veterinary conferences, and published on the subject
of internal fixation [27, 61, 68, 71, 72]. He furthered the de-
velopment of AOVET instrumentation and operation tech-
niques. With the Mathys company he developed the double-
hook plate with the corresponding instruments for the
correction-osteotomy procedure on the proximal femur of
dogs. He supported his veterinary colleagues in various ways
and generated fruitful collaborations internationally. Hence,
he helped to create an active core of membership within
AOVET.
Fig 50 Dr Dieter Prieur (left) served as Executive secretary of the AoVEt Center in Waldenburg from 1976 to 1991. Dr Gary Clayton-Jones (right), a past president of AoVEt and a valued long-term faculty member from UK.
71
The formation of the AOVET Center led to an increased
structuring of the AOVET organization and the spreading of
veterinary operative fracture treatment. The function of the
executive secretary provided continuity and stability. AOVET
introduced an office term of 2 years for the elected president.
However, before the new president takes office he/she surves
2 years as “president-elect” and after his/her 2 years in office
he/she would remain 2 years as “past-president.” This latter
presidential turnover protocol contributed to the organiza-
tional continuity as well. In 1980 Professor Wade Brinker
was elected as the successor of Björn von Salis who held the
presidency for over 10 years. All the AOVET presidents (see
Epilogue) have been dedicated, active AOVET members,
linked through friendship to many of their colleagues in the
organization. Similar to the AO, commissions for research
and education were also introduced.
During the reorganization of the AO Technical Commission
(TK) in 1982, the veterinarians received their own individ-
ual AOVET-TK subcommission chaired by Pohler, who had
continued to support AOVET interests. In addition to the
previously mentioned 3.5 mm cortex screw, other examples
of cooperation and exchange between the AO and AOVET
were small plates to be used with 2.7 mm screws that had
been developed for small animal surgery. These implants
were subsequently successfully applied in craniomaxillofacial
(CMF) surgery. The mechanical properties and measured
performance characteristics of the 3.5 mm screws developed
for veterinarians were documented by Pohler [49, 68]. By
1982 some of the veterinary clinics had many well docu-
mented cases without any complications or failures of those
screws. Therefore, when the advantage of this type of screw
was discovered by the human surgeons, the data generated
by the small animal veterinarians provided adequate proof
of their superior functionality. Consequently, after a short
pilot testing phase, AO TK was able to release this screw
directly for application in human surgery. It became the con-
ventional 3.5 mm cortex screw successfully applied today.
Such implant design transfers were possible because the
typical veterinary implants were produced from the same
standardized high-quality implant material and underwent
the same demanding technical manufacturing processes as
the implants for human surgery. The same is true for the
instruments.
72
8 Spreading the word—AOVET Center Waldenburg
To support the AOVET courses on the small animal fracture
management and give veterinary surgeons some basic intro-
duction to internal fixation techniques, a booklet for internal
use was created by Geoff Sumner-Smith, Dieter Prieur,
Terry Braden, and Wade Brinker on “AO Techniques in Small
Animal Orthopedic Surgery.” For years this booklet was kept
continuously updated. Comprehensive presentations of the
systematic AO osteosynthesis techniques that had been
developed for orthopedic corrections and for the operative
treatment of the various fracture types at the different ana-
tomical locations in large and small animals were provided
in specific manuals. In 1982 the Manual of Internal Fixation
in the Horse was published by Fackelman and Nunamaker in
collaboration with Björn von Salis (Fig 51) [66]. A second
revised edition followed in 2000 [67] edited by Gustave E
Fackelman, Jörg Auer, and David Nunamaker in cooperation
with Larry Bramlage, Dean Richardson, and Björn von Salis
(Fig 52). In 1984 the Manual of Internal Fixation in Small Ani-
mals was published by its editors Wade Brinker, Bruce Hohn,
and Dieter Prieur (Fig 53) [68]. Twenty additional contributors
were included in the production of this manual, clearly dem-
onstrating the effective collaboration among the veterinary
surgeons. In addition, this work had a positive effect on the
clarification and unification of the methodical AOVET prin-
ciples, and triggered further working projects. In 1997, there
followed a revised second edition of the Manual of Internal
Fixation in Small Animals [69] where Marvin Olmstead had
reliably substituted the late Bruce Hohn as a co-editor. And
in 2005 the first version of AO Principles of Fracture Manage-
ment in the Dog and Cat was published by Ann L Johnson,
John EF Houlton, and Rico Vannini [70]. The editing, layout,
and typesetting were completed by AO Publishing and pub-
lished by Thieme Verlag (Fig 54).
