Sir Robert Jones, 1st Baronet

In 1888 he was appointed Surgeon-Superintendent for the construction of the Manchester Ship Canal, responsible for the injured among the 20,000 workers during the seven-year project. He organised the first comprehensive accident service in the world, dividing the 36-mile site into 3 sections, and establishing a hospital and a string of first aid posts in each section. He staffed the hospitals with medical personnel trained in fracture management. The hospitals were linked by a railway which ran the length of the canal, and Sir Robert could be contacted in Liverpool by telegraphy if his presence was required.[5] He personally managed 3,000 cases and performed 300 operations in his own hospital. This position enabled him to learn new techniques and improve the standard of fracture management.[2]

On 3 November 1894, Robert Jones and Alfred Tubby convened a group of surgeons at the Holborn Restaurant in London to found the British Orthopaedic Society. The society had 31 members, most of whom were still general surgeons with an interest in orthopaedics; this lack of committed orthopaedic surgeons is likely to have been the reason that the society disbanded after 4 years.[1]

In 1913 Jones served as the President of the orthopaedic section of the International Medical Congress held in London. The subsequent congress was to be held in Munich three years later.[4]

Wilhelm Röntgen announced the discovery of X-rays on 28 December 1895. This discovery was published in the Frankfurter Zeitung newspaper which was translated for Robert Jones by Mrs. Wimpfheimer, a volunteer in his Sunday clinic in Liverpool.

On 7 February 1896, Jones and Oliver Lodge took a radiograph of the wrist of a 12-year-old boy to locate a bullet that could not be found by probing. The X-ray required a 2-hour exposure, but successfully demonstrated the bullet lodged in the third carpometacarpal joint. This case was published in The Lancet in February 1896,[6] the first published clinical radiograph.[1]

Jones continued to value the use of X-rays in his practice. In a paper published a few months before he died, he remarked:

Radiography here, as in all branches of medicine, is an essential aid to diagnosis. No matter how experienced we may be, we cannot afford to dispense with it, even in the apparently simple and obvious case. Not only should we insist upon procuring a film, but it is equally important that we should welcome the radiologist's reading of it. Some surgeons resent this and say, "Give me the film so that I can read it for myself," but this is an arrogant and stupid attitude, and not to the patient's advantage.[7]

Jones fracture of the 5th metatarsal of the foot, between the epiphysis (base) and the diaphysis (shaft).

Robert Jones described the fracture of the fifth metatarsal which bears his name in the Annals of Surgery in 1902. In his paper, Jones described the fracture in a series of six patients, the first of which was himself.[8] He had injured his foot while dancing several months earlier, and had thought the injury to be to a tendon in the foot. He examined himself the day after the injury, and found that the tendon was intact, but he could not find definite evidence of bony injury. He asked a colleague, David Morgan, to X-ray his foot, and a fracture above the base of the fifth metatarsal was found. The finding of similar fractures in several patients after his own prompted him to write about it. He also noted that the fracture was not caused by direct trauma to the bone, as had always been assumed before, but by a cross-strain being applied to the bone.[9]

At the outbreak of the First World War Jones was mobilised as a Territorial Army surgeon in the Royal Army Medical Corps. He observed that treatment of fractures both at the front and in hospitals at home was inadequate, and his efforts led to the introduction of military orthopaedic hospitals. He was appointed Inspector of Military Orthopaedics, with responsibility over 30,000 beds. The hospital in Ducane Road, Hammersmith became the model for both British and American military orthopaedic hospitals. His advocacy of the use of Thomas splint for the initial treatment of femoral fractures resulted in a dramatic reduction in morbidity and mortality from this injury.[10] Jones was promoted several times for his war service, ending his military career as a major general.[10]

Jones died, aged 75, in Bodynfoel, near Llanfechain.