Maurice E Müller

29. March 2018

‘A giant in the history of medicine’: celebrating 100 years since his birth

Maurice E Mueller

By the time the now commonly used term “disruptive innovation” was coined in 1997, Maurice E Müller—the founding father of the AO—had already been revolutionizing patient care for 50 years. Müller’s legacy of innovation in trauma surgery and medical education, along with his passion for philanthropy, are celebrated this year on the 100th anniversary of his birth.

Events commemorating his vast contributions to advancing patient care began on March 23, 2018 at the University of Bern, where the campus auditorium was named Auditorium Maurice E Müller. The ceremony included the unveiling of a bronze bust in the likeness of Müller and testimonials about his innovative work to advance patient care. 

Opening of 100-day exhibition

On March 28, the 100th anniversary of Müller’s birth, Canton Bern’s Zentrum Paul Klee officially opened its 100-day Hommage Maurice E Müller exhibition which will continue through July 6, 2018. In addition to his work as a visionary surgeon, educator, and inventor, Müller was known for his philanthropy: He was the founder and patron of the Zentrum Paul Klee, as well as founder and patron with his daughter, Janine Aebi-Müller, of the Children’s Museum Creaviva.

Müller’s interest in Klee was linked to his own affinity for teaching—and for meticulously documenting his patient cases.

“My father documented every operation he did after 1951, and Paul Klee documented his entire oeuvre. Both followed their vision as a passion and considered their professions as their vocation,” said Aebi-Müller, adding that the University of Bern will honor her father, who died in 2009, by opening a small museum on Bern’s Murtenstrasse in October.

Aebi-Müller said her father would not have expected the many ways that people are honoring him. She believes he would be grateful but remain focused on better health care and the lives of patients.

As a highlight of Zentrum Paul Klee event, AO Foundation Past President and Honorary Member Prof Emeritus Joseph Schatzker described Müller as “a giant in the history of medicine,” and recounted the legacy Müller, who was first his mentor and then ultimately his friend.

Prof Maurice E Müller, MD, instructs participants at the 10th AO Davos Courses in December, 1969.

‘All was part of a plan’

“Nothing in the life of Maurice came about by chance. All was part of a plan,” Schatzker said. He explained that prior to Müller’s groundbreaking work to pioneer fracture treatment through stable internal fixation with plates and screws, fractured bones were treated by many weeks of immobilization in plaster casts or traction, which caused stiffness, scarring, and muscle wasting and led to lifelong disability.

A Belgian surgeon, Robert Danis, conceived using surgery to reduce fractures and then using compression to keep the bone fragments reduced while they healed. To achieve compression between the fragments, Danis fixed them with special plates and screws of his own design. Casts became unnecessary, and patients could move their limbs and exercise freely while their bones healed. This avoided all the complications of conservative treatment. 

“Other surgeons had visited Danis, but none pursued his techniques,” Schatzker said.

Maurice E Müller and his daughter, Janine Aebi-Müller, with his book during the ceremony for the memorial plaque on his 90th birthday.

Unbelievable courage and self-confidence’

But Müller was not like other surgeons. He immediately recognized that he was witnessing the future of trauma surgery.

“Whenever Maurice encountered a promising new idea, he would study it thoroughly to make sure he understood it. Then he would see if he could make it better,” Schatzker said. “Armed with his new understanding of stable internal fixation, he wrote down his own, improved new principles of osteosynthesis.”

With “unbelievable courage and self-confidence,” Schatzker described how Müller put his new hypothesis to the test by treating 75 patients with broken tibias using internal fixation with compression that allowed immediate, full use of their extremities. Seventy-two of those patients regained normal function. He scrupulously documented his work to provide evidence for any who would challenge his treatment.

Beginning of the AO 60 years ago

Maurice realized why Danis drifted into obscurity. Danis worked alone and had no followers and did not do any research. Müller also realized that in order to establish a new school of surgery—which was his goal—one needed a team, a group of surgeons who would become disciples and would practice what was preached. Thus on weekends, away from Balgrist where he was chief resident, he would demonstrate his techniques to a few chief surgeons at Bern-area community hospitals, thus bringing together a team that shared his enthusiasm for his new principles. They were not burdened with the inertia of academic centers and had the freedom to do what they believed was good for their patients. 

“It was important that they were all Bernese; they had gone to the same schools, played the same sports, and belonged to the same medical fraternities. They had a feeling of kinship, fraternal spirit, and trust,” said Schatzker.

Together, on November 6, 1958 in Biel, they established the Arbeitsgemeinschaft für Osteosynthesefragen (Association for the Study of Internal Fixation), known today as the AO Foundation.

Furthermore, in the late 1950s in partnership with Robert Mathys, Sr., a watch components manufacturer, Müller designed a comprehensive AO system of screws plates and necessary instruments for fixation of every joint and bone. Believing that traditional teaching in the operating room was insufficient to make surgeons competent in the new techniques, Müller designed the first hands-on AO Davos Course, held in December 1960 during the first AO course. This hands-on teaching revolutionized how surgical skills are taught.

To mark the 60th anniversary of the AO’s 1968 founding and to celebrate the 100th anniversary of Müller’s birth, Schatzker has written a book, Maurice Edmond Müller- in His Own Words, to be published this July by the AO Foundation. 

“The genius and creativity of Maurice Müller—surgeon, scientist and medical entrepreneur—forever changed how fractures are treated and joints reconstructed,” Schatzker said. “Müller’s methods are now the standard of care throughout the world. They have brought healing and comfort to hundreds of thousands of patients.”

Participants in the first AO Davos Courses in December 1960 learn from Prof Maurice E Müller, MD, during a practical exercise.​