73
Fig 51 the 1st edition of the Ao Manual of internal fixation in the Horse.
Fig 52 the 2nd edition of the Ao Principles of Equine osteosynthesis. this represents the first Ao Manual of the new era containing video clips of basic principles on a CD-roM. the manual was published by the newly formed Ao Publishing under rainer Egle.
Fig 53 the 1st and 2nd enlarged editions of the Ao Manual Manual of internal fixation in small Animals.
Fig 54 the 3rd edition of Ao Principles of fracture Management in the Dog and Cat.
74
8 Spreading the word—AOVET Center Waldenburg
The AOVET has always closely followed new AO concepts
and developments, adapting and integrating them into their
programs. The limited contact dynamic compression plate
(LC-DCP), point contact fixator (PC-Fix), and in particular
the locking compression plate (LCP) became in many varia-
tions part of the AOVET equipment. As a matter of fact AOVET
members were actively involved in some steps in the devel-
opment of the forerunners of the LCP and PC-Fix. The first
clinical trial following research studies on sheep with the
PC-Fix were conducted on large animals at the University
of Zurich. Experiences gathered with these implants led to
the development of the PC-Fix II, which was initially tested
as 3.5 mm implants on small animals at the University of
Zurich again. Eventually the implants were released for use
on human humeral fractures. The specific veterinary tibial
plateau leveling osteotomy (TPLO) plate makes successful
use of the locking screw principle where a fine thread at the
lower portion of the screw head interlocks with a thread in
the plate hole. In plate shafts bridging severely comminuted
fracture zones, locking screws can stabilize the length pre-
cisely. The veterinarians changed the design of their LCPs to
incorporate a stacked locking hole on one side of the plate
associated with a round edge instead of the tapered and
pointed end as seen in the human plates. This allows inser-
tion of locking head screws closer to the articular margin
without having the tapered end protruding over the joint
margin (Fig 55).
The increasing emphasis placed by the AO on atraumatic
operation techniques and “biological” osteosynthesis con-
cepts, as expressed by Perren [43, 73], were of particular
interest to AOVET members. Observations by Matis [74]
of certain complications in smaller dogs with comminuted
fractures, where the small size of fragments cannot be well
stabilized with screws without damaging vitality, could be
explained. Clinical investigations by key AOVET members
on osteosyntheses carried out according to biological concepts
demonstrated that it is advantageous to keep the vitality of
comminuted fracture segments intact [75, 76].
Fig 55 one end of the veteri-nary locking compression plate (LCP) is pointed and tapered like a regular LCP, whereas the other end is rounded and contains a stacked combi-hole that allows placement of a locking head screw much closer to the joint. this prevents protruding of the tapered end when a locking head has to be placed near the joint. the stacked combi hole also al-lows insertion of a cortex screw.
75
The bridging fixation of such bone defects requires certain
plate properties. The plate strength and rigidity must be such
that neither lasting-bending deformation nor too much elas-
tic bending occurs. The latter could induce implant failure
under alternating-bending stresses. Excessive cross sections
of plates could cause irritation of the soft tissues and render
closure of the soft tissues over them difficult.
