Paul Randall Harrington
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Paul Randall Harrington (September 27, 1911 – November 29, 1980) was an American
orthopaedic surgeon Orthopedic surgery or orthopedics ( alternatively spelt orthopaedics), is the branch of surgery concerned with conditions involving the musculoskeletal system. Orthopedic surgeons use both surgical and nonsurgical means to treat musculoskeletal ...
. He is best known as the designer of the
Harrington Rod The Harrington rod (or Harrington implant) is a stainless steel surgical device. Historically, this rod was implanted along the spinal column to treat, among other conditions, a lateral or coronal-plane curvature of the spine, or scoliosis. Up to ...
, the first device for the straightening and immobilization of the spine inside the body. It entered common use in the early 1960s and remained the gold standard for scoliosis surgery until the late 1990s. During this period over one million people benefited from Harrington's procedure.


Early life

Harrington was born September 27, 1911 and educated in the
Kansas City The Kansas City metropolitan area is a bi-state metropolitan area anchored by Kansas City, Missouri. Its 14 counties straddle the border between the U.S. states of Missouri (9 counties) and Kansas (5 counties). With and a population of more ...
school system, from which he graduated in 1930, having been named one of the State of Kansas' 15 most outstanding high-school graduates. He had initially not planned to go to college but changed his mind after being offered a basketball scholarship by the
University of Kansas The University of Kansas (KU) is a public research university with its main campus in Lawrence, Kansas, United States, and several satellite campuses, research and educational centers, medical centers, and classes across the state of Kansas. Tw ...
. During his time at the University of Kansas from 1931-1934 he competed on their basketball team, which won the Big Eight championship three years in a row. In his senior year he was elected captain of the team. An initial interest in the field of physical education bloomed into an interest in medicine. He attended the University of Kansas School of Medicine and graduated in 1939, having worked his way through school playing semi-professional basketball. In 1936 he tried out for the national Olympic team and won the championship of his region in the
javelin A javelin is a light spear designed primarily to be thrown, historically as a ranged weapon, but today predominantly for sport. The javelin is almost always thrown by hand, unlike the sling, bow, and crossbow, which launch projectiles with th ...
, but did not end up attending the finals in Chicago due to the cost involved. Harrington undertook his
internship An internship is a period of work experience offered by an organization for a limited period of time. Once confined to medical graduates, internship is used practice for a wide range of placements in businesses, non-profit organizations and gover ...
and first year of surgical residency at Roper Hospital, Charleston, South Carolina, after which he returned to St Luke's Hospital in Kansas City, where he completed his residency in orthopaedic surgery in 1942, under Doctors Frank Dickson and Rex Dively. He then joined the United States Army. In the Army, from May 1942 to November 1945 Harrington served as a doctor at the 77th Evacuation Hospital in
World War II World War II or the Second World War, often abbreviated as WWII or WW2, was a world war that lasted from 1939 to 1945. It involved the vast majority of the world's countries—including all of the great powers—forming two opposin ...
, acting as chief of the orthopaedic service. The 77th Evacuation Hospital was made up largely of medical practitioners from the University of Kansas Schools of Medicine and Nursing, and saw service in Europe and Africa. It was during his time with the 77th that Harrington encountered such military celebrities as General
George S. Patton George Smith Patton Jr. (November 11, 1885 – December 21, 1945) was a general in the United States Army who commanded the Seventh United States Army in the Mediterranean Theater of World War II, and the Third United States Army in France ...
. Following the war Harrington moved to
Texas Texas (, ; Spanish language, Spanish: ''Texas'', ''Tejas'') is a state in the South Central United States, South Central region of the United States. At 268,596 square miles (695,662 km2), and with more than 29.1 million residents in 2 ...
and worked as a surgeon at Jefferson Davis County Hospital in
Houston Houston (; ) is the most populous city in Texas, the most populous city in the Southern United States, the fourth-most populous city in the United States, and the sixth-most populous city in North America, with a population of 2,304,580 in ...
. During the post-war years a
poliomyelitis Poliomyelitis, commonly shortened to polio, is an infectious disease caused by the poliovirus. Approximately 70% of cases are asymptomatic; mild symptoms which can occur include sore throat and fever; in a proportion of cases more severe sym ...
epidemic caused polio cases to swell dramatically and they eventually became his main priority. At this time he worked with the
Baylor College of Medicine Baylor College of Medicine (BCM) is a medical school and research center in Houston, Texas, within the Texas Medical Center, the world's largest medical center. BCM is composed of four academic components: the School of Medicine, the Graduate Sc ...
to create the Southwest Respiratory Foundation of the National Infantile Paralysis Association, the first such organisation in the United States. Polio patients would sometimes develop
scoliosis Scoliosis is a condition in which a person's spine has a sideways curve. The curve is usually "S"- or "C"-shaped over three dimensions. In some, the degree of curve is stable, while in others, it increases over time. Mild scoliosis does not t ...
, a condition where the spine becomes curved laterally (from side to side). Harrington realised that existing treatments for scoliosis, which relied heavily on
physical therapy Physical therapy (PT), also known as physiotherapy, is one of the allied health professions. It is provided by physical therapists who promote, maintain, or restore health through physical examination, diagnosis, management, prognosis, patient ...
, were inappropriate for patients paralysed by polio, and began to research new treatments. An early method he tried for scoliotic polio patients was manual correction of the scoliotic deformity at the time of surgery, and internal fixation of each facet. There were some benefits to this treatment but Harrington found that the fixation would not hold. The hooks and threaded rods used would corrode and break, causing curvature to return to the spine. Two patients of this procedure died. Undeterred, from the late 1940s to late 1950s Harrington worked on what would eventually become known as the Harrington implant, or Harrington Rod.


Harrington Rod

The Harrington Rod, or Harrington implant, is a device for the straightening of the spine inside the body, designed by Paul Harrington. The device consists of a stainless steel rod, attached to the spine at the top and bottom of the curve with hooks. Attached ratchets are then tightened to distract or straighten the spine. Following surgery to insert the rod, the patient wears a postoperative plaster cast or brace for a few months, until vertebral fusion has occurred, after which the cast or brace is removed. Harrington's first uses of the device that would become the Harringon Rod involved creating fresh instruments on the night before a prospective surgery. Following the surgery, he would modify the design for use on the next patient, making alterations based on his perception of the surgery outcome. Once Harrington was satisfied with the basic design, he arranged for extensive testing of the instruments at the Engineering Department at
Rice University William Marsh Rice University (Rice University) is a Private university, private research university in Houston, Houston, Texas. It is on a 300-acre campus near the Houston Museum District and adjacent to the Texas Medical Center. Rice is ranke ...
in Houston, Texas, and at a commercial testing company in
Chicago (''City in a Garden''); I Will , image_map = , map_caption = Interactive Map of Chicago , coordinates = , coordinates_footnotes = , subdivision_type = Country , subdivision_name ...
,
Illinois Illinois ( ) is a U.S. state, state in the Midwestern United States, Midwestern United States. Its largest metropolitan areas include the Chicago metropolitan area, and the Metro East section, of Greater St. Louis. Other smaller metropolita ...
. He publicly presented the process at the Annual Meeting of the
American Academy of Orthopaedic Surgeons The American Academy of Orthopaedic Surgeons (AAOS) is an orthopedic organization. Founded at Northwestern University in 1933, as of 2015 AAOS had grown to include about 39,000 members.AAOMembersPage accessed June 27, 2015 The group provides edu ...
in Chicago in 1958, where it was met with "astonishment and deep skepticism". However, the process slowly gained acceptance. In 1959 Harrington contracted with the medical manufacturing firm Zimmer to make his instrumentation available to other doctors. He insisted that no one be allowed to use the rods without first seeing him demonstrate the procedure.
Time Magazine ''Time'' (stylized in all caps) is an American news magazine based in New York City. For nearly a century, it was published weekly, but starting in March 2020 it transitioned to every other week. It was first published in New York City on Mar ...
reported in 1960, "Some ailments seem almost preferable to their cures. A case in point is scoliosis, an abnormal curvature of the spine that occurs in childhood. hetreatment seems so punishing that
arents Arents is a Dutch and German patronymic surname ("son of Arent"). The major drawback of the Harrington Rod is that it straightens out the normal front to back curvature of the segment of the spine that is fused, which in many patients results in a flat back deformity, also known as "flatback syndrome". Advances in surgical techniques and technology in the late 1990s were eventually able, in most cases, to correct scoliosis without causing flatback syndrome, leading to the gradual phasing out of the Harrington Rod.


