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Fred Payne Sage, M.D. 1923-1999

C., S. T.

The Journal of Bone & Joint Surgery: October 2000 - Volume 82 - Issue 10 - p 1522
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Dr. Fred Payne Sage died on March 20, 1999.

He was born in Drew, Mississippi, on December 13, 1923. After graduating from high school, he enrolled in Mississippi State College in Starkville, but his undergraduate studies were interrupted by World War II. In 1943, at the age of twenty, he left college to join the United States Army Air Corps. For two years, he piloted a B-24, towing gliders and dropping Allied troops behind enemy lines. For his bravery and skill, he was awarded an Air Medal with six Oak Leaf Clusters and an ETO Campaign medal with nine Battle Stars. In 1945, he returned to Mississippi State, where he served as student-body president. After completing his college education, he moved to Memphis, Tennessee, where he obtained his medical degree from the University of Tennessee College of Medicine. He then returned to his hometown of Drew and hung out his shingle as a general practitioner. In 1952, he decided to further his education in orthopaedic surgery; four years later, he graduated from the Campbell Foundation-University of Tennessee Orthopaedic Surgery residency program and joined the staff of the Campbell Clinic in Memphis.

Encouraged by the success of intramedullary nail fixation of femoral fractures, Dr. Sage turned his attention to the use of intramedullary nails for forearm fractures. In a classic article (Smith, H., and Sage, F. P.: Medullary fixation of forearm fractures. J. Bone and Joint Surg., 39-A: 91-98, Jan. 1957), Dr. Sage and Dr. Hugh Smith described the disappointing results with this technique and called for modifications in nail design and technique, especially for use in the radius. Two years later, he provided a detailed description of the anatomy of the radius, derived from studies of 100 cadaveric radii (Sage, F. P.: Medullary fixation of fractures of the forearm. A study of the medullary canal of the radius and a report of fifty fractures of the radius treated with a prebent triangular nail. J. Bone and Joint Surg., 41-A: 1489-1516, Dec. 1959). On the basis of this information, he designed a prebent triangular nail for fixation of radial fractures and a straight triangular nail for fixation of ulnar fractures. He reported union in almost 90 percent of the first fifty radial and ulnar fractures fixed with these nails. This landmark article describing the Sage nail and the basis for its design was among the first to emphasize the importance of maintaining the radial bow, and it presented the forerunner to modern radial and ulnar nails. Another of Dr. Sage's classic publications, co-authored with Dr. Harold B. Boyd, was a study of congenital pseudarthrosis of the tibia (Boyd, H. B., and Sage, F. P.: Congenital pseudarthrosis of the tibia. J. Bone and Joint Surg., 40-A: 1245-1270, Dec. 1958). Dr. Sage also was a consistent contributor to Campbell's Operative Orthopaedics, writing chapters for five editions of the text.

Over time, Dr. Sage's practice became more focused on children, especially those with poliomyelitis, cerebral palsy, and muscular dystrophy. He served as chief of staff at the Crippled Children's Hospital for eighteen years, and he was active in organizations involved in the treatment of children with neuromuscular diseases, such as the American Academy for Cerebral Palsy, the American Academy for Cerebral Palsy and Developmental Medicine, the Tennessee Council for Handicapped Children, and the United Cerebral Palsy Association. After his presidency in 1981, the American Academy for Cerebral Palsy and Developmental Medicine established the Fred P. Sage Award, which is given for the best audiovisual presentation at each annual meeting. However, his participation was not limited to such organizations. He also was a member of the American Orthopaedic Association, president of the Tennessee Orthopaedic Association, and president of the Russell A. Hibbs Society.

Despite the high regard in which he was held by his colleagues and despite his national and international reputation, most of Dr. Sage's patients knew little about his professional and academic accomplishments. It was his down-to-earth approach, his practical advice, and his obvious commitment to the welfare of his patients that endeared him to them and their families. His unswerving commitment to always do the best for his patients earned him the sobriquet of "the conscience of the clinic" from his partners.

As clinical professor in the Department of Orthopaedic Surgery at the University of Tennessee-Campbell Clinic, he was a favorite instructor of medical students and residents because he encouraged their questions and opinions and was never too busy to discuss a problem or to explain a procedure. With a few succinct, often humorous, comments he could distill the important points of diagnosis or treatment of a particular condition in a way that was sure to be remembered.

He decreased his surgical and clinical activities in 1993 in order to spend more time with his family and to pursue his favorite pastime, fishing. He was a senior warden at Grace-St. Luke's Episcopal Church and served for many years on the board of trustees, including one year as president.

When his illness was discovered in the summer of 1998, he faced that adversary as he had all others, with courage and grace. All of us who knew him will miss his wise advice and his unfailing good humor. He was truly a member of that "greatest generation," serving his country, his profession, his church, and his community with loyalty and humility.

Dr. Sage is survived by his wife, Anita; a son, Payne; three daughters, Alicia, Christina, and Katherine; and two grandchildren.

S. T. C.

Copyright © 2000 by The Journal of Bone and Joint Surgery, Incorporated