To assess what type of plate would be best for a bridging
fixation of a comminuted fracture defect in certain sizes of
patients, Matis initiated an extensive mechanical testing
project with the AO Research Institute (ARI) in Davos. In
an unstable defect model, which simulated a bridging fixa-
tion, 18 different types of AO plates were tested under bend-
ing and torsion loads until plastic deformation began. From
the data obtained, the bending and torsion stiffness as well
as the loads at the elastic limits were determined [77].
Minimally invasive osteosynthesis techniques also gained in
popularity among AOVET members. However, these tech-
niques are easier to apply in small animal surgery than in
equine patients.
When in 1984 the AO modified its organizational structures,
becoming the AO Foundation (Fig 56) with additional func-
tional groups, the AOVET became an integral part of this
Foundation.
Fig 56 the birth of the Ao foundation in 1984: left to right, top of table: Peter von rechenberg, CEo; front row: Martin Allgöwer, Maurice Müller, robert schneider, Hans Willenegger; back row: thomas rüedi, Peter Matter, fritz straumann, robert Mathys, stephan Perren, Hans-Jörg Wyss.
76
9 Consolidating the achievements of the AOVET founders
77
Co
nso
LiD
Atin
G t
HE
ACH
iEVE
MEn
ts
of
tHE
AoVE
t fo
Un
DEr
s
9
78
9 Consolidating the achievements of the AOVET founders
Fig 57 Monika Gutscher started her new job with AoVEt november 1, 1991, and took over as secretary after the AoVEt Center moved from Waldenburg to Zurich.
After the untimely death of Fritz Straumann, the support of
the veterinarians in Waldenburg was continued by his son
Thomas Straumann and Ortrun Pohler. Soon a management
buyout occurred and Ruedi Maag took over the orthopedic
section of the Straumann Institute and renamed it Stratec
Medical, while Thomas Straumann continued to lead the
dental implant section that remained under the name of
Straumann Institute. With this, the support Straumanns
had given to AOVET and the AOVET Center was lost. When
Dieter Prieur retired as executive secretary of AOVET at the
end of 1991, the AOVET Center was moved from Waldenburg
to the Veterinary Surgery Clinic at the University of Zurich,
which was directed by Jörg Auer who returned from the US
in 1989 to take over as Professor of Veterinary Surgery. His
decision to return to his alma mater was also influenced by
his desire to be more involved with the AO Foundation, a
wish that became true shortly after his arrival in Switzerland
when he was elected as successor of Dieter Prieur. The lead-
ership of the AO Foundation was happy to see the AOVET
Center being strongly supported by the leader of a Swiss
university clinic and offered generous financial support, which
included the employment of a secretary for AOVET at the
executive secretary level. It was understood from the begin-
ning that working at the AOVET Center did not keep the
secretary 100 % busy and that she could accept work related
to other business deemed appropriate by Professor Auer,
while being paid fully by the AO Foundation. This was seen
as a win-win situation, by having AOVET affiliated with an
academic institution and with that institution profiting from
AO Foundation.
For the secretary role, Professor Auer knew of a school friend
of his wife, who was involved in hotel management and was
returning home to Switzerland after opening the Swisshotel
in Beijing, China. Monika Gutscher (Fig 57) was looking for
a job in Switzerland and when Auer asked her if she would
be interested in something new and exciting, she accepted.
Gutscher was the right person because of her management
and language skills. For her, it was appealing as she did not
have to work evenings or weekends, as in the hospitality
industry. It was clear that she needed to familiarize herself
with the medical terminology. To prepare for her new job,
Monika started to work for AOVET on November 1, 1991.
She learned quickly and was accepted by everybody. She
79
participated in the Davos Courses the following month, which
allowed her to get to know many of the AOVET and AO
Foundation members. Soon she was asked to be part of the
front desk team at the Davos Courses.
In 1979, AOVET had been placed under the supervision of
AO International and continued to be a member after the
AOVET Center moved to Zurich. In 1992, AO International
was directed by Professor Peter Matter and later by Professor
Thomas Rüedi. As a member of AO International, the AO
Foundation started to support AOVET financially and gradu-
ally increased the financial support.
