The trailblazers: pioneering women in orthopaedic surgery

Abstract

In January 2024, New York University Langone Orthopedic Surgery achieved a significant milestone with the first all-women team, from chief residents to interns, at Bellevue Hospital. In a field still dominated by men, only 16% of orthopaedic resident physicians and 6% of practicing orthopaedic surgeons are female, this was no small feat. Although there are many factors that made this historic team possible, it is clear that the earliest female pioneers of orthopaedic surgery were absolutely critical. This paper aims to discuss 5 pioneering women who not only created a path for the now thousands of female orthopaedic surgeons but also left a legacy of significant contributions to the practice of orthopaedics. These trailblazers are as follows: Dr. Marian Frauenthal Sloane, Dr. Ruth Jackson, Dr. Jacquelin Perry, Dr. Claudia Thomas, and Dr. Ericka Lawler.

Dr. Marian Frauenthal Sloane

Marian Henrietta Frauenthal was born in New York City on November 16th 1904. She was the second child of Dr. Herman Frauenthal and Minnie Rothschild (Fig. 1). Herman Frauenthal and his older brother Henry had moved to New York City to become physicians, where they trained at Bellevue College of Medicine with Dr. Lewis Sayre, the first professor of orthopaedic surgery in the United States.¹

Figure 1.

Dr. Marian Frauenthal Sloane.

In 1906, 2 years after Marian's birth, the Frauenthal brothers founded the Jewish Hospital for Deformities and Joint Diseases, which, from the beginning, was a family business. When Marian's older brother, Frank, died because of polio at the age of 9 in 1910, the role of heir to the family business and the responsibility for continuing the family legacy in orthopaedic surgery fell to 6-year-old Marian.¹

Marian grew up with significant financial privilege. Her grandfather, Samuel Frauenthel, had emigrated to the United States from Germany in the mid-1800s and would become a prosperous merchant. Her mother's family, the Rothschild's, are a prominent banking family who during the 19th century possessed the largest private fortune in the world. Notably, the financial resources of the Rotschild family were critical to the founding of the Hospital for Joint Diseases because it was their donation of 4 brownstones that housed the hospital. This access to wealth and education proved critical to Marian's success, in a time where women's rights were still quite limited. For example, Marian owned a car and learned to drive—quite rare for a woman at this time. Marian went on to graduate from Smith College in 1926 and Bellevue Hospital Medical College of New York University in 1930.¹

At Bellevue, Marian was a member of the Zeta Phi Medical Sorority and was also on the staff of the yearbook, the Medical Violet. Although she would be the first woman to train in orthopaedics at Hospital for Joint Diseases (HJD), it did not seem to be a daunting challenge to her. When asked how she had believed that she could do this “man's job” given the social mores of the time, her nephew James Frauenthal remarked, “It never occurred to her that she couldn't do it, so she did.”²

On graduation, she began her training at what was now the Hospital for Joint Diseases. With the completion of her residency, she became the first female licensed orthopaedic surgeon in New York State. She continued on the staff at HJD and was also an attending at the New York Infirmary for Women. Her additional honors included being a fellow of the American Medical Association and a member of the American Women's Medical Society and the New York and Westchester County Medical Societies.²

According to the HJD annual reports, Dr. Frauenthal would go on to be a member of her father's team as she was assigned to his service.³ Notably, HJD is also where she would meet David Sloane, who was also assigned to her father's service. Mariane and David Sloane would marry in 1993 and would both continue in their roles as adjunct professors at HJD. Dr. Frauenthal published a total of 5 studies during her career, the first of which, a case report on quad tendon rupture, was published in 1935. This gives her the distinction of being the first US female orthopaedic surgeon to publish a scholarly article in a surgical journal.² Tragically, Dr. Sloane was diagnosed with breast cancer shortly after Elaine's birth in 1938. It is now believed that her disease was caused by the radiation treatments she received as a teenager for acne. Sadly, she died to the disease in 1940. Despite her early passing, her legacy continues in the form of multiple awards, including the Marian Frauenthal Sloane orthopedic scholarship which was initiated in 2020 by the Ruth Jackson Orthopedic Society.²

