On the diagnosis and treatment of fractures of the neck of the femur : being the introduction to a discussion in the Section of Surgery at the Annual Meeting of the British Medical Association held in London, July-August, 1895 / by Sir William Stokes.

  • Stokes, Sir William, 1839-1900.
Date:
1896
Catalogue details

Licence: Public Domain Mark

Credit: On the diagnosis and treatment of fractures of the neck of the femur : being the introduction to a discussion in the Section of Surgery at the Annual Meeting of the British Medical Association held in London, July-August, 1895 / by Sir William Stokes. 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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    manently crippled condition that Sir J. Erichsen speaks of, IMr. Southam, of Manchester, has practised and advocated a deliberate breaking down of impaction, instead of leaving it intact as surgeons hitherto have aimed at doing. The patient whose case Mr. Southam has published,* was aged 27 years, and all the usual signs and symptoms of extracapsular fracture of the neck of the femur were present. The patient was angesthetised, the impaction broken down, and the excision and shortening being overcome, the fracture was then treated by extension. “ The fi-acture readily united with the limb in the corrected position, no deformity ensuing.” It is possible that in the treatment of this case i\Ir. Southam may be the pioneer, so to speak, of a revolution in the routine practice adopted in such instances. As far as one can judge from a single example I should say that the treatment could only he applicable in a very limited number of cases, namely, those rare ones that occur at a period of life long antecedent to that of any senile anatomical change, and when the physical reparative powers are in full activity. In no other case, I should imagine, having regard to the senile changes in the bones to which I have alluded, could the practice be adopted with any reasonable hope of success. I have pointed out that in four different varieties of fractures of the cervix (intracapsular) osseous union, and that with little or no deformity, can take place. This satisfactory result is the result of one or other of two conditions being pi-esent, namely, penetration or the preservation of tlte integrity of the Stanley-Smith cervical ligament. Wlien either or both * Lancet, November 17II1,1894,