On the fractures of bones occurring in gun-shot injuries / by Louis Stromeyer.

  • Louis Stromeyer
Date:
1860
Catalogue details

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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    Injuries of bones form not only one of the meet frequent, but also one of the most dangerous complications of gun-shot wounds ; their diagnosis and suitable treatment is of the greatest importance, as in numerous injuries of this kind the life of the patient, or at least the preservation of the limb is endan- gered. For the diagnosis of gun-shot wounds affecting the long bones, the injuries of the shafts (Diaphyses) must be considered sepai'ately from those of the joint-ends (Epiphyses), as from the different structure of these parts, they are not affected in the same way by projectiles—and again with the latter the joints are implicated. If heavy projectiles strike a limb, the shattering of the bones and crushing of the soft parts is in general so great, that immediate amputation appears to be the only means to be employed. The circumstances are different, however, if the injuries are due to bullets or similar small shot. I. On tee injuries of Shapts of Bon.ss by Buxlets. 1. On the different kinds of these injuries. It occurs in rare cases that a bullet strikes the shaft of a long bone and pierces it without destroying the continuity. This happens especially in those places where the spongy substance composes the far greater portion of the volume. In the upper third of the tibia three such cases occurred; two of the patients were cured comparatively quick, the third proved fatal after pro- tracted suffering, as the greater part of the tibia became necrosed. In 1848 I treated a patient in whom the left ulna was pierced close beneath the coro- noid process, and yet not broken. The Danes employed at that time car- tridges containing two small bullets and a piece of lead, with one of which bullets the injury was probably caused, as the two little fingers could only with difficulty be introduced so far, that their tips met in the centre. This case also healed perfectly and without anchylosis of the elbow joint. Henuen relates two cases, in which the femur was pierced in the middle of its shaft by a bullet without fracture: he could introduce a finger through the aperture, which had sharp, clean-cut edges. [In St. George's Hospital Museum is a humerus in which a bullet has lodged in the wide portion of the shaft, just above its articular surface; a little more force would have completed its pas- sage without fracture.]