New mode of treatment for delayed or non-union of a fractured humerus : read before the Medical Society of the County of Erie, June, 1854 / by Frank H. Hamilton.

  • Hamilton, Frank Hastings, 1813-1886.
Date:
[1854?]
Catalogue details

Licence: Public Domain Mark

Credit: New mode of treatment for delayed or non-union of a fractured humerus : read before the Medical Society of the County of Erie, June, 1854 / by Frank H. Hamilton. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    union of a fractured humerus where it is delayed, by straightening the fore- arm upon the arm, and confining them to this position. A straight splint, extending from the top of the shoulder to the hand, made of some firm but moulding material, and made fast with rollers, will secure the requisite im- mobility to the fracture. The weight of the forearm and hand will only tend to keep the fragments in place, and if the splint and bandages are sufficiently tight, the motion occasioned by swinging the hand and forearm will be conveyed almost entirely to the shoulder joint. Very little motion, in- deed, can in this posture be communicated to the fragments, and what little is thus communicated, is a motion which experience has elsewhere shown not disturbing or pernicious, but a motion only upon the ends of the frag- ments as upon a pivot. I do not fail to notice that this position has serious objections, and that it is liable to inconveniences which must always, probably, prevent its being- adopted as the usual plan of treatment for fractured arms. It is more in- convenient to get up and lie down, or even to sit down, in this position of the arm; and the hand is liable to swell. But I shall not be surprised to learn that experience will prove these objections to have less weight than we are now disposed to give them. Remember, the practice is yet untried—if I except the case which I am about to relate, and in which case, I am frank to say, these objections scarcely existed. The swelling of the hand was trivia], and only continued through the first fortnight, and the patient never spoke of the inconvenience of getting up or sitting down, or even of lying- down. The following is the case to which I have just referred. Michael Mahar, laborer, set. 35, broke his left humerus just below its mid- dle, Dec. 14, 1853. The arm was dressed by a skillful surgeon in Canada West, and who is well known to me as exceedingly clever. After a few days from the time of the accident, the starch bandage was put on as tight as it could be borne, and brought down on the forearm so as to con- fine the motions of the elbow joint. Six weeks after the injury, Jan. 29, 1854, Mahar applied to me at the hospital. No union had occurred. The motion between the fragments was very free, so that they passed each other with an audible click. There was little or no swelling or soreness. In short, every thing indicated that union was not likely to occur without operative interference. The elbow was com- pletely anchylosed. His health was unimpaired. I explained to my students what seemed to me to be the cause of the