Treatment of compound fractures of the thigh from gunshot wounds, as observed in some of the American military hospitals / by Redfern Davies.

  • Davies, John Redfern, 1835?-1867.
Date:
1863
Catalogue details

Licence: Public Domain Mark

Credit: Treatment of compound fractures of the thigh from gunshot wounds, as observed in some of the American military hospitals / by Redfern Davies. 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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    foreign bodies and disorganized structures—many portions of which, although not admitting of removal at first, will be ultimately cast out—has to reunite by the formation of new tissues (bony and soft), attended by a prolonged and weak- ening process of suppuration and confinement in bed. Hence, when the patient has recovered, the condition of his limb will be far different from what it probably would have been had the traumatic injury been effected by one of the usual causes in civil life. Two methods for the treatment of compound fractures were adopted in the General Hospital, Frederick City, Maryland, after the battles of South Mountain and Antietam (United States), and where for four months I had the opportunity of being professionally engaged. These methods were— 1. Dr. Gordon Buck’s “Extension Apparatus.” 2. Dr. Nathan Smith’s “ Anterior Splint.” The theory upon which fracture of a long bone is treated by the extension plan may be thus briefly summarized. The sharp and jagged ends of the fractured bones, by hurting and irritating the adjacent parts, afford to the muscles &c. surrounding them such a stimulus as induces them to contract and to spasmodi- cally twitch; the extremities of the bone ride, and thus general deformity is induced, and a permanent shortening of the limb. But if these extremities be adapted to each other perfectly, and an amount of extension be applied equivalent to the natural contractility of the muscles, the surrounding tissues, being un- irritated, would serve as natural splints, and the continuity of the bone will be complete. This may be demonstrated by the accompanying model, con- sisting of a thick bar of wood, some eighteen inches long, at- tached at each end to a board; closely surrounding the cylinder of wood (which is obliquely cut through) are cords. By exert- ing a sufficient amount of extension, and, of course, an equiva- lent of counter-extension, in a straight line with the attach- ments of the strings, the surfaces of the divided bone will be brought into complete apposition with one another. The application of Dr. Gordon Buck’s extension apparatus can be readily understood from the diagram (Fig. 1). A roller