Born in Stratford, Ontario, a sixth-generation Canadian of Loyalist descent, Dr. Robert Salter has earned a distinguished international reputation as an orthopedic surgeon. A major contribution to the field has been his innovative concept of Continuous Passive Motion (CPM), a development that stemmed from many astute and detailed clinical observations and at least partially from injuries he received while playing sports at the University of Toronto. Somehow he learned that by avoiding a cast on an injured limb, one recovered much faster.
 

Dr. Robert Salter discovered that continuous motion promotes the healing of injured joints. Machine devices based on Dr. Salter’s findings are currently being used in more than 15,000 hospitals in some 50 countries. Three million people around the world with joint injuries are healing faster and walking more easily, thanks to the medical achievements of this world-renowned orthopedic surgeon. [Photo, courtesy Charles G. Roland]

By the time he was awarded his medical degree in 1947, Salter’s career direction had already been cast. After two years in the Grenfell Mission, Newfoundland and Labrador, he began extensive postgraduate training in orthopedic surgery; by 1955 he was on the active staff at the Hospital for Sick Children, Toronto, as an orthopedic surgeon. Two years later he was chief of the orthopedic division. In that year he devised an operation that today is known worldwide as the “Salter Operation” for children with severe congenital dislocation of the hip.

In addition to a career arising from his own injuries, Salter gives credit to the example of medical practitioners whom he came to know while growing up in Southwestern Ontario. In particular, a Dr. David Smith was an inspiration. Seeing his twin brother recover from a chronic illness was another.

By the time he enrolled at university, Salter had already made up his mind to be not only a doctor but also a medical missionary. His time at the Grenfell Mission became his introduction to the field. That his dream was not fulfilled was the direct result of international politics in 1949-1950. It quickly became evident that medical missions to China, always a major commitment for Canadian missionaries, would not continue. But the loss to the far east was Canada’s gain, as Salter’s mentor teachers, including Dr. William Mustard, persuaded him to pursue his career in orthopedic surgery in Toronto.

That career has been studded with significant contributions. The introduction in 1970 of CPM was the most important. The principle is that bones, cartilage, and ligaments mend more quickly if they are moved very gently and continuously instead of being totally immobilized. Salter has been conducting relevant basic research on joints in animals ever since. After the first eight years of laboratory research, he collaborated with John Saringer, a professional engineer, to design motorized Continuous Passive Motion devices for various extremity joints of patients. The patient is almost unaware of the slow, gentle motion, but the injured or diseased tissues heal rapidly and effectively. It has been estimated that, to date, more than three million patients throughout the world have been successfully treated using this innovation.

Salter has also established a widely recognized reputation for excellence in teaching. His interest in this area he traces back to his efforts to tutor his twin brother so that the latter did not fall behind in grade school during his long illness. The results include textbooks and hundreds of professional articles that contribute to the education of his students as well as his peers. More directly, he has lectured and/or taught in nearly 40 different countries and has served as mentor to many hundreds of medical students, residents, and international visitors to Toronto’s Sick Children’s Hospital. Countless men and women have taken his methods and beliefs and spirit into, literally, hundreds of communities around Canada and the world.

As a consequence of his major scientific contributions to the field of orthopedic surgery, Dr. Salter has been much honoured. A few of his awards include being made a Fellow of the Royal Society of Canada and a Companion of the Order of Canada (1997). Dr. Salter, who has lectured in over 140 universities worldwide, is the recipient of numerous honorary degrees, honorary fellowships, and honorary memberships in scientific societies. He was one of seven doctors initially inducted into the Canadian Medical Hall of Fame.

Salter continues in his semi-retirement to conduct research, to teach orthopedic residents, and to update the third edition of his textbook for medical students.

Charles Roland