Full financial responsibility of AOVET through the AO Foun-
dation that started on January 1, 1992, with the move to
Zurich, came about through the AOVET Center. Therefore,
the executive secretary and his secretary turned in the bud-
get and allocated all the funds. The AOVET Association itself
was only responsible for the money gathered through the
yearly membership fees. These funds were accumulated un-
less a special cause was proposed by the AOVET board and
voted on by the membership. The AOVET Center team got
involved in the organization of AOVET courses, first mainly
in Europe. Through Dieter Prieur’s efforts good connections
were established with various universities across Europe and
with time, yearly courses were organized in France, Italy,
Austria, and Germany. Other countries followed and these
arrangements were continued after the move of the AOVET
Center to Zurich. The courses offered in OSU were inte-
grated into AOVET’s annual course plan and slowly the
courses expanded to Latin America and Asia Pacific.
In 1992, Auer was elected as chair of the Veterinary Techni-
cal Commission (TK), which was later renamed the Veterinary
Expert Group (VEEG). Through this he was elected as an ex
officio member to the Board of Trustees of the AO Founda-
tion. Being part of the executive office of the AO Foundation
led to good connections with the leaders of the Foundation
across the world. Slowly the stature of AOVET rose and with
the help of the President of AO International, Professor
Peter Matter representation of AOVET on the Board of
Trustees was doubled by granting the President of AOVET
an additional ex officio membership. This increased repre-
sentation was a big advantage in moving forward the AOVET
cause for official recognition.
80
9 Consolidating the achievements of the AOVET founders
Unfortunately, there was inadequate recognition of AOVET
from Stratec Medical and Mathys Inc. Only Synthes USA
actively supported AOVET aside from the AO Development
Institute. Despite these facts, Ortrun Pohler, who continued
to work for Stratec Medical following the management buy-
out that occurred after Straumann’s death, supported AOVET
whenever possible. To be fair, it has to be kept in mind that
the producers were under constant pressure to produce an
adequate amount of implants, instruments, and new devel-
opments to satisfy the rapidly expanding human market,
which resulted in a less than optimal support for AOVET.
At each trustee meeting Jörg Auer was asked to report on
the activities of the AOVET TK but in most instances the
meeting ran behind schedule, so that he was asked to keep
it short. On most occasions he did that, except in 1996 in
Gleneagles, Scotland. When he was asked by the moderator
to “keep it short,” Auer went to the podium and told the
audience that he was about to use all of his allotted 15 min-
utes of speaking time. During his presentation he pointed
out all the achievements AOVET had contributed to the AO
Foundation. He also mentioned that the veterinarians were
only supported by Synthes USA and that Mathys AG and
Stratec Medical no longer contributed to the development
of new implants and instruments. At the end of his presen-
tation he posed the key question to all trustees: “Do you
want AOVET to continue to be part of the AO Foundation?”
He added that if the answer was “yes, we want AOVET to
continue,” then it must also be properly supported in the
future. On the other hand, if the answer was “no,” AOVET
would quietly pack its bags and leave the AO Foundation.