Dr. Ruth Jackson

Mary Ruth Jackson was born to William and Belle Jackson on a farm in Jefferson, Iowa, on December 13, 1902 (Fig. 2). Ruth was the 6th of 7 children, with a younger sister Edythe who was 2 years her junior. Ruth was a tomboy growing up–always preferring to play with her older brothers. She also loved working with her hands, whether it was doing chores on the farm or making a bobsled from scratch using spare parts she found on the farm.⁴

Figure 2.

Dr. Ruth Jackson.

The family would eventually move to the Rio Grande (pronounced grand) Valley in Texas where Ruth would attend high school, graduating from McAllen High School in 1920. Despite maintaining a very high-grade-point average throughout high school, she was relegated to 3rd place because of an extended absence her freshman year due to typhoid fever. Her consolation prize was to give the class history at the commencement. Although Ruth did have early exposure to medicine through her mother's work as a midwife, there would be a specific moment in college that would ignite her desire to be a physician.⁴

At the University of Texas Austin, Dr. Jackson initially pursued economics and sociology. As part of a sociology assignment, Dr. Jackson was sent to a family's home in East Austin to see how many groceries they needed for the week. On entering the home, she found the father with a knee so swollen that he was unable to work to provide for his family. Dr. Jackson said in an interview that at this moment she told herself, quote, “Ruth Jackson, this is not for you. Anybody could do this. What you really want to do is find out what's wrong with that man's knee and put him back to work so he can take care of his own family.”⁴ Following this encounter, she switched to a premedicine track, notably, against her father's wishes. After adding 2 summer courses to finish prerequisite classes, Ruth Jackson graduated in 1924 with a Bachelor of Arts degree in Zoology and a minor in chemistry.⁴

Dr. Jackson entered the Baylor University College of Medicine in 1924 where she was just one of the 4 women in a class of 112. During her time at Baylor, Dr. Jackson excelled despite numerous instances of outright sexism. At freshman orientation, an instructor, Dr. Morrison, announced to the 4 women in front of the entire class that they would have to score 10 points higher to earn the same grades as the men. Furthermore, the women were prohibited from examining male patients in the urology clinics, despite the fact that the men were allowed to examine women while on the obstetrics service. Despite these hurdles, Dr. Jackson and her classmates persevered. Dr. Jackson went on to graduate ranked eighth in her class. Notably, of the original 112 members of her freshman class, only 58 finished medical school, while all 4 women medical students were among the graduates.⁴

After medical school, Dr. Jackson hoped to pursue a career in general surgery. However, in 1928, general surgery internships were closed to women, including at her alma mater, Baylor University. Dr. Minnie Maffet, a professor of gynecology at Baylor and a mentor to Dr. Jackson, assisted her in finding a rotating internship at an all-female program at Memorial Hospital in Worcester, Massachusetts. Still unable to find a position in general surgery during this internship, Dr. Jackson applied for an orthopaedic residency position at the University of Iowa with renowned surgeon Dr. Arthur Steindler.⁴

When she arrived in Iowa City, Dr. Jackson's plan was to use the year to bolster her chances of finding a general surgery residency. However, under Dr. Steindler's guidance, she quickly discovered that orthopaedics was her true passion. She was impressed with the work of the orthopaedic surgeons, their treatment of young polio victims, and the rehabilitation of children with birth defects. In a 1984 interview, Dr. Jackson said of her time at Iowa, “I can't describe the feeling I had when I was helping one of these kids, but I knew then this experience was among the most rewarding for me. It was then that I decided on orthopedic surgery.”⁵

Although Dr. Jackson would return to Worcester for another year of orthopaedic residency, Dr. Steindler would continue to serve as a mentor throughout Dr. Jackson's career. In a 1976 interview, she described one of the most encouraging things he said to her during her time in Iowa. He told her, “Ruth, you are going to become a good orthopaedic surgeon because you pay attention to the little things. The rest, well, they pay attention to the surgery and everything else, but you concentrate on the little things, and that is what will make you great.”⁵ Back at Worcester, Dr. Jackson would learn spinal fusion techniques under Dr. Charles Ayers. She then completed her third and final years of residency at the Scottish Rite Hospital for Crippled Children in Dallas, Texas.

