Advances in Limb Lengthening and Reconstruction: Alessandro Codivilla, MD, 1861–1912

Alessandro Codivilla was born and raised in Bologna. His father was a pawnbroker [4] and he evidently tutored students to finance his education. He completed his medical education at the University of Bologna in 1886 and trained in general surgery as an assistant to Loreta and Poggi, following which he had successive appointments at several hospitals. In 1898 he was offered the directorship of the Rizzoli Institute of Bologna, which he accepted as of January, 1899, and at which time he elected to exclusively practice orthopaedics [6]. However, prior to beginning his appointment, he traveled to a number of centers in Europe to gather experience. The Rizzoli had been founded by the Bolognese surgeon, Francesco Rizzoli, who purchased a convent and the hill of San Michele in Bosco [6], just south of Bologna (and where still stands the Church of San Michele constructed by Olivetan monks between 1517 and 1523). Rizzoli left the property in his will to the Province of Bologna to be used as an orthopaedic hospital. The Institute opened in 1896 and quickly became prominent in the world of orthopaedic surgery in large part owing to the work of Codivilla and then Vittorio Putti, who succeeded Codivilla in 1912 upon Codivilla’s death [9]. (Putti, an inveterate scholar, amassed one of the world’s largest collections of historic books related to surgery and orthopaedics, and that collection now contains more than 32,000 volumes [6].) Codivilla, a quiet and apparently humble man of nonetheless great energy, reported new ways to treat many conditions, including polio residuals, clubfoot, scoliosis, and congenital dislocation of the hip. He published 124 articles, collected in two volumes by Bartolo Nigrisoli and printed in 1944; of those 25 were in foreign languages and published in the periodicals of their respective countries [6]. There was some controversy about the priority of the use of pins for skeletal traction [5]. Codivilla’s 1903 report [1] described the use of skeletal traction for treating malunions, while Steinmann’s later reports [7, 8] in 1907 and 1910 advocated its use in the treatment of fresh fractures. There appears no controversy regarding Codivilla’s report of external pin fixation and traction for limb lengthening [1, 2]. We republish here his first publication in English, from 1905 (which was presented at the Annual Meeting of the American Orthopaedic Association in June, 1904), two years after his initial description in Italian. Codivilla acknowledged, however, he was not the first to try limb lengthening: