William Little (English surgeon)
Encyclopedia
This article is about the English surgeon; for other people named William Little see William Little (disambiguation)
William Little
William Little may refer to:* William Brian Little , founding partner of Forstmann Little & Company, a private equity firm* William Carruthers Little , Ontario farmer and political figure...

.


William John Little (1810-1894) was an English surgeon
Surgery
Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...

 who is credited with the first medical identification of spastic diplegia
Spastic diplegia
Spastic diplegia, historically known as Little's Disease, is a form of cerebral palsy that is a neuromuscular condition of hypertonia and spasticity in the muscles of the lower extremities of the human body, usually those of the legs, hips and pelvis...

, when he observed it in the 1860s
1860s
The 1860s were an extremely turbulent decade with numerous cultural, social, and political upheavals in Europe and America. Revolutions were prevalent in Germany and the Ottoman Empire...

 amongst children. While spasticity
Spasticity
Spasticity is a feature of altered skeletal muscle performance in muscle tone involving hypertonia, which is also referred to as an unusual "tightness" of muscles...

 surely existed before that point, Little was the first person to medically record the condition in writing. Thus, for many years, spastic diplegia was known as Little's Disease; only later did the name change. Also, Little founded the Royal Orthopaedic Hospital
Royal National Orthopaedic Hospital
The Royal National Orthopaedic Hospital is a specialist orthopaedic hospital located in London, United Kingdom and a part of Royal National Orthopaedic Hospital NHS Trust...

 of London.

Little is also known for his doctoral dissertation in 1837 on tenotomy
Tenotomy
A tenotomy is a surgical act which involves the division of a tendon.When it involves the Achilles tendon, it is called a "Achillotenotomy".It has been used in the treatment of cerebral palsy.It has also been used for hammer toe....

, the first monograph on the subject ever published, and Little became the known source of this operation, intended for the correction of skeletal deformity secondary to neuromuscular disorders.

Little did not have any spasticity himself, but he suffered childhood poliomyelitis
Poliomyelitis
Poliomyelitis, often called polio or infantile paralysis, is an acute viral infectious disease spread from person to person, primarily via the fecal-oral route...

 with residual left lower-extremity paraparesis, complicated by severe talipes. This undoubtedly sparked his special interest in lower-extremity mobility impairments, as well as his medical-orthopedic inclinations more generally. As a youth he was an apothecary
Apothecary
Apothecary is a historical name for a medical professional who formulates and dispenses materia medica to physicians, surgeons and patients — a role now served by a pharmacist and some caregivers....

's apprentice, surrendering his indentures at the age of 18 and entering medical school at the London Hospital. He was admitted to the Royal College of Surgeons
Royal College of Surgeons of England
The Royal College of Surgeons of England is an independent professional body and registered charity committed to promoting and advancing the highest standards of surgical care for patients, regulating surgery, including dentistry, in England and Wales...

 in 1832.

Little later travelled to Germany to study the technique of subcutaneous tenotomy with its originator, Louis Stromeyer
Louis Stromeyer
Georg Friedrich Louis Stromeyer was a German surgeon who was born in Hanover. He was the son of surgeon Christian Friedrich Stromeyer .-Biography:...

, who subsequently corrected Little's deformed foot by this method. Among his many publications was "On the Deformities of the Human Frame" (1853) in which he first described pseudo-hypertrophic muscular dystrophy
Muscular dystrophy
Muscular dystrophy is a group of muscle diseases that weaken the musculoskeletal system and hamper locomotion. Muscular dystrophies are characterized by progressive skeletal muscle weakness, defects in muscle proteins, and the death of muscle cells and tissue.In the 1860s, descriptions of boys who...

, preceding Guillaume Duchenne
Guillaume Duchenne
Guillaume-Benjamin-Amand Duchenne was a French neurologist who revived Galvani's research and greatly advanced the science of electrophysiology...

's paper on the same condition by eight years.

The techniques originated by Stromeyer and applied by Little are used today in the surgical management of quite a few neuromuscular conditions today, although obviously in modern times they are quite a bit more advanced due to technological progress and improvements in surgical concepts and methods. Little was one of the first to bridge the gap between neurology
Neurology
Neurology is a medical specialty dealing with disorders of the nervous system. Specifically, it deals with the diagnosis and treatment of all categories of disease involving the central, peripheral, and autonomic nervous systems, including their coverings, blood vessels, and all effector tissue,...

 and orthopaedics, and his important work continues to impact both of these fields, including the fact of continually-increasing cooperation between orthopaedic surgeons and neurosurgeons in today's management of spastic cerebral palsy and similar neuromuscular disabilities.

Source

Historical Vignette #9. Little big man: the life and genius of William John Little (1810-1894). Orthopedic Review 1988; Nov. 17 (11):1156, pp. 1161–6.
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