The history
From bark splints in Egypt to 3D-printed bones: 4,500 years of learning how bones hold us up, grow and heal.
People have been setting broken bones for thousands of years, with bark, bamboo and linen. For centuries, though, nobody could see inside a living body, and most doctors thought bone was dead, like stone. Then came careful dissection, the microscope, dye experiments, X-rays and plaster casts. Today we can rebuild hips, regrow legs, measure bone strength in minutes and print a new vertebra.
c. 2450 BCE
Oldest known splints
Naga ed-Der, Egypt
c. 1600 BCE
Oldest known surgery text with fractures
Edwin Smith Papyrus, Egypt
1543
Accurate printed atlas of the human skeleton
Andreas Vesalius, Padua
1741
The word orthopaedics
Nicolas Andry, Paris
1851
Plaster of Paris cast
Antonius Mathijsen, Netherlands
22 Dec 1895
Famous first medical X-ray
Anna Bertha Röntgen's hand, Würzburg
1962
Low-friction hip replacement
John Charnley, England
2014
3D-printed vertebra implant
Peking University Third Hospital, China
2500 BCE – 1100
Splints in Egypt, bark and bamboo in Sushruta's India, traction in Greece, and a surgery book from Córdoba.
2450 BCE
c. 2450–2325 BCE (Fifth Dynasty)
Archaeologists digging old graves in Egypt found two skeletons with splints still tied on. One broken forearm was held by three pieces of acacia bark wrapped in linen. A broken thigh bone had four wooden splints bound around it.
Why it mattered. People were already trying to hold broken bones still so they could heal.
1600 BCE
c. 1600 BCE (copy of older texts)
The Edwin Smith Papyrus lists 48 injury cases, from the head down to the spine. For each one it gives the examination, the diagnosis and a treatment, including splints and bandages for broken bones. It is mostly practical, not magic.
Why it mattered. It is the oldest known surgical text, and it treats broken bones in a step-by-step way.
600 BCE
Traditionally dated c. 600 BCE; text compiled over centuries
The Sushruta Samhita, a great Indian surgery text, sorts broken bones and dislocated joints into types and explains how to pull them back into place. It tells healers to bind the limb with splints made of tree bark or bamboo. It even counts about 300 bones in the body.
Why it mattered. It is one of the most detailed early guides to fixing fractures and dislocations anywhere.
400 BCE
c. 5th–4th century BCE
The Greek books On Fractures and On Joints explain how to line up broken bones and put dislocated joints back. A wooden bench with ropes and a winch, later called the Hippocratic bench, could stretch a limb. A way of popping a shoulder back with a foot in the armpit was still used 2,000 years later.
Why it mattered. It showed that pulling steadily on a limb, called traction, helps bones slide back into line.
170
2nd century CE
Galen wrote a short book, On Bones for Beginners, to teach students the skeleton first. He told them to go to Alexandria and look at a real human skeleton with their own eyes. But most of his own dissections were on apes, so some of his details were wrong for humans.
Why it mattered. His bone book was followed for well over a thousand years, mistakes and all.
1000
c. 1000 CE
Al-Zahrawi wrote a 30-part medical encyclopedia, the Kitab al-Tasrif. Its last part, on surgery, has a whole section on fractures and dislocations, with drawings of tools. A way to put back a dislocated shoulder that is now named after a 19th-century Swiss surgeon appears in it centuries earlier.
Why it mattered. Translated into Latin, it became a standard surgery book in Europe for about 500 years.
1500 – 1700
Leonardo draws it, Vesalius corrects Galen, Borelli treats bones as levers and Havers finds the tiny canals inside.
1510
c. 1510–1511
Working with an anatomy professor at Pavia, Leonardo dissected human bodies and drew the bones from several sides, like an engineer drawing a machine. His skeleton shows the gentle S-curve of the spine and the slant of the ribs. The drawings were not published, and stayed hidden for centuries.
Why it mattered. They were among the most accurate pictures of the skeleton made up to that time.
1543
June 1543
Vesalius, a 28-year-old professor, cut up human bodies himself and published De humani corporis fabrica, with more than 250 woodcut pictures. He showed that Galen had described apes, not people. For example, the human lower jaw is one bone, not two.
Why it mattered. It made careful looking, not old books, the way to learn the skeleton.
1680
1680–1681 (published after his death)
Borelli, a mathematician, studied how animals walk, run, swim, jump and fly using the rules of machines. He treated bones as levers pulled by muscles, and worked out how the body shifts its centre of gravity to move. His book De Motu Animalium came out just after he died.
Why it mattered. He is often called the father of biomechanics.
