ARTHUR STEINDLER:FOUNDER OF IOWA ORTHOPAEDICS

Joseph A. Buckwalter, M.D.*

ARTHUR STEINDLERthe physician, scholar and teacher

whose influence spread from a small midwesterncity to the far reaches of the world,

whose compassion fused a kindred bond with thesaddened or fearful patient,

whose humility often withered the prideful coun-tenances of lesser men and instilled humblenessin many of his students and colleagues,

whose dedication and vision helped to shape astate's system of medical care for the poor,

and whose name was honored in many foreign lands,bringing honor to his own state and country.

-author unknown

As we publish the first Iowa Journal of Orthopaedics, itis appropriate to honor Arthur Steindler (Figure 1). Hefounded the Department of Orthopaedic Surgery at theUniversity of Iowa and directed its growth for thirty-four years. During that time his scholarship, teaching,and clinical work helped Iowa develop into a nationallyand internationally recognized orthopaedic center. Hepersonally cared for over 70,000 patients, many of themchildren crippled by polio, spastic paralysis, scoliosis,congenital deformities, and degenerative neuromus-cular diseases. To improve the function of their weak-ened and deformed limbs, he developed and evaluatedmany innovative operations. He wrote over 130 papersand 9 books in several languages on the natural history,etiology, and treatment of musculoskeletal diseases andthe science of kinesiology. He taught over 250 or-thopaedists, including Drs. Albert, Finder, Friedman,Luck, Milgram, Obletz, O'Donohue, Ponseti, Slocum,Soto-Hall, Thornton, and Willis. Thus, through hiswork and his students, Steindler contributed signifi-cantly to the growth of orthopaedics and the scientificfoundation of the specialty.

* Department of Orthopaedic Surgery, University of IowaHospitals and Clinics, Iowa City, Iowa 52242

_ _~~~~~~~~~~~~~~~~. .s_Pr,_Figure 1. A posed portrait of Arthur Steindler in hislater years.

Arthur Steindler was born June 22, 1878, in Graslitz,Czechoslovakia. Shortly thereafter his family moved toVienna where he spent the early years of his life. Hisfather was a lawyer who valued rigorous classicaleducation. Thus, Arthur's education emphasized litera-ture, language, philosophy, and music. He learnedseven languages which enabled him to follow the worldorthopaedic and scientific literature closely, translateimportant papers for others, write for foreign publica-tions, and teach students from many countries. As ayoung man, Steindler demonstrated considerablemusical talent, and expressed an interest in becoming aprofessional musician, but with his father's advice hechose a career in medicine and entered medical schoolat the University of Vienna.

In 1902 Steindler graduated from the University ofVienna. After his internship, he focused his attention onthe study of orthopaedic surgery. Two Europeanschools influenced his orthopaedic education: initially,

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JA. Buckwalter

the Vienna School through Edward Albert and AdolfLorenz; and, later, the Liverpool School through JohnRidlon. Ridlon also gave Steindler the opportunity tolearn the evolving American approach to orthopaedicproblems.Edward Albert had been professor of surgery at Inns-

bruck, but in 1873 he transferred to Vienna. An eagerteacher and innovator, Albert is perhaps most famousfor developing and advocating arthrodesis to improvethe function of flail limbs. He emphasized that arthrod-esis could eliminate bracing and improve function oflimbs that might otherwise be useless. Correcting de-formities and stabilizing joints by arthrodesis in pa-tients crippled by polio and other neuromuscular dis-eases became an important part of Steindler's work.During his years in Vienna, Arthur Steindler was alsoexposed to the work of Adolf Lorenz. Lorenz was inter-ested in children's problems, including club foot correc-tion, treatment of congenital dislocation of the hip, andmanagement of scoliosis. In 1886 Lorenz had publishedan extensive monograph summarizing theoretical con-ceptions of scoliosis, including the effect of posture andassymetrical weight-bearing. Lorenz also challengedthe concept that corsets and braces could correctscoliosis. Steindler later incorporated these ideas intohis own approach to scoliosis.