Following the completion of her residency, Dr. Jackson had been promised a position by Dr. William Carrell at his clinic where she had also worked as an assistant during her last year of residency. At the last moment, he rescinded this offer—she was later told by her friend and mentor Dr. Maffett that a hospital superintendent had told Dr. Carrell that she was a lesbian, leading him to break his promise. Dr. Jackson instead opened her office alongside 4 other physicians on August 1, 1932 in Dallas, during the height of the Great Depression. She would often perform reconstructive surgery without pay, learning techniques that would serve her well in the future. To support herself, Dr. Jackson earned money by working for President Roosevelt's Works Progress Administration, performing physical examinations for the fee of 3 dollars an hour. Dr. Jackson often needed expensive surgical instruments which she could not afford in the early days of her career. Always innovative, she improvised, making her own instruments using simple parts from hardware stores.⁴

Dr. Jackson's early academic interest centered on foot and ankle conditions. She had been advised to make this field her focus by Dr. Carrell who had told her “When your feet hurt, you hurt all over.”⁴ “So with this choice, she would attract more patients than if she had chosen another field.” Her first papers, “A Few Remarks Concerning Painful Feet” and “The Care of the Feet,” which reviewed the pathophysiology of metatarsalgia, were published in 1935 and 1938 in the Physiotherapy Review.^6,7

At the same time Dr. Jackson was building her clinical and academic practice, the American Academy of Orthopaedic Surgeons would be formed, with the first meeting held in Chicago at Northwestern University Medical School from January 12 to 14 in 1933. Any orthopaedic surgeon who was practicing was automatically certified for membership with a grandfather's clause, except Dr. Jackson, who was denied membership because of her sex. Dr. Jackson had completed the required training, had limited her practice to orthopaedic surgery, and even had been Chief of Orthopaedic Service at Parkland Hospital for a year at that time, but none of this mattered. Dr. Jackson instead was required to wait 4 years. She was finally admitted after taking the boards in Cleveland, Ohio, in January 1937.⁴

In this historic letter (Fig. 3), Dr. Lewin wrote to Dr. Jackson informing her of her membership, adding a postscript that she was the first woman elected to membership.⁵ With this news, Dr. Jackson officially became the first woman orthopaedic surgeon to be board certified and a member of the AAOS. It would be 6 years before another woman, Dr. Penelope Sherwood was admitted. And another 4 before Dr. Jackson's eventual partner, Dr. Margaret Watkins would join in 1947.⁴

Figure 3.

1937 letter from AAOS secretary Dr. Lewin confirming Dr. Jackson's membership.

Following her board certification, Dr. Jackson joined the Baylor University Hospital staff in 1939 and served as a role model for Margaret Watkins, the first female resident to be trained at Baylor University Hospital. Between 1936 and 1941, Dr. Jackson was also Chief of the Orthopaedic Service of Parkland Hospital in Dallas, where she established the first orthopaedic residency.⁴

In 1945, Dr. Jackson eventually built her own private clinic in Dallas. Dr. Watkins had joined her as a partner in 1942, and they would work together in this clinic until 1950, when Dr. Watkins decided to limit her practice to cerebral palsy. It was truly a full-service clinic, containing examination rooms, an operating room, an x-ray suite, and physical therapy facilities. She continued to practice here for 38 years. Although she stopped operating in 1974, she continued to see patients until 1989 when she retired at the age of 87. Along with her private practice, Dr. Jackson would have a long career at Baylor where she served as an attending physician and a clinical instructor. In 1961, Dr. Jackson founded the Ruth Jackson Research Fund at Baylor University. Later in 1975, the Ruth Jackson Research Foundation was established to support research and seminars in orthopaedic surgery. Dr. Jackson also donated the funds to create the Ruth Jackson Academic Wing at Baylor, and on September 9, 1986, the wing was dedicated with a testimonial dinner in her honor and a large celebration.⁴

