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.

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    consequence longer excision. Other tilings being equal, it is better not to wait unnecessarily. The only case I have encountered of ultimate failure, was one of extreme softening of the bone by interstitial absorption, a condition which was not ameliorated by invigorating measures, including the free and protracted use of the phosphates. Case I.—Humerus. Patient, E. J., aged 22, entered the Hospital, October 15th, 1857. Eleven months before, his right arm was caught in a “ splitting ma- chine,” and drawn in between the cylindei’S. A compound, commi- nuted fracture of the radius and ulna was produced at about their middle; and a compound fracture of the humerus rather below the middle. The fracture of the humerus did not unite, that of the fore- arm did. October 14th.-—-A seton was passed between the fractured ends. February 24th, 1858.—No union. Seton removed. Subsequently, emplastrum cantharidis was applied over the fracture; the ends of the bone were rubbed together. May 12th.—No union. An incision was made over the fracture; the two ends were exposed, and an inch removed from each. November 21st.—He was discharged, not relieved. November 15th, 1859.—He returned to the Hospital; the arm was perfectly useless, and occasionally caused pain. He was pre- pared for anything that should offer a reasonable prospect of suc- cess, or even amputation as a last resort. December 17th.—He was etherized, and, with the view of produc- ing irritation, each fractured extremity split with a pair of strong forceps, made for the purpose with chisel blades (which punctured the skin at opposite points, and slowly penetrated the bone, the ends of the forceps being placed in a vise), and a splint applied, consist- ing of a shoulder-cap, with a band around the opposite side, and a cap for the elbow and forearm. These two caps were made to ad- vance towards each other by a screw, so as to crowd the ends of the bones together. 18 th.—Comfortable. January 15th, 1860.—In consequence of pain about the shoulder, the apparatus was removed, and the arm bandaged. Little or no union. February 14th.— Operation by Dr. Bigelow. He was etherized, and a crucial incision made over the external surface of the arm over the fracture. The band of ligamentous tissue connecting the bones was divided, and each extremity of the humerus turned out. The periosteum was carefully detached, for an inch or more, from each end. The denuded ends were then sawed off. A hole was drilled through each end, and a stout silver wire passed through. The ends