In 1907, five years after medical school, Steindler leftVienna for Chicago to become an assistant to JohnRidlon at the Home for Crippled Children. Ridlon wasborn in Vermont, graduated from the College of Physi-cians and Surgeons in New York, and worked withNewton Shaeffer in New York. In addition to his Ameri-can education, Ridlon was profoundly influenced byHugh Owen Thomas. Thomas' skill in constructing andusing braces and splints, such as the Thomas splint, theThomas collar, and a number of foot orthoses, hadearned him considerable fame and a large group of pa-tients. Thomas also taught that most deformities shouldbe corrected by manipulation, rather than surgery, andthat the prime method of treating tuberculosis andother conditions must be rest, "enforced, uninterrupted,and prolonged." Ridlon visited Liverpool twice andadopted many of the practices and devices advocatedby Hugh Owen Thomas. Ridlon also worked withThomas' nephew, Sir Robert Jones, and collaboratedwith Jones on a number of articles describing the prin-ciples of orthopaedics expressed by Hugh OwenThomas. Ridlon considered these principles to be thebasis of good orthopaedic practice and stressed theirimportance to Arthur Steindler.

In 1910, on Ridlon's advice, Steindler accepted theposition as professor of Orthopaedic Surgery at theDrake Medical School and began his practice in Des

Moines, Iowa. During his years in Des Moines,Steindler formed friendships with a number of people instate government. These friendships facilitatedSteindler's later efforts to promote the development ofthe University of Iowa Hospitals, including Children'sHospital, and state funded services for crippled childrenand indigent patients. In 1912 he joined the faculty atthe University of Iowa and began traveling to Iowa Cityby train at least once a week to hold orthopaedic clinicsand act as an instructor in orthopaedic surgery at theUniversity of Iowa Hospital.The years 1914 and 1915 brought significant changes

in Steindler's life. In 1914 he married Louise Junk, anurse he had met when they both worked at theChicago Home for Crippled Children. Although Louisemet Arthur Steindler in Chicago, her family was fromDixon, Illinois. In the same year as his marriage,Steindler became an American citizen. At the age ofthirty-seven, in 1915, Arthur Steindler moved to IowaCity to become the first professor of OrthopaedicSurgery at the University of Iowa. At that time, he wasthe only orthopaedist. When Steindler moved to IowaCity, the University Hospital (Figure 2) was located on

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Figure 2. The entrance to the first University of IowaHospital (now East Hall). A patient with crutches is stan-ding near a brick pillar. St. Mary's Catholic Church is visi-ble in the background to the far left. (F. W. Kent)

6 The Iowa OrthopaedicJournal

Arthur Steindler: Founder ofIowa Orthopaedics

the east side of the Iowa River and consisted of clinics,laboratories, operating theaters (Figure 3), and about240 inpatient beds. This building was the first Univer-sity Hospital and had been opened in 1898. While com-muting from Des Moines, Steindler had recognized that

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tion of patients benefiting from these acts, Steindlerhelped organize the hospital car and ambulance systemthat allowed patients to be picked up at their homes,brought to University Hospitals, and returned to theirhomes following treatment (Figure 4). The hospital carsystem still serves orthopaedic and other medical pa-tients today.

Increasing numbers of patients and an expandingstaff required newer and larger orthopaedic facilities,and in 1917 construction of Children's Hospital beganon the west side of the Iowa River (Figure 5). Thisbuilding was the first part of what became the Universi-ty of Iowa Health Sciences Complex. Steindler wasinfluential in both obtaining financial support and de-signing Children's Hospital. When the building wascompleted about 1920, he became chief surgeon and

Figure 3. The operating theater in the first University ofIowa Hospital. The scrub sinks, operating table, basins,and seats are visible. (F. W. Kent)

many people with serious orthopaedic problems couldnot reach Iowa City. Since only two other physicians inthe state practiced orthopaedics, many crippled adultsand children did not receive treatment. These observa-tions and his interest in crippled children led Steindlerto encourage the state to provide support for themedical care of these children. Iowa was fortunate tohave a progressive legislature, and in 1915 the IowaGeneral Assembly approved the Perkins Act which au-thorized medical treatment for children under sixteen.This led to the development of field clinics throughoutthe state for the evaluation of crippled children. Thosechildren needing hospital care, therapy, or surgery weretransported to University Hospital. Today the StateServices for Crippled Children continues to providefield clinics for children in all parts of the state. ArthurSteindler also advocated providing medical care toneedy adults. In 1919 the state legislature approved theHaskell-Klaus Act extending state supported medicalcare to all indigent adults. To facilitate the transporta-

Figure 4. The 1934 fleet of hospital cars and am-bulances. The University Hospitals, dedicated in 1928,are in the background.

