Compound and comminuted gun-shot fractures of the thigh and means for their transportations, etc / John Swinburne.

  • Swinburne, John, 1820-1889.
Date:
1864
Catalogue details

Licence: Public Domain Mark

Credit: Compound and comminuted gun-shot fractures of the thigh and means for their transportations, etc / John Swinburne. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

    4/18
    J// was invited to participate in the discussion of the important sub- ject, and in so doing, laid before the society, in cursory manner, the plan herein proposed for carrying into immediate effect the system of extension whereby the stretcher becomes the splint, in accordance with the diagram hereinafter presented. A still further inducement for me to present this plan of treat- ment is that my efforts of last season on this subject met with favor from scientific medical men.* I now desire to present some of the data as extracted from the statements of Doctors Hamilton and Krackowiser in the American Medical Times, of December 2nd and 19th, 1863. Prof. Frank H. Hamilton reports the results of 58 successful cases of compound and comminuted fractures of the thigh ; in 13 of which no mention is made of lateral distortion ; 15 are mentioned as straight ; in 27, there is more or less lateral distortion, and they are characterized as crooked, quite crooked, bent back at fracture, very crooked, much bent out, pretty straight, &c. The longitudinal distortion varied from \\ to 4^ inches. Now here is a point worthy of note, viz : that only 15 are men- tioned as straight, and still the average of those mentioned are nearly two inches short, or longitudinally distorted. Now, I sim- ply ask of you, gentlemen, ought we to have this large proportion of the cases with such decided lateral distortion? I concede we cannot prevent some shortening, but we ought certainly to devise some means by which this almost constant record of crooked, very crooked, not straight, &c, being made, else nature's efforts to save those limbs without the application of the sur- geon's knife, will avail little. The remarks of Dr. Krackowiser consisted principally of sta- tistics; those from the Franco-Sardinian army are in point, and show most fully the advantage of a conservative in opposition to a heroic plan. In 165 cases of gun shot fractures of the thigh, conservative treatment gives 50 per cent, of deaths, while 431 * A kind]}' and encouraging notice appeared in the American Medical Journal of Not. 4, 1863, in which it says : The section on resections of joints and conservative surgery is an able defence of exsections as opposed to amputations, and a judicious discrimination of the rules that should be observed in the selection of cases and performing the operation. We most heartily concur in the opinions put forward, and can only hope that they will be widely circulated in the army, where they must be productive of good results. The simple truth seems to be, that in wounds of the upper extremities, amputation- should be rarely performed. Nothing but life can compensate the loss of the arm. Without the overpowering weight of statistics which Dr. Swinburne brings to his aid, wo should be prepared to accept his arguments as conclusive.