1691
Havers, a young English doctor, published Osteologia Nova, New Observations of the Bones. He described the tiny channels that run along the hard outer bone, now called Haversian canals. They carry blood vessels and nerves right through the bone.
Why it mattered. It showed that bone has plumbing, a first hint that it is living tissue.
1736 – 1965
Red dye shows bone growing and being eaten away, cells that dissolve bone get a name, and vitamin D beats rickets.
1739
1739–1743; Hunter c. 1754–1764
Madder, a plant dye, turns new bone red. Duhamel fed it to pigs and birds on and off, and found red and white rings, like tree rings, laid down under the bone's outer skin. Years later John Hunter used madder and lead pellets in pigs to show bone is also eaten away on the inside as it grows.
Why it mattered. It proved bone is built up and removed all the time: it remodels.
1741
Andry, a Paris professor then in his eighties, wrote a book on preventing and correcting crooked bodies in children. He invented the word orthopédie from Greek words for straight and child. His picture of a bent young tree tied to a straight stake is still the symbol of orthopaedics.
Why it mattered. It named the medicine of bones and joints.
1873
Kölliker, a Swiss anatomist, wrote a book on how bone is normally dissolved. He described large cells with many nuclei sitting in little pits on the bone surface, and named them osteoclasts, bone breakers. We now know they work with bone-building cells called osteoblasts.
Why it mattered. It explained who does the removing when bone remodels.
1892
Wolff, a Berlin surgeon, published The Law of Transformation of Bone. It says the shape and inner struts of a bone change to match the forces put on it. Use a bone more and it grows stronger. Leave it unused and it thins.
Why it mattered. Wolff's law is why exercise builds bone and astronauts lose it.
1919
1919–1922
Rickets makes children's bones soft and bent. In 1919 Huldschinsky cured it with ultraviolet lamps, and Mellanby cured it in dogs with cod liver oil. In 1922 McCollum showed the helpful thing in the oil was a new vitamin, and named it vitamin D.
Why it mattered. Bones need vitamin D, made in sunlit skin, to take in calcium and harden.
1965
Urist found that bone with its minerals removed, placed in muscle, could make new bone grow there. He said something in bone tells nearby cells to turn into bone cells, and later called it bone morphogenetic protein, or BMP. Scientists, including India-born A. Hari Reddi, went on to purify these proteins.
Why it mattered. It opened the way to proteins that help broken bones and spines fuse.
1851 – 1955
Plaster casts, X-rays, splints in the trenches, metal nails and a ring frame from Siberia.
1851
1851; published February 1852
Mathijsen, a Dutch army surgeon, rubbed plaster of Paris into cloth bandages. Wetted and wrapped around a broken limb, they set hard in minutes, instead of the day that older starch bandages took. He tried it on chickens first, and his method spread around the world within about ten years.
Why it mattered. The plaster cast made it easy to hold a broken bone still while it heals.
1895
22 December 1895
Six weeks after discovering a new kind of ray, Röntgen photographed his wife Anna Bertha's hand with it. The picture showed her finger bones and her wedding ring. She is reported to have said, I have seen my death.
Why it mattered. For the first time, doctors could see bones inside a living person without cutting.
1914
1914–1918
In the First World War, Marie Curie fitted cars with X-ray machines so surgeons near the fighting could find bullets and broken bones. She learned to drive, and trained about 150 women to work the machines. About 20 mobile units, nicknamed petites Curies, and some 200 fixed X-ray rooms helped examine an estimated million or more wounded soldiers.
Why it mattered. It brought X-rays of broken bones to where they were needed most.
1916
1916–1918 (splint described 1875)
Thomas, a Welsh bone-setter's son, designed a simple metal splint that keeps a broken thigh bone stretched and still. His nephew Robert Jones made it standard in the British Army from 1916, with splint drills for medics. Deaths from open thigh-bone fractures fell from about 80 percent to under 20 percent by commonly quoted figures.
Why it mattered. Holding a broken femur still in the field turned a usually deadly wound into a survivable one.
1939
November 1939
Küntscher pushed a long metal nail down the hollow centre of a broken thigh bone to hold the pieces in line from inside. When he showed 12 cases in 1940, many surgeons disapproved. Today these nails are a standard way to fix a broken femur, and patients can walk far sooner.
Why it mattered. It fixed bones from the inside, using the marrow cavity as a channel.
1951
Ilizarov, a country doctor in Siberia, built a frame of metal rings joined by rods, held to the bone by thin wires. He found that if a cut bone is pulled apart very slowly, new bone fills the gap. In 1980 he fixed the leg of Italian explorer Carlo Mauri, and the method spread to the West.
Why it mattered. It showed bone can be coaxed to regrow, to lengthen legs and heal breaks that would not join.