Figure 5. Children's Hospital. The Iowa River is visiblein the upper right corner. Patients have been moved ontoa patio on the left. The structure with the U-shaped roofprojecting into the central courtyard is a ramp whichallowed patients in wheel chairs or beds to be easilytransported to the "gymnasium" in the basement. (F. W.Kent)

head of the growing Orthopaedic Surgery Service. Thenew facility incorporated many features to facilitate thecare of orthopaedic patients. The arrangement of inpa-tient units allowed patients to be moved outside duringfavorable weather (Figures 5 and 6). The basement4 'i".-t-r SIONW _ _

Figure 6. Children on a patio next to Children'sHospital. (F. W. Kent)

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J.A. Buckwalter

(Figure 9.) The operating rooms in Children's Hospital+ (Figure 10) were located at the north end of the hos-

pital. Figure 10 shows one of the Children's Hospitaloperating rooms in the 1920's (the schedule written on

it the blackboard indicates that a shoulder arthrodesisand a shoulder stabilization were to be performed). TheOrthopaedics Department was located in Children's

b Hospital until 1978 when it moved to the Carver= Pavilion (Figure 11).

Figure 7. Children's Hospital brace shop showing the fit-ting of an orthosis. (F. W. Kent)

Figure 10. Operating room in Children's Hospital in theearly 1920's. The operating schedule on the blackboardindicates that a shoulder arthrodesis and a shoulderstabilization were scheduled. (F. W. Kent)

Figure 8. Children's Hospital brace shop showing castsof patients' torsos and limbs, scoliosis braces, as weil asother orthoses. (F. W. Kent)

floor housed a large brace shop (Figures 7 and 8) and a"gymnasium" for physical therapy (Figure 9). A ramp(Figure 5) allowed transport of patients in wheel chairsand beds between the first floor and the basement

Figure 9. Patients in the basement "gymnasium" ofChildren's Hospital.

Figure 11. Carver Pavilion. The Carver addition islocated to the right of the fountain and behind the flag,and the Orthopaedics Department occupies the first,third, and fourth floors. (Medical Photography)

Soon after the approval of the Haskell-Klaus Act,other medical departments, still located in the firstUniversity Hospital, felt the strain of increasingnumbers of patients and the need for more modemfacilities. In 1924 the state legislature appropriated $2.5million, matching a grant from the Rockefeller Founda-tion, to build the new 900 bed University Hospital nearChildren's Hospital. The new University Hospital wasdedicated in 1928 and is shown in the background ofFigure 4.

8 The Iowa OrthopaedicJournal

Arthur Steindler.: Founder ofIowa Orthopaedics

In the 1920's, Steindler built his own home on a bluffoverlooking the Iowa River. The site he selected pro-vided a view of the river and was located within one-half mile of Children's Hospital. He had Horace's quota-tion, "Ihle terrarum mihi praeter omnis angulus ridet"carved in the stone pediment above his door. He hadfound "the corner of the earth that smiled to him aboveall others." Mrs. Steindler directed the landscaping ofextensive gardens around the house. The Steindlersentertained frequent visitors and relatives. To managetheir large home and provide for their guests, theyusually had a cook, two maids, and two students whotook care of the maintenance work, some of the garden-ing, and served as chauffers. Louise Steindler tookcharge of running the household and organized thesocial gatherings at the Steindlers' home to allow herhusband freedom to work, study, and write.The new facilities of Children's Hospital, combined

with the additional patients and staff, enabled Steindlerto develop a strong program for orthopaedic care andthe education of medical students and residents. In1927 he was named head of the Department of Ortho-paedic Surgery which became a separate departmentwithin the College of Medicine. Together with ErnestFreund he built a laboratory within the department tostudy orthopaedic pathology. This laboratory, throughthe work of Drs. Freund, Luck, Ponseti, and Bonfiglio,has provided excellent contributions to teaching andresearch. Steindler believed residency should be basedon systematic, critical education in the basic sciencesand clinical orthopaedics rather than on a purely ap-prenticeship system. His approach to residency educa-tion influenced not only his students and residents, butled other departments to organize similar programs. Heestablished a one-year graduate course in orthopaedicswith a required series of lectures. Each year he took agroup of approximately ten physicians (many fromother countries) as graduate students. The physicianspaid a tuition of $50 to $100 a year and received at leastone lecture a day, many delivered by Arthur Steindler.At the end of each year, Dr. Steindler would accept twoor three of the graduate students into a three yearresidency. Residents participated in daily conferencesorganized by Steindler (Figure 12) in which he stressedunderstanding of the lesions underlying orthopaedicproblems and the natural history of diseases, as well ascritical evaluation of proposed treatment and of results.He remarked that, 'There will always be those who areanxious to find a short cut to results and in their hurrypass by the stations of diagnosis and indications, mak-ing specific operative techniques their first step. Nodoubt they will be disappointed" (IVP). To stress theimportance of unbiased reasoning he would say, "I

