An essay on the treatment of compound and complicated fractures : being the annual address before the Massachusetts Medical Society, May 28, 1845 / by William J. Walker.

  • Walker, William Johnson, 1789-1865.
Date:
1845
Catalogue details

Licence: Public Domain Mark

Credit: An essay on the treatment of compound and complicated fractures : being the annual address before the Massachusetts Medical Society, May 28, 1845 / by William J. Walker. 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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    CASE D. Mr. Edward Cutter of Somerville, forty years of age, and of temperate habits, was kicked by a horse, three inches below the knee. One of the calkins of the horse-shoe had here penetrated the tibia, and produced a very oblique fracture. At this spot, and here only, were the fascia and soft parts much injured. Two splinters, each more than a couple of inches long, of the compact shell of the tibia were removed, together with some of its can- cellated structure. The fibula was sound and entire. The wound was dressed with the mildest applications, no attempt ever being made to approximate its lips. Neither splints, bandages, nor apparatus of any sort were used, at any time. An elevated and easy posture for the leg, rest, spare diet, and a moderate purge, daily, for the first week, constituted the whole treatment. Under this simple management, the wound cicatrized in eighteen days, with only slight superficial suppuration. Nothing untoward oc- curred to retard the cure, which was completed within forty days, W. J. W, CASE E. March 7, 1840, Edward L. Heath, a convict in the Massachu- setts State's Prison, about twenty-eight years of age, and of sound constitution, suffered a compound, not comminuted, fracture of the right leg, in consequence of a block of granite falling upon it. The upper fragment of the tibia protruded through the skin, about five inches below the knee. There appeared to be much lacer- ation of the fascia, as evinced by the looseness of the lower frag- ment of the tibia, and the presence of a large cavity, reaching nearly to the inner ankle, filled with venous blood. The bones were easily replaced in apposition. A free counter opening was made near the inner ankle, through which blood and serum found a ready exit, as soon as they were effused, into the wound. The limb was laid on its heel, elevated about twelve inches above the body.