A report on excisions of the head of the femur for gunshot injury.

Date:
1869
Catalogue details

Licence: Public Domain Mark

Credit: A report on excisions of the head of the femur for gunshot injury. Source: Wellcome Collection.

    9/156 (page 7)
    Convinced of the importance of distinguishing the intermediate operations, and of adopting precise definitions, I have used for purposes of statistical comparison those cases only in which the notes permit the period of the operation to be determined or approxi- mated with reasonable accuracy. I describe as primary excisions those performed in the interval between the reception of the injury and the commencement of the inflammatory symptoms, a period rarely exceeding in duration twenty hours, although in a few excep- tional instances it is prolonged to thirty-six or forty-eight hours. I classify as intermediate excisions those performed during the persistence of the inflammatory stage, a more variable period, extending over one, two, or three months, according to the extent of the injury, the constitutional powers of the patient, and the conditions under which he is treated. I place in the category of secondary excisions those performed after inflammation has sub- sided, the traumatic phenomena have abated, and the local lesions have become analogous to those resulting from chronic diseases. Although excision of the upper extremity of the femur for gunshot injury was first practised only forty years ago, the bibliography of the subject is inaccessible to many of the medical officers, and it is thought best to review concisely what has been written upon it. The operations performed during the war will then be described. Some infor- mation additional to that contained in Circular No. 7, S. Gr. 0., 1867, in regard to ampu- tation at the hip-joint will be recorded. Numerous abstracts of cases of gunshot fractures involving the hip-joint, and treated without operative interference, will bo given; and, in the concluding observations, the comparative value of excision, amputation, and tempo- rization, will be discussed.