Some points of special interest in the treatment of compound fractures : including a report of five hundred and sixteen cases / by Frederic S. Dennis.

Dennis, Frederic S. (Frederic Shepard), 1850-1934.

Date:: [1886]

Credit: Some points of special interest in the treatment of compound fractures : including a report of five hundred and sixteen cases / by Frederic S. Dennis. 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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$Another important point in reference to an ampu- tation in compound fracture is the proper line of treatment to be pursued up to the time of the opera- tion. It often happens that a patient is suffering too profoundly from shock to make it expedient to ope- rate. In these cases I have found great benefit to be derived from deferring the amputation, even several days, until the condition was such as to justify the operation. Formerly this could not be done without subjecting the patient to a greater risk from septic infection than would be incurred in an amputation during shock. If the wound is made at once aseptic and compresses be placed over the fracture to control the hemorrhage, and these com- presses do not extend any higher than the wound itself, the amputation can be deferred. It is im- portant that these compresses be applied only over the wound, and that no form of compress or bandage be applied to the limb above the injured part, for if this is done there is danger of dry gangrene in the flaps above the wound. In one case this accident occurred from a neglect of this rule, though the com- pression was made before the patient was brought to the hospital, and in no way could any neglect be attached to the hospital authorities. The complete history of the five hundred and six- teen cases of compound fractures I have here before me on this table for inspection and examination. Each case is given in full with the name of the pa- tient, the date of his or her admittance to the hos- pital, the age, a description of the injury, the treat- ment in full, and the result. I have also here in this large roll of papers most of the temperature charts. In these glass bottles are the pieces of skull which have been preserved, and are labelled to cor- respond to the cases given in the table. Upon this$