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]
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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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    bones united without difficulty or much deformity. The same author fur- nishes four other cases, observed by different gentlemen in our country, in all of which fragility existed in remarkable degrees. In the cabinet of M. Esquirol (Dictionnaire de Medecine, xiii, p. 407, 2d ed.) the skeleton of a rachitic woman is to be seen, in which exists traces of upwards of two hundred fractures, all more or less firmly consolidated. Scurvy, fevers of a low type, or any other disease inducing great debility, or actual prostration, may also prevent the reparative process after fractures from taking place as in ordinary cases. The cause of want of union is sometimes to be found in the general im- poverished and bad state of the system, produced by improper abstinence from food, or the withdrawal of an habitual stimulus. The following cases illustrative of this cause are given by Sir B. Brodie. (Lond. Med. Gaz. xiii, p. 56, 1833.) A gentleman was growing fat, and not liking to do so, he placed himself on a very slim diet, though accustomed to good living previously. After six months of starvation, he broke his arm, and the bone would not unite. I saw him many months afterwards, and there was scarcely any union, even by soft substance. Another patient about whom I was consulted, a lady, was growing fat, and thought she would also prevent it, by pursuing a similar system of diet. Some months afterwards she broke her arm and union did not take place. A striking instance of the same cause in pre- venting union is related by M. Noel, {Prix de VAcad. de Chirurg. v, p. 45, 8vo, Paris, 1819,) of a girl, setat. 18, of good constitution, in whom no attempt at union had taken place after a fracture of the leg at its middle part, at the end of eight months. The patient was greatly reduced from want of nourishment, she having subsisted for some time upon six ounces of bread, with water, per diem. Supposing want of union to depend upon insuffi- cient nourishment, the patient was placed upon a good diet, and about six weeks afterwards union of the fractured bones was perfect. Beckett relates the case of a patient, setat. 23, with fractured os humeri, in whom the loss of a large quantity of blood, and the denying him a competent sustenance prevented re-union till the end of nine months. {Chirurgical Observations, p. 16.) A case in which want of union may perhaps be attributed to slim diet together with repeated bleedings, is given by Dr. Hewson. {North American Journ. for Jan. 1828, p. 11.) This patient was admitted into the Pennsylvania Hospital in March 1827, on account of an imperfect union of the tibia near its centre. In August 1818, both bones of the leg were broken. He was subjected to a severe antiphlogistic treatment and lost several pounds of blood. It was not until six weeks after the accident that he was allowed any portion of animal food. Other striking illustrations of the effect of an altered mode of living, may be found in the Medico-Chirurgi- cal Review for January 1836. The influence of a low diet, long continued, upon the parts interested in No. V.—January, 1842. 3