Fractured femurs : their treatment by calliper extension / by Maurice G. Pearson ... and J. Drummond.

  • Pearson, Maurice G. (Maurice Grey)
Date:
1919
Catalogue details

Licence: Public Domain Mark

Credit: Fractured femurs : their treatment by calliper extension / by Maurice G. Pearson ... and J. Drummond. Source: Wellcome Collection.

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    and yet we find evidence of a search for something better, for something to produce direct traction on the bone, in the evolution and use of the Steinman Pin, transfixing the femur. This pin had one disadvantage, among others, common to it and to the practice of plating. It was restricted in its use, and as a rule was the perquisite of the highly skilled surgeon only. For the majority of general practitioners the long Liston splint, with all its attendant worries and dissatisfactions, was the usual implement. With the advent of the war we were, so to speak, “‘ snowed under.’ Worked out from the statistical point of view, the incidence of fractured femur was one in sixty of all battle wounds. In the last nine months of the war there were 5,000 new femur cases in the British Army in France. Think of the problems! Casualties mounting into thousands and tens of thousands daily, the whole question of transport under most trying and difficult circumstances, and the appalling sepsis which played such havoc! And yet -these problems had to be faced con- currently in many parts of the world. Most of us were faced for the first time with all the horrors of septic wounds with attendant gas gangrene, tetanus, etc.; and to meet the situation we had only our pre-war knowledge with all its deficiencies. We found that many cases arrived at the casualty clearing stations in a moribund state so that no surgical skill could save them, and that many of those operated on according to our pre-war methods died of gas infection early or of prolonged sepsis or secondary hemorrhage during the subsequent treatment. The number of surgeons was limited and could only deal adequately with a tithe of the work, and the problem so worked on the minds of the operators that the pendulum swung in the direction of early amputation for all cases with a view to saving lives. Fortunately, this policy was never adopted in its entirety. It was realised that any improvement must include the whole system of transport and treatment. It had to begin where the patient was picked up and end at the gymnasium in England. A man with a smashed arm can walk in and get treatment ; a man with a broken tibia can hobble in between two comrades, but the man with a femur fractured by shell or other missile is helpless indeed ; he can neither help himself nor can he, without special splints, bear to let others help him. For a leg is a heavy thing, one-fifth of the body-weight, and deprived of its own motive power is a most difficult thing to manipu- late. So it comes about that these cases stay out longer after a battle than the rest ; they lie out in shell holes until stretcher parties can get to them, and many of them die out there from immediate hemorrhage, from shock or from exposure and exhaustion. )