Clinical notes upon two years' surgical work in the Liverpool Royal Infirmary / by W. Mitchell Banks.
- William Mitchell Banks
- Date:
- 1884
Licence: Public Domain Mark
Credit: Clinical notes upon two years' surgical work in the Liverpool Royal Infirmary / by W. Mitchell Banks. 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.
48/207 page 44
![and in liospital work it is the usual thing to send a man out at the end of six or eight weeks as cured, when his cure is really only commencing. As a result of prolonged immo- bility of the joint, and non-use of the quadriceps, I have seen two cases of undoubted bony union within the last three years. One of these was one of the five cases under con- sideration. The patient was a labourer aged 35. He fractured liis patella in tlie beginning of June, 1881. After his discharge he wore a Thomas's calliper splint, working on it as a quarry- man, until the end of January, 1882. Wlien seen at that time there was no appreciable liiatus between the fragments, which were clearly united by bone. Some years ago I treated in private a young gentleman who broke first one patella and then, twelve months afterwards, the other. He was a noted horseman and waltzer. By keeping the knees motionless for long periods he recovered with about a quarter of an inch of interval between the fragments, and rode and danced as well as ever, never feeling, as he often assured me, that anything liad ever happened to him. Surely what can be done with one ]3atient can be done with another. T cannot resist making these remarks in \dew of the great interest which has been excited by Sir Joseph Lister's paper, recently delivered before the Medical Society of London, in which lie narrated a series of admirable cases where, in conse- quence of bad union and uselessness of the limb, he had opened the knee-joint, removed the imperfect band of union, freshened the edges of the patella, and united them by suture, leaving a thor- oughly useful limb. One cannot but regard this as a triumph of surgical art and of the antiseptic system, when it is remembered that, not a quarter of a century ago, the mere fact of a joint being opened was considered as bringing amputation witliin measurable distance. But one could not but be astounded at the opinion ad- vanced by certain gentlemen that this was to be the practice of the future for all fractures of the patella. I can only say that, if ever I am unfortunate enough to break my patella, nothing in the world will induce me to have my knee-joint laid open so long as I can get hold of a Thomas's laiee-splint and a yard of sticking plaster. Such a proposition savours of surgery run mad. At this rate, why not at once cut down upon every simple fracture of the femur, and wire it at once so as to prevent all chance of bad union ?](https://iiif.wellcomecollection.org/image/b22294806_0048.jp2/full/800%2C/0/default.jpg)
