Use of needles in fractures and epiphyseal separations / by C.R.L. Putnam.

  • Putnam, C.R.L.
Date:
1914
Catalogue details

Licence: In copyright

Credit: Use of needles in fractures and epiphyseal separations / by C.R.L. Putnam. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    USE OF NEEDLES IN FRACTURES AND EPIPHYSEAL SEPARATIONS * BY C. R. L. PUTNAM, M.D. Adjunct Professor of Surgery in the New York Post-Graduate Medical School and Hospital. The difficulty of holding small portions of bone in place is familiar to us all. I have used chromic gut, fine wire, and finish- ing or cabinet nails. The latter are very useful but have the dis- advantage of being of a fixed length. The other methods are useful in suitable cases. In two cases I have used needles with advantage. In November 1911, I operated on the first case shown this evening. It had been a dislocation backward of radius and ulna at the elbow with intracapsular fracture of the radial neck. (Fig. 1. J. C.- Age 16, New York Hospital, Private P.D. Dec., 1911.) At operation, it was found that the small fragment had turned over so that the articular surface was in contact with the broken end of the shaft. The wound was deep owing to the swelling which the extreme trauma had produced. With difficulty the head was turned over in its capsule but it turned back again. I then thought of spearing it with a Hagedorn needle and so holding it. I did so, using two straight needles at slightly dif- ferent angles. With these I gradually brought the bone into position, and then pushed one of the needles diagonally through the cartilage and soft bone and so on until it touched the inside of the cortex of the shaft. I then broke the needle off between two hemostatic forceps, and pushed the little part still pro- jecting until it went below the surface. The other needle was moved to a suitable place and used in the same way.f The elbow had been brought into acute flexion before the first needle was pushed home, and was kept so during the closing and dressing of the wound. * Read in the Surgical Section of the New York Academy of Medicine, Friday evening, February 7, 1913. t Reported fully in The Post-Graduate April, 1912.