M- >Figure 12. Arthur Steindler, at right, with residents andvisitors. Dr. Ponseti is seated on Steindler's right.

would rather be wrong with an impartial reason thanright without one" (JVL, JBJS 41A: 1366-1367 [1959]).Thus, although his lectures were didactic presenta-tions, the conferences encouraged students andresidents to participate by expressing their ideas. As hesaid, ". . . no justice can be done to the case by adoptinga partisan standpoint. All opinions are needed and mustbe heard and explained" (IVP).

In 1949, at the age of seventy, having served theDepartment of Orthopaedics at the University of Iowafor thirty-seven years, Steindler became professoremeritus at the University of Iowa and chief of theOrthopaedic Service at Mercy Hospital. At Mercy heremained active in patient care and teaching. Duringthe last years of his life he prepared lectures on theinterpretation of pain in orthopaedic conditions andreviewed drafts of this book shortly before his death onJuly 21, 1959.

In reviewing Arthur Steindler's career, his contribu-tions to the state of Iowa and the University are clear.By founding a strong orthopaedics program, he madepossible the orthopaedic education of medical studentsand residents who later practiced in Iowa. He facilitatedthe organization of the state services for crippledchildren and indigent patients, and promoted thedevelopment of the University Medical Center.Through these efforts, medical care became availableto people who might otherwise have gone untreated.

In addition to his influence on the state and theUniversity, Steindler made important contributions tothe field of orthopaedics. He wrote on almost everyorthopaedic problem, including back pain, scoliosis,tuberculosis, polio, congenital deformities of the hand,Dupuytren's contracture, upper and lower extremity re-construction, and foot deformities. Steindler was ableto absorb information and ideas from many sources andorganize them. Through this process he reviewed manyorthopaedic problems and presented the available infor-mation, including his own experience, in a concise,systematic form. He also worked to bring many of the

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J.A. Buckwalter

orthopaedic advances from continental Europe to theUnited States.Through his teaching, speaking, and writing,

Steindler encouraged basic research and incorporationof the basic sciences into orthopaedic education. In his1933 presidential address to the American OrthopaedicAssociation, he emphasized the need for basic scientificresearch in orthopaedics pointing out the need forbroad-based study of anatomy, pathology, physiology,and biochemistry (JBJS XV: 567-573 [1933]). In addi-tion to encouraging others in the study of the sciences,Steindler immersed himself in the investigation ofhuman mechanics. He felt that human mechanics repre-sented a virgin field with great potential application andobserved that ". . . biomechanics is a powerful and in-dispensable ally of the orthopaedic clinician" (JBJS XV:567-573 [1933]). He frequently stressed that or-thopaedic progress would not occur through the pursuitof technical perfection, but rather through advances inthe basic medical sciences.

In his study of orthopaedic problems and their treat-ment, Steindler pointed out the importance of under-standing the natural history of diseases and criticallyreviewing the results of treatment. In his publicationshe presented and critically analyzed his operative ortho-paedic experience, even when the results were un-satisfactory. For example, in Orthopaedic Operations: In-dications, Technique, andEnd Reswdts (Thomas, 1940) hediscussed the indications and surgical techniques foreach operation. However, unlike many authors of histime he reviewed the results of each operation and sug-gested reasons for failure. In analyzing the results of hisflexor transposition to restore elbow flexion (one of hisbest known operations), he found 30 percent poor andfair results. He noted that causes of failure included in-secure anchorage of the transposed muscles and errorsin the indications.Two problems that Steindler studied over many years

were scoliosis and cavus deformity of the foot. His firstarticle dealt with scoliosis (J Amer Med Assoc 52:1572-1573 [1909]), and he continued to study scoliosisthroughout his career. As might be expected from hisearly training, he felt, ". . . that the proper way of deal-ing with structural scoliosis is to follow the footsteps ofnature and to develop secondary compensating curves,rather than to persist in unsatisfactory attempts atdirect correction" (Lancet, July 1, 1926). He describedthe compensation-derotation treatment of scoliosis(JBJS VIII:570-586 [1926] and JBJS XI:820-830 [1929])as a three-fold program involving: 1) mobilizing seg-ments of the spine to produce counter curves and re-store balance; 2) stabilizing the compensated spine bymechanical support (Figure 7); and 3) developing and