Dr. Jackson's career is also notable for several connections to New York University Langone Orthopedics. The first came in 1936 when as Chief of Orthopaedic Service at Parkland Hospital, Dr. Jackson received a letter from Dr. Leo Mayer, the father of modern tendon surgery.⁵ Dr. Mayer, who had joined the staff of the Hospital for Joint Diseases in 1924, asked if she could find a residency in Orthopaedic Surgery for Dr. Wilhelm Zuelzer, a German trained orthopaedic surgeon who was doing some postgraduate work with him at the HJD. Dr. Jackson ultimately accepted, and Dr. Zuelzer became the first resident in Orthopaedic Surgery at Parkland in 1936.⁵

Significantly, Dr. Jackson is also considered the first female orthopaedic spine surgeon.⁸ In fact in a 1979 interview when she was asked what was her greatest contribution to orthopaedics, she replied. “My work on the neck.”⁵ Her interest in the cervical spine was seeded in personal experience. In 1936, she was involved in a motor vehicle accident and injured her neck. She suffered significant pain for years, spurring her to study the pathologies of the spine and to treat patients with similar injuries.⁴

In 1947, she published her first work on the spine, entitled “The Cervical Syndrome as a Cause of Migraine” in the Journal of the American Medical Women's Association.⁹ She defined the cervical syndrome as “a group of cases which present definitely similar symptoms and clinical findings, the causative factor of which is the irritation of the cervical nerve roots.” Her papers included meticulous descriptions and impressive illustrations of the anatomy of the cervical spine. She would go on to publish “The Cervical Syndrome” and “The Mechanism of Cervical Nerve Root Irritation” in the Dallas Medical Journal in 1949 and 1952, respectively.^10,11

These early publications were well received by the orthopaedic community, and in 1952, Dr. Jackson received an invitation from the AAOS to give an instructional course on the cervical syndrome at the 1953 academy meeting.⁵ Her first instructional course lecture at the 1953 meeting was quite the success. So much so that in May of 1953, she received a letter from the AAOS describing her course's popularity and an invitation to repeat the course in 1954 with a larger venue and a 3-hour period instead of 2.⁵ With the continued success of this course at the 1954 meeting, she was again invited to give the instructional course lecture at the 1955 academy meeting.⁴

Following the success of her instructional courses at the Academy, Dr. Jackson¹² published the first edition of her textbook, “The Cervical Syndrome” in 1956. This text would describe her treatment of more than 15,000 patients and would later be updated in second and third editions. In the forward for this text, her mentor, Dr. Steindler commends her attention to the contribution of the uncovertebral joints to foraminal compression. He concludes by writing “it has been my privilege to know Dr. Jackson for many years and to follow the keen interest she has taken in this subject and the earnest and intensive studies she has devoted to it. They have made her one of the foremost authorities in this specific field.”¹² Dr. Steindler was not alone in his assessment of this text. The cervical syndrome was well reviewed on its publication. This review from JAMA commends the anatomical description of the uncovertebral joints, concluding that “this valuable book should be useful to the general practitioner, orthopedist and neurosurgeon.”