The trustees responded to this question with a unanimous
standing ovation. As an immediate reaction to this presenta-
tion, AOVET representation on the Board of Trustees was
increased, with the President-Elect becoming an ex-officio
member during his/her 2-year term, followed by a 2-year
term as President and ending after the first year as Past Pres-
ident, resulting in a 5-year membership on the Board of
Trustees. The increased number of AOVET members on the
Board of Trustees resulted in better visibility and better ac-
ceptance of the “fledgling” but “oldest” clinical division
within the AO Foundation. Shortly afterward Jörg Auer was
elected to the Academic Council. During the Schatzalp II
Specialty Reorganization project, AOVET was officially
81
voted in as one of the four AO Foundation clinical divisions,
along with AOTrauma, AOSpine, and AOCMF. The last piece
of the puzzle was added at the Trustee Meeting in Chicago
in 2009 when the membership had to vote on the new
bylaws. These bylaws contained a provision that the Chair-
persons of all the clinical divisions were also members of
the Board of Directors (AO Verwaltungsausschuss—AOVA);
however, the Chairperson of AOVET was not included. Chris
Colton, a Past President of the AO Foundation, noticed this
discrepancy, which was also obvious to all veterinarian trust-
ees, and he proposed that the Chairperson of AOVET also be
included as a member of the AOVA. This proposal was
subsequently accepted unanimously together with the new
bylaws. Therefore, Jean-Pierre Cabassu (Fig 58), Chairperson
of AOVET and an esteemed small animal practitioner from
Marseille, France, became the first AOVET member to be a
member of the AOVA, a supplementary duty that he had
not planned on when he accepted the nomination to be
Chairperson of AOVET a few months earlier. Nevertheless,
he fulfilled his term on the AOVA very successfully, earning
the full respect of his fellow AOVA members.
Fig 58 Dr Jean-Pierre Cabassu with his family left to right: Julien, also a specialist veterinary surgeon, Beatrice, his wife and veterinary ophthalmologist, Laurent, Jean-Pierre, and Antoine.
82
9 Consolidating the achievements of the AOVET founders
Being accepted as an equal among the clinical divisions led
to a complete restructuring of AOVET according to the guide-
lines established in the other clinical divisions and a substantial
increase in the annual budget.
At that time the VEEG membership consisted of three small
animal and two equine veterinarians. Most activities within
the VEEG dealt with new implants for small animals but it
was important not to forget the few projects supported by
the equine members. It was the duty of the VEEG chair to
assure adequate time for both groups. With the acceptance
of AOVET as the fourth clinical division and increased funds,
it was possible to get more members involved in key posi-
tions. Therefore, in 2008 Jörg Auer passed the leadership of
the VEEG on to Professor Jeffrey Watkins (Fig 59) of Texas
A&M University, again an equine specialist. He established
himself as an objective VEEG Chairperson, one who could
listen to different arguments and suggest solutions that could
be accepted by all members. He was the right choice, despite
the fact that it was again an equine specialist that led the
VEEG.
Fig 59 Professor Jeffrey Watkins during the practical exercises of the Equine Course in 2004. He took over leadership of the VEEG in 2008. He presently still acts as Chairperson of the joint Equine and small Animals subgroups, a demanding task.
83
With the reorganization of the AO TK, the other three clinical
divisions could establish their own TKs. However, the VEEG
was assigned to the AOTrauma TK. In addition one small
animal and one equine member were added to the VEEG.
In 1999 Synthes USA took over Stratec Medical and formed
the company Synthes-Stratec headquartered in Waldenburg.
In 2003 Synthes-Stratec and Mathys AG completed their
merger. Subsequently, the company acquired the Synthes
trade name and was from then on named Synthes Inc with
its headquarters in Solothurn, Switzerland. The company
established contracts with the different clinical divisions and
it was decided that AOVET needed to organize at least elev-
en courses per year. Ever since that decision the number of
courses organized by AOVET rose continually to the present
number of more than 26 worldwide courses. Initially, the
courses were mainly concentrated in Europe and the US but
recently AOVET has expanded the course organization into
Latin America and Asia Pacific. In the future, the number of
courses offered in these regions, particularly in Asia Pacific,
has to be expanded while the number of courses offered in
Europe may have to be reduced, especially if funding cannot
be significantly increased.
In 2005 Hansjörg Wyss, owner of Synthes Inc, reacted favor-
ably to the request of the AOVET Trustees during the Trustee
Meeting in Venice and established a special unit dealing only
with veterinary issues, specific veterinary instruments and
implants, many of which were identical to their human coun-
terparts but equipped with special veterinary order num-
bers—SynthesVET. This unit works closely with the VEEG,
a section of the AO Trauma TK-System, in developing new
implants and instruments.
