On the fractures of bones occurring in gun-shot injuries / by Louis Stromeyer.
- Louis Stromeyer
- Date:
- 1860
Licence: Public Domain Mark
Credit: On the fractures of bones occurring in gun-shot injuries / by Louis Stromeyer. Source: Wellcome Collection.
Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.
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![sliould be directly attributed to the operation, as the patient went on perfectly well, as long as he was treated by our surgeons, and the wound was nearly healed, when he came under the care of Danish medical men. They later performed amputation of the arm, and the patient did not survive the ope- ration. I have not been able to learn, >yhat cause rendered amputation necessary. It is to be hoped, that after these results of resection of the elbow-joint after gun-shot wounds, the practice may become more and more common among army-surgeons, and that in future the arms may be preserved to many •warriors, in whom formerly amputation was at once performed. I give here briefly the history of those cases in which resection of the elbow- joint was performed. [Of these cases nine are translated.] Ca53 II—Comminution of the internal Condyle of the Humerus. Eesec- tion on the 19th day. Healing.—The Danish Major von W. , aged 56, of slight stature and suffering from chronic cough and asthma,—was shot in the left elbow at Oeversee, the 24th of April, 1848. The joint was opened on its outer side, and the external condyle comminuted. On the 10th of May, phlegmonous inflammation had spread to the shoulder, so that the surgeon in attendance was thinking of exarticulation of that joint. The Surgeon-in-Chief, Dr. Langenbeck, proposed resection, and performed thai operation on the 13th of May. He made one longitudinal incision, dissected back the ulnar nerve and removed, by the saw, the ends of all the three bones. The great swelling of the soft parts added much to the difficulty. After the patient had recovered from the effects of the chloroform, it was evident, that both sensibility, in the com'se of the ulnar, and power of motion of the hand and fingers was still possessed by him. Complete cicatrization took place about the end of August, and the arm already was capable of some extent of jnobility,—the patient now retm'ned home. Casii III.—Communitioa of the Joint-end of the Ulna. ■ Eesection the next day. Healing.—The Hanoverian private, K , was shot through the right elbow by a musket-ball, on the 6th of April, 1849, in the skirmish at XJlderup. The upper end of the ulna was much comminuted. The Surgeon- in-Chlef, Stromeyer, resected the joint on the following day. He em- ployed the H -formed incisions through the skin, on purpose to shew to the numerous young army-surgeons present, the easiest method of performing the operation. One longitudinal incision was over the outer—the other over the inner—condyle, the transverse one over the upper part of the olecranon. The ulnar nerve was now dissected back, and drawn aside by a blunt hook. After division of the triceps tendon, the joint was opened, the fiee splinters of the ulna removed, and the sharp points of the same, and the head of the radius sawn off. In a similar manner, the greatei portion of the cartilaginous surface of the humerus was taken away by tk.a saw. The skin was united by some interrupted sutures. Eecovery proceeded slowly, but without any particularly bad symptoms. I have not been able to learn whether complete anchylosis followed, or whether mobility remained in the elbow; at any rate the patient was able to use his hand well, when he left the hospital.](https://iiif.wellcomecollection.org/image/b21079432_0104.jp2/full/800%2C/0/default.jpg)