Dr. Jackson also developed a pillow, specifically designed to aid in the nonoperative management of cervical pathologies. Named “the Cervipillo,” Dr. Jackson demonstrated its effectiveness in maintaining cervical alignment during sleep in her textbook. Dr. Jackson outsourced the manufacturing of this pillow to several companies, and in fact, it is still available to purchase today. Although Dr. Jackson is largely known for her nonoperative management of cervical pathologies, she was also a surgical pioneer. She routinely performed spinal fusions for patients with trauma and would perform lumbar discectomies under local anesthesia. In a 1977 letter in response to a British physician, she describes a wide awake lumbar discectomy, noting that the patient would only experience pain when she probed the facets, but not when the extruded disk material was removed.⁵ This unpublished manuscript also describes her experience with the “Knowles vertebral support,” which was an early iteration of an interspinous device invented by Dr. Fred Knowles and published in 1958 in the Journal of the Iowa State Medical Society.⁵

Dr. Jackson would become internationally renowned for her expertise in the cervical spine, giving lectures in Mexico, Germany, and Sweden. Among these lectures was a 1959 presentation in Guadalajara to the Western Medical Assembly.⁵ In 1962, she gave a lecture to the 50th Congress of the German Orthopedic association in Munich.⁵ To have a better sense of the high level of respect that Dr. Jackson garnered, one needs to look no further than the caliber of individuals who she regularly corresponded with. They included luminaries such as Dr. Wiltse and Dr. Ponsenti; Dr. James Miles, who was the chairman orthopaedics at the University of Colorado; and Dr. O.L. Miller, who was the 10th president of the AAOS.⁵ Dr. Walter Thompson, who was the Chair of Orthopedics at Bellevue from 1950 to 1976, wrote to Dr. Jackson in 1963 to recommend Dr. August Juliano, a 1963 graduate of HJD for employment (Fig. 4).⁵ Dr. Jackson would go on to hire Dr. Juliano as staff in her clinic. Notably, in 1967, Dr. Jackson was also offered the chairmanship of the orthopaedics department at Woman's Medical College of Pennsylvania, now known as Drexel College.⁵

Figure 4.

1963 letter from Dr. Walter Thompson recommending Dr. Juliano.

Throughout her career, Dr. Jackson not only practiced at the highest level, but she was also a champion for women entering the field. In 1969, she received a letter from a high school student, Paula Bureau, asking her for guidance in pursuing a career in orthopaedics. In her reply, Dr. Jackson rightly points out that “orthopedics involves more skill and brains, than brawn.” She concludes, “If you are secure in your belief that you want to study medicine and then specialize in orthopedic surgery, please do not let anyone talk you out of it. It is a most gratifying field of medicine and a most interesting one.”⁵

Dr. Jacquelin Perry

Dr. Jacquelin Perry was born on May 31, 1918, in Denver, Colorado (Fig. 5). Her mother was a clothing shop clerk and her father a traveling salesman. By the age of 10, Dr. Perry had made up her mind to become a physician, saying that even at this young age, she would read every medical book in the Los Angeles library. Dr. Perry attended University of California Los Angeles for college, graduating with a degree in physical education in 1940. She obtained her physical therapy training at Walter Reed Army Hospital from 1940 to 1941 and went into practice with the US Army as a physical therapist for 5 years during World War II. With funding from the government issue bill, she enrolled in medical school at the University of California, San Francisco, and graduated in 1950. She remained at University of California San Francisco for residency, graduating in 1955, giving her the distinction of being the first female graduate of this program. After residency, Dr. Perry passed the boards, becoming the 10th woman board certified orthopaedic surgeon.¹³

Figure 5.

Dr. Jacquelin Perry.

In 1955, Rancho Los Amigos Rehabilitation Center recruited Dr. Perry to launch its physical therapy program. While at Rancho, Dr. Perry treated patients with severe spinal deformity and respiratory muscle paralysis secondary to polio. In collaboration with Dr. Vernon Nickel, they developed the halo for spine, head, and neck immobilization, which aided in upright positioning for patients with polio. This device allowed for precise control in all 3 planes, adjustable longitudinal traction, rigid stabilization, and minimal patient discomfort.¹⁴

