On the occurrence of non-union after fractures : its causes and treatment / by George W. Norris.

  • Norris, George W. (George Washington), 1808-1875.
Date:
[1842]
Catalogue details

Licence: Public Domain Mark

Credit: On the occurrence of non-union after fractures : its causes and treatment / by George W. Norris. 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.)

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    union of broken bones. M. Berard, after numerous researches, sums up his opinion in the following language (Op. citat. p. 11): Despite the numerous occasions in which surgeons have witnessed the co-existence of syphilis with fractures, it has been very rarely proved that the syphilitic virus exercises any influence upon the formation of callus. Pregnancy and suckling, are stated in most of our treatises also at times to retard, or prevent, firm union from taking place after fracture. As a general rule it may be said that these states do not interfere with the occurrence of bony union. Of fifty-six cases examined by Mr. Amesbury, (On Fractures, 2d ed. p. 197, 1829,) but two happened during the process of gestation, and these he is not disposed to attribute to the peculiar disturbance of the system which is observed in pregnancy. Callisen (Syst. Chir. Hooliern. Pars 1, § 1313) reports that he has in several cases seen fractures in pregnant women get perfectly well, though the time required for firm union, was a little longer than that ordinarily demanded. Of four cases of fracture which came under the care of Mr. Latta, in the 5th, 6th and 7th months of pregnancy, (two of the thigh, one of the tibia, and one of the fore- arm,) all were cured in the ordinary time. (System of Surgery, iii, p. 363.) Mr. Liston (Elements of Surgery, 2d ed. 1839, p. 686) has often seen fractures in women carrying children unite as speedily and firmly as if the patients had not been in that state, and otherwise in robust health; but observes, profuse uterine or vaginal discharges, or determination to particular parts, or organs, will certainly retard union. Several of my friends who have observed fractures in this class of patients, have assured me that the injuries have been repaired in the usual period. That however these states do occa- sionally retard the reparation of fractured bones, there can be no doubt. Werner (Richter, quoted from Cooper's Diet. p. 546, ed. 1838) has pub- lished the case of a fractured radius in a pregnant woman, where the cure was apparently retarded for a long time by this circumstance, and though the union took place previously to delivery, the callus was not very firm till after that event. Fabricius Hildanus, (Opera. 1681, Cent. 5, Obs. 87, and Cent. 6, Obs. 68,) Wilson, (On the Human Skeleton, p. 214,) Ferdinand Hertodius, (Ephem. des Cur. de la Nat. Ire annee obs. 25, quoted from Bib. Choisie de Med. xxiv, p. 595,) have all witnessed cases in which this retardation had taken place. A remarkable and well detailed instance of this kind is recorded by Mr. Alanson, (Med. Obs. and Inquiries, iv, 1772.) It is that of a delicate female, who in the second month of pregnancy met with an oblique fracture of the tibia, which in spite of a well directed treatment had not united when she was delivered at full time (seven months after the accident), but which as she recovered strength after her confinement be^an to unite, and nine weeks after this period was able to walk about her room with a firm limb. What proves beyond a doubt in this case that the want of union was owing entirely to her pregnant state was, that three months before impregnation she had been very happily and speedily cured of a fractured femur.