User:AlexSmeele/Anselmo Reyes Gallardo

Dr. Anselmo Reyes Gallardo (30 June 1952 – 26 September 2012) was a Mexican orthopaedic surgeon and one of the pioneers of orthopaedic damage control and orthopaedic education.

Early life and education
Dr. Anselmo Reyes Gallardo was born in Mexico City in 1952 to parents Rafael Reyes Romero and María Libier Gallardo Muñoz. Coming from a poor family and in order to pursue his career as a surgeon, Reyes Gallardo worked as a truck driver transporting guano, thanks to his firsthand experience in the needs of Mexican population and the wide understanding of the socioeconomic conditions of the country he was able to fully apply the knowledge of metalworking acquired in his early life as a driver in his medical career.

Higher education
Gallardo studied as a surgeon at the National Autonomous University of Mexico (UNAM); later graduating with a speciality in orthopaedics and traumatology from the 21st Century National Medical Centre of the Mexican Social Security Institute (IMSS). From 1978 - 1979 he did his postgraduate internship at the La Raza Medical Center Hospital of IMSS.

Humanitarian efforts
During his time at the UNAM, Gallardo organised medical brigades in the Chinanteco Zone in the Sierras of Oaxaca, independent of the medical faculty, in his quest to provide assistance to the most remote and vulnerable communities in the country. It was there that he developed his potential and his humanism. From 1977-1978 he performed his social service in the Sierra de Tlaxcala.

Professional career
In 1979, Gallardo joined the Orthopaedics and Traumatology Specialty of the 21st Century National Medical Center of the Mexican Social Security Institute (IMSS). Due to the earthquake of 1985 and with the disappearance of the Traumatology Hospital of the 21st Century National Medical Center, his alma mater, he joined the Magdalena de las Salinas Traumatology Hospital in 1986. It was there that he developed his love for surgery, for surgical techniques, surgical instrumental design, study, research and his great passion, the teaching of orthopaedics. He would later become director of this hospital from 2000 until 2009.

Gallardo was a great enthusiast of the integral management of patients with infections, exposed fractures, polytrauma, and injured spines, giving great impetus to the teaching of the management of these pathologies, leaving precedent in the current methods of evaluation, diagnosis, treatment and management of the consequences of these conditions. After having worked alongside Dr. Fernando Colchero Rozas (inventor of the Colchero Nail, deceased), he devoted several years to the management and research of patients with bone infections. This knowledge served to provide better care to patients with exposed fractures, motivating and requesting the authorities of his hospital to create an exclusive service for this delicate area, which would later attend to polyfractured patients with high complexity in their management. The number of these patients was so numerous that in 1998 he published the case studies of 5,207 of exposed fractures, having a range of infection and amputations well below of what was reported in other institutions up to that date.

Due to his constant restlessness for learning, Gallardo travelled to Memphis, Tennessee, to learn about the surgical technique of blocked nails (Russell and Taylor). He then started at the Magdalena de las Salinas Traumatology Hospital, using the intramedullary nailing to a closed focus, as well as locking with bolts guided by the image intensifier, popularising its use. In the medullary nailing technique, he made us fully understand the quantity and quality of spinal milling and the application of milled and non-milled nails under precise indications and adequate postoperative management to successfully lead to the consolidation of the patient's traumas.

He began bone transportation and the bone extension substitute methods for the management of bone length losses, and with the study of these cases obtained, in 1995, the first place in free works in the Orthopaedics Days of the Mexican Orthopaedic Society. In addition, he developed and applied a uniform criterion for the evaluation of a severely injured limb for decision-making in definitive treatment if limb amputation or salvage was practiced, criteria that are currently applied throughout Mexico. Likewise, Dr. Gallardo promoted logical and systematic osteosynthesis through AO philosophy, by establishing an adequate classification of the lesion, preoperative planning, surgical indications according to the biomechanical principle, adequate surgical techniques and comprehensive postoperative management, raising Mexico's level of orthopaedics.

In the field of polytraumatized and poly-fractured patient management, he conducted multiple studies and contributions aimed at reducing complications, using prophylaxis and adequate classification and diagnosis, and applying the appropriate treatment as soon as possible. He promoted the use of initial external fixators as the ideal bone stabilisation management despite the critical conditions of the patient, institutional adversities and the costs involved, motivating the entire health system to address each case in a multidisciplinary manner, what is currently known as "orthopaedic damage control".

As a result of his tireless concern and study of osteosynthesis materials, he was selected to carry out a multi-centre study of the UTN nail (unreamed tibial nail), being the site that provided the most evaluation cases in that trial. He also participated in another multi-centre study about the usefulness of the UTN nail, being again the centre that contributed the most cases; on this occasion corrections were made to the nail design, which were accepted by all. In 1997, he participated in the evaluation of the DAD (Distal Aiming Device), a device for locating the distal holes of the UTN nail, to which multiple corrections were made to its initial lack of precision, making it as effective as it is today. In 2000, he also participated in the design of the MODAD (Modular Distal Aiming Device) for the AO-ASIF femoral and humeral intramedullary nails; This led him to travel to Switzerland on multiple occasions during the study. He also participated in the application and clinical evaluation of tubular external fixators. For all the above, in 2005 he received in Davos, Switzerland, by the AOASIF, the recognition as the traumatologist who most promoted teaching and research in Latin America.

Dr. Reyes promoted the use of biological osteosynthesis, absolute and relative stability, the use of plates with a specific and adequate biomechanical principle with the least aggression and maximum respect for soft tissues. With it we witness the evolution of the plates, from those of wide contact to those of low contact, those of zero contact and those of non-contact, even reaching the current internal fixator with angular stability plates.

He participated in the preparation of the Clinical Practice Guidelines of the Specialty, multiple standardised research and evaluation studies, as well as his participation in textbooks where he has bequeathed us an accumulation of invaluable experiences.

He fought tirelessly because all doctors had the possibility of learning and training, both nationally and internationally, with the sole purpose of "offering the best and the first to the patient."

Personal life
In January 1979, Gallardo married Carmen Patricia Fuchs Gómez in Mexico City. They have 3 children: Mónica Patricia Reyes Fuchs, Esteban Rafael Reyes Fuchs, Carmen Gabriela Reyes Fuchs.

In his spare time he was an avid mechanical engineer, photographer, runner, and gardener.

Death
Gallardo died at the age of 60, on September 26, 2012, in Mexico City, after a rapid onset of myeloproliferative blood cancer (leukaemia). It was his sudden and unexpected death that led his daughter Gabriela to make the discovery that would come to be known as Dead Soon.