Since 2009, which marked its 40-year anniversary, AOVET
is fully recognized and viewed as an equal, valuable partner
in the AO Foundation’s daily activities. We all look forward
to a joint and mutually successful future.
84
10 Special events
85
sPEC
iAL
EVEn
ts
10
86
10 Special events
Since the early years of AOVET Courses in Davos, one event
remains a special tradition even today: the AOVET fondue
party! It was Geri Kása’s original idea to create an event
where the faculty and the course participants could get to
know each other a little better. The fondue party was a great
success from the beginning (Figs 60 and 61). When Jörg Auer
and Monika Gutscher took over the reins of the AOVET Cen-
ter, this tradition was continued and expanded over the years.
Some AO Foundation members, AO Research Institute staff,
AO Foundation staff, Synbone staff, and friends of AOVET
were invited to the AOVET fondue party. Another tradition
gradually developed where Jörg Auer presented fun gifts to
selected participants (Fig 62). Every year the AOVET fondue
party is always held on the evening of the first course day.
Traditionally, the AO Foundation President participates, Chris
van der Werken called the AOVET fondue party the “real”,
official opening of the Davos Courses, a self-explanatory and
justified expression.
In 1999, the 30-year AOVET Jubilee was celebrated with a
special dinner at the Hotel Flüela (Fig 63). During the evening,
Björn von Salis, Feri and Geri Kása, and Dieter Prieur were
honored as Honorary AOVET Members. In 2009, a similar
party was held to celebrate 40 years of AOVET.
Fig 60 Geri Kása (left) who introduced the AoVEt fondue Party during the Davos AoVEt Courses, at one of the first such events. Joining her are ortrun Pohler (middle) and fridolin séquin (right).
87
Fig 61 Björn von salis celebrating the tradition of the AoVEt fondue Party.
Fig 63 some of the participants of the 30-year AoVEt celebration in 1999 at the Hotel flüela; Davos, left to right: front row: Jörg Auer, Cathrin von salis, Björn von salis, Uschi nunamaker, David nunamaker; middle row: Peter Dätwyler, Geri Kása, Urs Guggenbühl, rosemarie Widmer, ortrun Pohler; back row: roberto Köstlin, feri Kása.
Fig 62 Jörg Auer presenting a bottle of premium italian wine called no. 1 (nummero uno in italian) to two number 1s during the 2004 AoVEt fondue Party: Ao foundation President James Kellam, and newly installed CEo of synthes inc. Michel orsinger.
88
10 Special events
The American Association of Equine Practitioner (AAEP)
bestowed the “Distinguished Educator Award” (Fig 64) to
AOVET in recognition of its pronounced impact on teaching
fracture management in horses around the world. During
its 2003 Annual Meeting in San Francisco, California, Auer
personally accepted this award from the AAEP President,
Tom Lenz (Fig 64).
Brigitte von Rechenberg, the daughter of the first AO Foun-
dation CEO and frequent faculty member of early AOVET
small animal courses, was instrumental in organizing the
Biotechnology Advisory Board (BAB) of the AO Foundation
in 2003. The BAB was responsible for evaluating novel
technologies that were important to the AO Foundation. It
consisted of top-level scientists across the world—including
one veterinarian (David M Nunamaker of the University of
Pennsylvania) and set the stage for modern evidence-based
research in the AO Foundation. Because of her exceptional
visionary input, von Rechenberg was honored with the TK-
Recognition Prize at the 2004 Davos Courses (Fig 65).
Fig 64 the American Association of Equine Practitioners (AAEP) presents its “Distinguished Educators Award 2003“ to AoVEt. Jörg Auer accepts the award in the name of AoVEt from AAEP President Dr tom Lenz.