Dr. Perry was a frequent collaborator with Dr. Nickel, and they regularly published on the surgical management of cervical instability and paralytic scoliosis. Their 1959 Journal of Bone and Joint Surgery paper describes their management of a polio patient with marked cervical instability. He underwent a C2-T3 fusion, with maintenance in halo traction for 3 months postoperatively. This patient did well and was able to return to work managing his printing service. With her groundbreaking work on paralytic scoliosis, Dr. Perry was one of the founding members of the scoliosis research society in 1966. Notably, she was the only female member.¹⁴

In the late 1960s, cerebral artery stenosis forced Dr. Perry to pursue a new direction in her professional career. In 1967, after the height of the polio epidemic in the United States, she established the Pathokinesiology Laboratory, currently known as Rancho Los Amigos National Rehabilitation Center, to study the biomechanics of walking and gait analysis. Dr. Perry also became a research consultant at the Kerlan-Jobe Orthopaedic Center and directed projects on kinesiologic electromyography and motion analysis for throwing, golf swing, and swimming.

This focus on gait analysis led to an eventual international reputation as a leading authority on walking biomechanics, a reputation that continues through her textbook, Gait Analysis: Normal and Pathological Function, which was first published in 1992, and revised in 2010.¹⁵ During her career, Dr. Jackson ultimately coauthored more than 400 scholarly articles and became a highly respected clinician and researcher.¹⁴

Dr. Perry was a mentor to many students, including Dr. Lisa Lattanza, who worked with her as a physical therapist and was encouraged by her to become an orthopaedic surgeon. Dr. Lattanza is now the chair of orthopaedic surgery at Yale University. In 2009, in an effort to inspire young women to become leaders in the fields of orthopaedic surgery and engineering, Dr. Lattanza and her colleague Jenni Buckley founded The Perry Initiative. In an interview, Dr. Lattanza recalled a moment where Dr. Perry coached a student on how to implant a femoral intramedullary nail. “The student got it, and Dr. Perry had the biggest smile on her face. It was a beautiful moment.”¹⁶ Through the Perry Initiative, more than 15,000 women in high school and medical school have been reached during pivotal times in the decision to pursue a given career path.¹⁶

Dr. Claudia Thomas

Dr. Claudia Thomas was born on February 28, 1950, to Charles and Daisy Thomas, and raised in Queens, New York with her older sister Catherine (Fig. 6). From a young age, she was inspired by her childhood doctor, Dr. Pearl Foster, to pursue medicine.¹⁷ Dr. Jackson excelled academically, attending the High School of Music and Art in New York City, and received National Merit and New York Regents scholarships. Dr. Thomas attended Vassar College in New York, starting as a math major but eventually graduating with honors in 1971 with a Black studies major. Notably, Dr. Thomas led 34 Black women students to take over the main building of Vassar College in 1969, demanding that the college administration accredit the Black Studies program.¹⁸ They were successful in their protest, and Dr. Thomas credits that experience with teaching her that crucial decisions do not come without risk, but that one must be steadfast in a commitment to their values. Dr. Thomas obtained her medical degree from Johns Hopkins University School of Medicine. There, she confided in one of her mentors, Dr. Andy Booker, that although she was interested in orthopaedics, she was concerned because she did not “see any women doing orthopedics.” He replied, “You're, right. There aren't many women in orthopedics. But there's no reason why you cant’ do this.”¹⁷

Figure 6.

Dr. Claudia Thomas.

Dr. Thomas notes in her autobiography that she had never personally met a female orthopaedic surgeon. When applying to residency programs, she had wanted to be close to New York because her father had recently been diagnosed with Parkinson disease. She even interviewed at HJD, but was concerned about the hospital's location. Dr. Thomas would ultimately completed her orthopaedic surgery residency at Yale University-New Haven Hospital in 1980, becoming the first woman to complete that residency and the first Black female orthopaedic surgeon in the United States. She then completed her fellowship in trauma at Shock Trauma at the University of Maryland.¹⁷

After completing fellowship, Dr. Thomas joined the faculty at the Johns Hopkins Department of Orthopaedics in 1981, as an assistant professor. Dr. Thomas was based at the Baltimore City hospitals. Here, she cherished teaching residents. She also independently started an orthopaedic clinic in West Baltimore where she would examine patients 1 evening a week. Dr. Thomas entertains broad research interests from the treatment of hip dysplasia to the biomechanics of casting for kyphotic deformities. A talented artist, Dr. Thomas',¹⁷ publications often featured her own original illustrations.