Figure 13. Drawing imustrating the compensation treat-ment of scoliosis. (J Bone Joint Surg VIII:570-586, 1926,Figure 5)

educating muscles to maintain the new balance of thebody (Figure 13). Despite his strong belief that comple-tion of compensation treatment would enable the pa-tient's muscles to balance the spine, Steindler did pointout that established curves might prove incurable andthat further bracing or surgery might be necessary. Inconsidering surgical treatment of scoliosis he observedthat, UIn the advanced deformities of non-compensatedcases, it will be the only refuge ... ." However, themaintenance of compensation, "... is not a problemthat is best solved by totally abolishing the mobility ofthe spine; in other words, by operative fusion, althoughin many, if not the majority of cases, one has to acceptthis compromise. In many other cases, however, wehave shown that the return to normal balance by way ofmobilization and compensation and ultimate re-develop-ment of muscle forces of the back, is possible; andfurthermore, that such is the most natural and the moredesirable solution of the problem" (AS, Diseases andDeformities of the Spine and Thorax, C. V. Mosby,1929). However, by the 1940's, Steindler had observedthat scoliosis could progress even in patients who hadachieved compensation (IVP). Although compensationtreatment did not ultimately prove to be a satisfactoryanswer to the problems of scoliosis, Dr. Steindler'sinterest in scoliosis and his close follow-up of his pa-tients made possible the landmark paper of Drs.Ponseti and Friedman. This study, reported in the Jour-nal of Bone and Joint Surgery (32A:381-395), describedthe natural history of scoliotic curves, the classificationof curves, and their prognosis. These observations sig-nificantly advanced understanding of the natural his-tory of scoliosis and made clear the importance of iden-tifying the type of curve to determine the prognosis.Arthur Steindler found deformities of the foot and

resulting problems particularly interesting, and hisname is still mentioned frequently in papers dealingwith cavus feet. In 1917 (Surg Gynec Obstet, May 1917,

10 The Iowa Orthopaedic Journal

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Arthur Steindler: Founder ofIowa Orthopaedics

pp. 612-615) he published his first description of whathas become known as the Steindler stripping operation(Figure 14). At that time, he felt that the short musclesof the foot were responsible for the cavus deformity,and he recommended release of the plantar soft tissues.In 1921 (Arch Surg II:325-337) he returned to the pro-blem of the cavus foot and noted that the results ofsome of his soft tissue releases were not satisfactory.He suggested that these unsatisfactory results were dueto failure of complete correction of the deformity andindicated that complete correction should result from

Figure 14. Drawings illustrating Arthur Steindler'srelease of the plantar soft tissues for cavus deformity ofthe foot. (Surg Gynec and Obstet, May 1917, pp. 612-615)release of the plantar soft tissues combined with correc-tion of the skeletal deformities by cuneiform osteotomy(Figure 15). In 1928 (Surg Gynec Obstet, Oct. 1928, pp.523-562) he again discussed problems in his patientswith treated cavus deformities of the foot. He statedthat the poor results of his previous procedures mightbe due to failure to stabilize the foot after correction ofthe deformity and recommended combining correctionof the deformity (by soft tissue release and osteotomy, ifnecessary) with stabilizing procedures, such as tendontransfers or arthrodesis.