Late life

During the late 1950s and early 1960s, Harrington traveled extensively, demonstrating the techniques associated with the Harrington Rod. During this time he developed an interest in boats, which led to designing and building a 54-foot aluminium catamaran. He also dabbled in photography and high-fidelity systems. In 1966, Harrington was one of the founding members of the
Scoliosis Research Society, of which he later served as President from 1972 to 1973. He also acted as orthopaedic consultant to the
United States Air Force The United States Air Force (USAF) is the air service branch of the United States Armed Forces, and is one of the eight uniformed services of the United States. Originally created on 1 August 1907, as a part of the United States Army Signal ...
and
United States Army The United States Army (USA) is the land service branch of the United States Armed Forces. It is one of the eight U.S. uniformed services, and is designated as the Army of the United States in the U.S. Constitution.Article II, section 2, cla ...
in San Antonio, Texas. He acted as a Professor of the Division of Orthopaedic Surgery and a Professor of the Department of Rehabilitation at
Baylor College of Medicine Baylor College of Medicine (BCM) is a medical school and research center in Houston, Texas, within the Texas Medical Center, the world's largest medical center. BCM is composed of four academic components: the School of Medicine, the Graduate Sc ...
. In 1973 he received the Cora and Webb Mading Medal from TIRR Memorial Hermann, formerly the Institute for Rehabilitation and Research, and Baylor College of Medicine, and in the same year he also received the Nicolas Andry Award from the
Association of Bone and Joint Surgeons ''Clinical Orthopaedics and Related Research'' is a peer-reviewed medical journal. It was established in 1953 as ''Clinical Orthopaedics'' by the Association of Bone and Joint Surgeons as an alternative to the ''Journal of Bone and Joint Surgery ...
. In 1975 he received a Most Distinguished Alumnus Award from the Medical Alumni Association at the University of Kansas. Between 1972 and his death in 1980, Harrington worked with Marc Addason Asher to institute the Mary Alice and Paul R. Harrington Distinguished Professorship of Molecular Orthopedics at Kansas University Medical College.


Death and legacy

Harrington died in Houston, Texas, on November 29, 1980. In an obituary following his death, the
Journal of Bone and Joint Surgery ''The Journal of Bone and Joint Surgery'' is a biweekly peer reviewed medical journal in the field of orthopedic surgery. It is published by the non-profit corporation The Journal of Bone and Joint Surgery, Inc. It was established as the ''Transact ...
said, "Paul will be remembered not only for the development of the Harrington instruments, but for his straightforward frankness, his bowties, his par golf, his smile, his trumpet, and above all for being a nice person." By will, Harrington left his professional materials to the
University of Kansas Medical Center The University of Kansas Medical Center, commonly referred to as KU Med or KUMC, is a medical campus for the University of Kansas. KU Med houses the university's schools of medicine, nursing, and health professions, with the primary health science ...
, where they are now known as the Harrington Archives (a subset of the Spine and Orthopedic Historical Collections). The archives contain "Harrington's professional papers, photographs, publications, manuscripts, blueprints, drawings, and examples of the Harrington Rod." They also include "biographical information, presentations, professional correspondence files, personal correspondence, personal photographs, movies, and videotapes. Display cases in the archives exhibit photographs, documents, and artifacts that depict the history of Harrington's life and career." In 1992, Harrington's writings were collected by Nancy J. Hulston and Marc A. Asher in ''The Collected Writings of Paul Randall Harrington, MD'', published by Lowell Press. In 2015, Marc A. Asher published ''Dogged Persistence: Harrington, Post-Polio Scoliosis and the Origin of Spine Instrumentation'', which chronicles his development of the Harrington Rod. Baylor College of Medicine awards the Paul Harrington Award for Excellence in Orthopaedic Research in recognition of Harrington's contribution to spinal surgery.


See also

*
Baylor College of Medicine Baylor College of Medicine (BCM) is a medical school and research center in Houston, Texas, within the Texas Medical Center, the world's largest medical center. BCM is composed of four academic components: the School of Medicine, the Graduate Sc ...
* Harrington implant *
Scoliosis Scoliosis is a condition in which a person's spine has a sideways curve. The curve is usually "S"- or "C"-shaped over three dimensions. In some, the degree of curve is stable, while in others, it increases over time. Mild scoliosis does not t ...
* Scoliosis Research Society


References

{{DEFAULTSORT:Harrington, Paul Randall 1911 births 1980 deaths Baylor College of Medicine people American orthopedic surgeons United States Army personnel of World War II Kansas Jayhawks men's basketball players Military personnel from Kansas University of Kansas School of Medicine alumni American men's basketball players 20th-century surgeons United States Army Medical Corps officers