In 2004, Dr. Thomas left Johns Hopkins to join Tri-County Orthopaedic Center, a private practice in Leesburg, Florida, where she practices alongside 2 former students, Dr. Isaac Mitchell and Dr. J. Mandume Kerina. To this day, she continues to be an active mentor with organizations such as Nth Dimensions and the J. Robert Gladden Orthopaedic Society.¹⁸

Dr. Ericka Lawler

Dr. Ericka Lawler was born to Karen and Gary Andrusiak in Woodhaven, Michigan, in 1974 (Fig. 7). She has an older sister and grew up camping with her family in the great outdoors of Michigan. Dr. Lawler was successful from the outset. In high school, she was both the class president and valedictorian. She then matriculated to Yale where she would major in Molecular Biophysics and Biochemistry. She then attended medical school at the George Washington School of Medicine and Health Sciences in Washington, D.C. She graduated in the top percentile of her class, receiving an invitation into Alpha Omega Alpha in 2000. She also received the Robert J. Neviaser Award in Orthopaedic Surgery, the beginning of a lifetime of orthopaedic achievements.¹⁹

Figure 7.

Dr. Ericka Lawler.

Dr. Lawler credits her husband's aunt, Dr. Shawna Willey, who was a breast surgeon at George Washington, for inspiring her to pursue a surgical field. Dr. Lawler shadowed Dr. Willey during her second year of medical school and absolutely fell in love with surgery. She decided to pursue orthopaedics in her third year and notes that the then chairman, Dr. Neviaser, widely known as an expert in shoulder and elbow surgery, was highly supportive of her choice. Dr. Lawler developed a passion for hand and upper extremity surgery during her residency at HJD. One of her closest mentors, Dr. Posner, made her sign on the operating room drapes at the start of every case that she would be a hand surgeon before they began to operate. Dr. Lawler graduated in 2005, making her the 11th woman to complete this residency.²⁰

Dr. Lawler went on to Iowa City for her hand and upper extremity fellowship in 2005 and then joined the orthopaedic faculty at the University of Iowa Hospitals and Clinics in 2006. Over her 17-year career at Iowa, Dr. Lawler became well regarded in the world of academia and research. She has published numerous peer-reviewed articles in high-impact journals, book chapters, and textbooks. She has received multiple grants for her work in the field of hand surgery and resident education. She is repeatedly invited to give lectures at multiple national meetings, including the American Society for Surgery of the Hand, and the American Orthopaedic Association. Of all these accolades, Dr. Lawler noted in an interview that she was most proud to receive the 2021 Faculty Teacher of the Year Award, honoring her outstanding work and commitment to resident education.²⁰

Conclusion

There are numerous lessons to be learned from the careers of these 5 trailblazers. A significant common thread is the value of mentorship. Whether it was Dr. Steindler at Iowa, or Dr. Posner at HJD, the encouragement of these women by individuals already established in the field was critical to their success. A significant question is whether orthopaedic surgery will ever reach gender parity. One study by Acuna et al.²¹ found that at the current pace, it will take more than 200 years for orthopaedic surgery to achieve gender parity with the overall medical profession. Despite significant strides made in recent years, closing the gender gap in orthopaedic surgery still requires considerable effort. Pioneers such as Dr. Frauenthal, Dr. Jackson, Dr. Perry, Dr. Thomas, and Dr. Lawler played crucial roles in paving the way for women in the field through their groundbreaking work and advocacy. Their contributions helped challenge barriers and set a foundation for future generations, but ongoing initiatives are essential to address remaining disparities and promote greater inclusion. Continued support, mentorship, and policy changes are vital to ensure equal opportunities and representation for women in orthopaedics.