1957 – 2014
Marrow transplants, new hips, the Jaipur Foot, bone density scans and a 3D-printed vertebra.
1957
12 September 1957
The soft marrow inside bones makes blood cells. Thomas and his team reported giving patients marrow through a drip after strong radiation and chemotherapy. Most early attempts failed, but decades of work made bone marrow transplants a cure for some leukaemias.
Why it mattered. It turned the inside of bones into a treatment. Thomas shared the 1990 Nobel Prize for it.
1962
November 1962
Charnley replaced worn hip joints with a small metal ball on a stem and a plastic cup, fixed with bone cement. His first plastic, Teflon, wore away and irritated the body. In November 1962 he switched to a tough polyethylene, and it worked for many years.
Why it mattered. Hip replacement became one of the most common and successful operations in the world.
1963
October 1963
Cameron and Sorenson passed a thin beam of low-energy rays from a radioactive source across a forearm bone. By counting how much got through, they could work out how much mineral the bone held, to within about 3 percent. It was called single photon absorptiometry.
Why it mattered. It was the first practical way to measure bone strength in living people.
1968
1968 (some accounts say 1969)
Western artificial feet were costly and did not let people squat, sit cross-legged or walk barefoot in fields. Craftsman Ram Chandra Sharma and surgeon P. K. Sethi made a flexible foot from wood, rubber and tyre-cord. Through the charity BMVSS it is fitted free, and has helped over 2.5 million people.
Why it mattered. It showed a cheap, clever design can give millions of people their walk back.
1983
March 1983
Doctors in Mumbai gave a 9-year-old girl with leukaemia marrow from her younger brother. The transplant worked, and she lived more than 20 years without the cancer returning. Christian Medical College, Vellore, began its own programme in 1986.
Why it mattered. It brought marrow transplants, and the blood-making power of bones, into Indian medicine.
1987
The first commercial DXA scanner, the QDR-1000, swapped the radioactive source for an X-ray tube shooting two energies. Comparing how each is absorbed gives bone density quickly, with a low dose. A result called the T-score compares you with a healthy young adult.
Why it mattered. It became the standard test for weak bones around the world.
1994
Osteoporosis means bones so thin they break easily. A WHO study group defined it in older women as a DXA T-score of minus 2.5 or lower. That is, bone density 2.5 standard deviations or more below a healthy young adult's.
Why it mattered. One shared number let doctors everywhere diagnose and track weak bones before they break.
2014
A 12-year-old boy had a tumour in the second bone of his neck. Surgeons replaced it with a titanium vertebra printed to match his own. Tiny pores in the metal let his real bone grow into it.
Why it mattered. Printed implants can be shaped for one person and joined by living bone.
Did you know?
Babies are born with about 270 bones; some fuse as they grow, leaving about 206 in an adult.
Your skeleton is never finished: most of the adult skeleton is replaced about every 10 years.
In 1736 a London surgeon noticed that pigs fed on madder, a red plant dye, had pink bones, and scientists used that trick to watch bone grow.
The Sushruta Samhita counted 300 bones, while other Ayurveda teachers of its time counted 360.
The Jaipur Foot is fitted free of charge, and has helped more than 2.5 million people in India and over 40 other countries.
The people
Traditionally c. 6th century BCE · Surgeon (attributed author) · Kashi, India
The Sushruta Samhita, named after him, classifies fractures and dislocations and uses bark and bamboo splints.
1514 – 1564 · Anatomist · Brussels, worked in Padua
Dissected human bodies himself and corrected Galen's ape-based anatomy in the Fabrica.
1657 – 1702 · Physician · Essex, England
First to describe the tiny canals inside bone that carry blood vessels.
1805 – 1878 · Army surgeon · Budel, Netherlands
Invented the plaster of Paris bandage after watching workers mend a church.
1839 – 1919 · Subject of the famous first medical X-ray · Zürich, lived in Würzburg
Her hand, ring and all, became the image that showed the world X-rays could see bones.
1867 – 1934 · Physicist and chemist · Warsaw, worked in Paris
Built mobile X-ray units in the First World War and trained women to run them.
1921 – 1992 · Orthopaedic surgeon · Born in Białowieża, worked in Kurgan
His ring frame showed that slowly pulled-apart bone grows new bone.
1911 – 1982 · Orthopaedic surgeon · Bury, England
Made hip replacement last by pairing a small metal ball with a polyethylene cup.
1927 – 2008 · Orthopaedic surgeon · Varanasi, worked in Jaipur
Co-created the Jaipur Foot with craftsman Ram Chandra Sharma; Magsaysay Award 1981.
Where it happened
Sources
Dates marked “c.” are approximate, and historians sometimes disagree about who was first. If you spot a mistake, tell us.
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