Ununited fracture successfully treated : with remarks on the operation / By Henry J. Bigelow ... With abstracts from Dr. Bigelow's clinical lectures on the subject, and cases. (Reported by Richard H. Derby.).

  • Bigelow, Henry Jacob, 1818-1890.
Date:
1867
Catalogue details

Licence: Public Domain Mark

Credit: Ununited fracture successfully treated : with remarks on the operation / By Henry J. Bigelow ... With abstracts from Dr. Bigelow's clinical lectures on the subject, and cases. (Reported by Richard H. Derby.). Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

    19/28
    Case X.—Humerus. Patient, W. M. W., carpenter, aged 33, entered the Hospital Janu- ary 26th, 1866. He was wounded with a ininie ball at the battle of* Gettysburg, and suffered a compound comminuted fracture of the rio-ht humerus. July 5th, the bone was resected and about three inches removed. The wound healed in five months after exfoli- ation of the sawn extremities of the humerus. No attempt was made to keep the bones in apposition, and no union was obtained. He resumed duty and served out his full time with his regiment. The wound has never re-opened or caused him any trouble. Now seve- ral inches of the middle of the right humerus are gone, and the two extremities can be felt, pointed and considerably absorbed. The whole arm is quite small from disuse. The motion in the shoulder and elbow is perfect, but the arm hangs useless from the loss of substance in the shaft of the humerus. January 27th.—Operation. Being temporarily disabled, Dr. Bigelow requested Dr. Hodges to perform the operation. Patient was etherized. A longitudinal incision was made over the ends of the fragments. The end of the lower fragment was then everted; the periosteum was carefully detached for a sufficient distance and turned back, and half an inch was sawn off from the end of the bone, which was firm and healthy. The upper fragment was treated in the same way, but the end, three quarters of an inch of which was removed, was degenerated and quite soft. These ends were then drilled: silver wire was inserted and the ends approximated, leav- ing a small interval to allow slight movement. The periosteum was returned to its place, a few vessels were tied and the external wound partly closed by sutures. The arm was placed in an internal angu- lar splint. Water dressing. 30th.—The arm is in excellent position. Suppuration is beginning. Feb. 21st.—A large abscess above wound evacuated itself to-day. March lltli.—He walks about every day. Apparently some stiffening at the point of fracture. 17th.—An abscess is forming on the inner aspect of arm. 20th.—The abscess was opened and discharged freely. 31st.—The humerus is quite firm. He was discharged to-day, to return once a week. April 27th.—Scarcely any motion can be detected at the point of fracture. May 23d.—An incision was made down upon the wire, which was cut and withdrawn. The union of the fractured ends is firm. Tho apparatus was removed. Patient returned to work. Case XI.—Humerus. Patient, P. M., laborer, aged 23, entered the Hospital, January 12th, 1867. He was wounded at the battle of Cedar Mountain,