Figure 15. Drawing illustrating Arthur Steindler'srelase of the plantar soft tissues combined with acuneiform osteotomy. (Arch Surg II:325-337, 1921)

Certainly, Steindler's close follow-up of his patientsand long-term review of the results of treatment werenot common practices during his time.Arthur Steindler was clearly an exceptional orthopae-

dist, but study of his many contributions does not revealhis personality, nor the talents and abilities that enabledhim to immigrate to the United States and rapidlybecome an enthusiastic and successful Iowan andAmerican.He enjoyed refining and developing his own mind and

stimulating others to do the same. He had a strikingability to assimilate and remember large amounts of in-formation coupled with a genuine love of learning. Hisfacility with languages clearly proved an asset in learn-ing of new developments in other countries and inwriting for orthopaedists outside of the United States.He continually sought comprehensive understanding ofproblems, and this search brought him to recognize theimportance of scientific investigation and reasoning forfuture advances in clinical practice. Through histeaching and his example, he encouraged his pupils toseek broad education and develop the habit of life-longlearning. When he began his classic studies of humanmovement in the 1920's, he recognized the importanceof higher mathematics and took courses in basiccalculus, physics, and engineering. In his last year oflife, while seriously ill, he continued to participate in theeducational activities of the American Academy of Or-thopaedic Surgeons, giving his instructional course andavidly taking notes during the talks of others.

In addition to his interest in learning, ArthurSteindler had unusual energy, a remarkable capacity toorganize his efforts, and the will to demand the best ef-forts from himself and others. Well into his 70's hewould arise before 5 a.m. and take a walk to watch thefirst train of the day pass through the countryside. Hethen studied until 7 a.m. and usually was in his office by7:30. At 5:30 he returned home and dinner was at 6:00.He rested until 7:00 and then worked, studied, or wroteuntil 10:00 when he retired to read in bed. By organiz-ing his time and demanding his own best efforts, hegained the maximum from his talents and oppor-tunities. Undoubtedly, his ability to command his timewas aided by his wife, Louise, who protected his timefor work and study.Despite his strenuous work habits and the demands

he placed on himself, Steindler was not aloof norremoved from people and events around him. After hisimmigration from Vienna, he followed the changes inEurope with great concern. Before and during WorldWar II, he brought many friends and relatives to theUnited States to escape the war and persecution. To hisfriends, colleagues, and family he was lively, outgoing,

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JA. Buckwalter

and warm. He was deeply loyal to his students andfollowed their careers with great interest. To his pa-tients he was a concerned and caring physician. His af-fection for children was especially strong, perhaps part-ly because he did not have children of his own. Hepossessed a great and kindly sense of humor in bothtelling and enjoying jokes. His after-dinner speechesusually included humorous anecdotes. Occasionally, hetook the role of a part of the body, such as the neck ofthe femur or the intervertebral disc, and defended thispart against its bad reputation in orthopaedic circles.

Figure 16. Arthur Steindler with a group of residents.

For relaxation, Arthur Steindler enjoyed walks in thecountry, reading, music, and conversation with friends.His interest in literature included Virgil, Horace, andLucretius in Latin, as well as classical and modern Ger-man, French, Spanish, and Italian works. In his earlyyears in Iowa City, he was fond of playing the piano and

spending a musical evening with friends. During theseevenings, he played duets with Professor Clapp whowas the head of the Department of Music or Beethovensonatas with Dr. Byfield who was the head of theDepartment of Pediatrics and an accomplishedviolinist. Arthur Steindler also belonged to two dinnerclubs where he eagerly engaged in discussions ofliterature, history, and philosophy. His broadknowledge, retentive mind, and sense of humor madehim an especially valued member of these clubs.Arthur Steindler's documented accomplishments

confirm his position as a great orthopaedist, scholar,and teacher (Figure 16). He cared for patients withmany types of challenging and complex problems,helped the state of Iowa and University of IowaHospitals establish a system of patient care for the poorin advance of other institutions, authored many influen-tial papers and books, and personally taught a numberof outstanding orthopaedists. Through his scholarlywork and the orthopaedists he educated, his influencespread from the University of Iowa throughout theUnited States and to many other countires. More dif-ficult to measure are the values he inculcated in hisstudents and established as traditions in his depart-ment-excellence in patient care, unbiased review oftreatment, study- of the sciences, and critical broad-based orthopaedic education.

Acknowledgments

This brief review of Arthur Steindler's life and contri-butions was made possible by the kind help from thefollowing people: Ignacio Ponseti, Hans Ehrenhaft, PatHicks, Eberly Thornton, Reginald Cooper, WilliamBean, and Carl Gerbhour.Despite Arthur Steindler's wide influence and prolific

writing, many of the details of his life and work are noteasily available. I would greatly enjoy hearing fromanyone who would like to correct, confirm, or expandupon the information and ideas presented in this article.

12 The Iowa OrthopaedicJournal