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James Russell Neff, MD 1940-2005

G., K.

Journal of Bone & Joint Surgery - American Volume: January 2006 - Volume 88 - Issue 1 - p 244–245

James Russell Neff, an internationally recognized faculty member and orthopaedic surgeon for the University of Nebraska Medical Center in Omaha, Nebraska, died on July 12, 2005, at the age of sixty-five after an extended battle with cancer.

James (Jim) Neff was born in Beloit, Kansas, in 1940, but spent his childhood years in Topeka, Kansas, where he attended public school until his graduation from high school in 1958. He received his undergraduate degree from Kansas State University in 1962, and went on to receive his medical degree from the University of Kansas College of Medicine in 1966. Jim spent the years of 1966 through 1968 at the University of Michigan at Ann Arbor, completing an internship in surgery, followed by a residency in general surgery.

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Jim's training was interrupted by the call of duty, and he spent a year aboard the submarine USS George Marshall as a lieutenant commander. Following a year at sea, he was stationed at the United States Naval Submarine Base in Groton, Connecticut, as an orthopaedic surgeon.

His duty honored, Jim resumed his training in Michigan, completing his orthopaedic residency in 1973, followed by a fellowship in musculoskeletal pathology at the University of Florida. While there, he was exposed to novel limb-sparing procedures for patients afflicted with osseous and soft-tissue malignant tumors.

Until the early 1970s, immediate amputation for malignant tumors of bone and soft tissues had been the standard of care for unfortunate patients with a five-year survival rate of less than 20%. With the almost simultaneous development of isotope bone-scanning, sophisticated angiography, and chemotherapy, studies that led to the delineation of low-risk limb-preserving procedures were cautiously embarked upon. Jim played an important and integral part in all of these studies. He was a gifted orthopaedic surgeon on arrival, and by the completion of his fellowship he was a consummate tumor surgeon with extraordinary skills in both the intricacies of tumor removal and the reconstructive techniques required to achieve a successful functional result. In due course, he would make his mark as an innovative surgeon on the regional, national, and international scene.

Jim left the University of Florida a much richer institution for his contributions and returned to the University of Kansas in 1975, where he pioneered the development of an outstanding program of patient care, education, and research. He was later appointed professor of surgery at the University of Kansas, and, in 1991, he joined the University of Nebraska Medical Center as professor and chairman of the Department of Orthopaedic Surgery and Rehabilitation.

A specialist in treating cancer of the bone and soft tissues, Jim was known around the world for performing innovative procedures to help people lead a more normal life following cancer. Two such procedures were the rotationplasty and the hemipelvectomy.

The rotationplasty, a procedure used for patients with osteosarcoma, allowed Jim to avoid amputation of the entire leg, providing those patients with much more mobility and flexibility. Jim received training for this procedure in Vienna and was one of only a handful of surgeons who performed this complex surgery in the United States.

Jim was an innovator who was always thinking, always tinkering with new ideas. He created a workshop in his basement to test out his ideas and invented a device used for arthrodesis of the knee in patients in whom knee surgery had failed. The device, created nearly twenty-five years ago, is known as the “Neff Nail” and continues to be frequently used by orthopaedic surgeons today.

Jim also developed a custom hemipelvis and modular implant system to be used during a hemipelvectomy that could be adjusted in the operating room to fit the patient's precise needs.

Jim's presence at the University of Nebraska Medical Center was evident far beyond the realm of orthopaedics, impacting the departments of Radiology, Oncology, Radiation Oncology, Pediatrics, Pathology, Genetics, and Physical Therapy. The orthopaedic residency program was revolutionized by the vast amount of knowledge that Jim contributed in all of these areas, expanding the education and training of the residents far beyond orthopaedics.

Over the years in Kansas and Nebraska, Jim's group characterized more than 5000 bone and soft-tissue tumors genetically. He elevated the standard of care for these life-destroying diseases, and his group literally rewrote the textbooks, especially in regard to the pathogenetic mechanisms central to these conditions. These works have had a major impact on patient care.

Jim's resume was laden with accomplishments and honors. He published over 150 articles in scientific journals and authored fourteen books or book chapters. He gave 149 presentations at scientific meetings, including those held internationally in Sweden, Italy, France, Japan, Singapore, Germany, Australia, Greece, and Scotland.

Over the years, Jim was active in many national and international leadership roles, was a member of countless organizations, and served on dozens of boards and committees. For nearly two decades he served as an examiner for the American Board of Orthopaedic Surgery, and for twenty-five years he was an associate editor for Clinical Orthopaedics and Related Research.

Jim served on the osteosarcoma committee of the National Children's Oncology Group, as president of the Musculoskeletal Tumor Society, on the executive committee of the American Orthopaedic Association, and on the musculoskeletal tumors and diseases committee of the American Academy of Orthopaedic Surgeons. He represented the University of Nebraska as an academic member of the Musculoskeletal Transplant Foundation, the world's largest bone bank and a major source of research funding for aspiring young orthopaedic surgeons, and rose to become the president of its Medical Board of Trustees and a member of the Board of Directors. In addition, Jim played an enabling role in the establishment of the North American Musculoskeletal Tumor Society and the International Society of Limb Salvage, which is known as a group of premier thinkers and visionaries. Just recently, he was selected to receive the University of Kansas Distinguished Medical Alumni Award.

Jim was described by friends and colleagues as “a giant in his field,” “a world-class pioneering surgeon,” “a true leader,” and “an innovator.” Both colleagues and patients, including children, often praised his compassionate demeanor. A caring smile, charm, wit, knowledge, and quiet confidence were the qualities felt by patients, and as he spoke with and examined a patient, one would begin to see the tension in the faces of the patient and his or her family lessen. A child diagnosed with osteosarcoma more than a decade ago wrote that “he makes cancer seem not so bad after all.” Other patients described him as “caring and courageous,” “calm and compassionate,” and a “gifted healer.” Hundreds of patients thanked Jim's family for allowing him to share his time and devotion with so many who desperately needed his healing hands.

Jim kept his own twelve-year battle with cancer a secret. He wanted to be defined by what he did, not by his hardships. For example, Jim would rise at 4 AM to undergo radiation treatment and then prepare for his surgeries later that morning. He was most concerned about the care of his patients and would often place their health needs before his own. Jim was blessed with a balanced and just moral compass. This guided him and served as the sextant for generations of acolytes whom he trained.

Since his passing, many people have shared memories of their personal experiences with Jim. Patients, operating-room personnel, nurses, support staff, and colleagues have offered their feelings of respect, affection, and reverence for Jim, both personally and professionally. The medical community has lost an intellect, his patients have sustained the departure of a trusted friend and healer, his students are bereft of their mentor, colleagues will miss his counsel, and friends are left with memories.

Jim is survived by his wife, Julia Bridge, MD, a professor in the Department of Pathology and Microbiology at the University of Nebraska Medical Center; daughters, Rachael and Kirsten; son, Gregory; and stepson, Stuart.

At a memorial service on August 6, 2005, at the Dundee Presbyterian Church in Omaha, Nebraska, many people gathered to pay their respects to a surgeon, a colleague, a husband, a father, and a friend. In a heartfelt statement written by Jim prior to his death, he stated, “I have so many people to thank for my rich and eventful life-patients, colleagues, friends, and family... I bid you farewell as I assume the role in my next challenge. I implore you to make the most of life.”

On October 5, 2005, Dr. James Russell Neff was buried at Arlington National Cemetery in Arlington, Virginia, with full military honors.

Copyright 2006 by The Journal of Bone and Joint Surgery, Incorporated