Fig 65 Dr Brigitte von rechenberg (left) receiving the recognition Prize of the technical Commission in 2003, while Urs Jann, secretary of the Ao foundation was installed as Honorary Member of Ao Latin America.
89
During the 50-year Golden Jubilee celebration of AO in 2008,
the AO Foundation bestowed its Recognition Prize on Jörg
Auer for his “outstanding achievements on behalf of the AO
Foundation” (Fig 66). Up to then, this prize had been award-
ed to a total of seven recipients, either research groups or
individuals, all of which belonged to the clinical divisions
for human medicine.
For the 50-year Celebration of the AO Foundation during
the Trustees Meeting in Davos in 2008, all the past presidents
of AOVET and their spouses were invited. It was very refresh-
ing to meet with our former and present leaders and discuss
all the changes that have occurred over the past 39 years.
Unfortunately, David Nunamaker could not participate. Aside
from the two past presidents who have left us forever,
Wade Brinker and Bruce Hohn, all other past presidents were
present (Fig 67).
Fig 66 Ao foundation President Chris van der Werken (left) and Chairperson of the technical Commission norbert Haas (right) presented Jörg Auer with the “Ao recognition Prize” (the highest award of the Ao foundation) during the 50-year-Jubilee trustee Meeting in Davos 2008.
Fig 67 AoVEt past presidents and participants at the 50-year Ao foundation Celebration in Davos during the trustees Meeting 2008; left to right: Ken Johnson, 2002–2004; Geoffrey sumner-smith, 1986–1988; Don Piermattei, 1990–1992; John Houlton, 2000–2002; Gary Clayton Jones, 1988–1990; Ulrike Matis, 1996–1998; Michel Baron, 1992–1994; Donald Hulse, 2006‒2008; rico Vannini, 2004–2006; Jean-Pierre Cabassu, 2008–2012; Jeffrey Watkins, Chair VEEG, Jörg Auer, Executive secretary; Björn von salis, founding president 1969–1980; frerenç Kása, founding member; Urs Guggenbühl, founding member.
90
11 Epilogue
91
EPiL
oG
UE
11
92
11 Epilogue
In general, this short history of AOVET has been structured
chronologically. This may vary in order to maintain the con-
tinuity of certain processes or tendencies; however, this should
not be interpreted as errors in the text. To give a flavor of
the early pioneering days of AOVET, the corresponding sec-
tions are longer and casual in content compared with other
sections. Some of the very early history of the AO is mentioned
to highlight AOVET’s background and to illustrate the simi-
lar driving forces behind the creation of both organizations.
The publications referenced are limited; manuals are listed
to provide sources of information to those interested. Other
publications cited in the text were selected to show the state
of the art within a certain time frame. With much regret it
must be noted that it was not possible to include more of the
extensive veterinary literature related to orthopedic surgery
and fracture treatment in the reference list.
Unfortunately, given the text limitations it was also not
possible to mention all AOVET members who contributed
in friendship and with enthusiasm to the development
of AOVET. Many good memories are connected with our
membership past and present, without them the establishment
of AOVET would not have taken place.
93
1969−1980
1980−1982
1982−1984
1984−1986
1986−1988
1988−1990
1990−1992
1992−1994
1994−1996
1996−1998
1998−2000
2000−2002
2002−2004
2004−2006
2006−2008
2008−2012
von Salis Björn Switzerland LA
Brinker Wade † United States SA
Meutstege Freek Netherlands SA
Piermattei Don United States SA
Matis Ulrike Germany SA
Nunamaker David United States LA
Houlton John United Kingdom SA
Johnson Kenneth United States SA
Vannini Rico Switzerland SA
Hulse Donald United States SA
Cabassu Jean Pierre France SA
Hohn Bruce † United States SA
Sumner-Smith Geoffrey Canada SA
Clayton Jones Gary United Kingdom SA
Baron Michel France SA
Olmstead Marvin United States SA
LA = large animal practitioner SA = small animal practitioner
AOVET Presidents
94
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