A Treatise on Gunshot WoundsLongmore, T. (Thomas), Sir
History
A Treatise on Gunshot Wounds
Longmore, T. (Thomas), Sir
Gunshot wounds
There is not space to follow the details of the treatment of this
case. The cure was protracted by large and troublesome bed–sores; and
attention to these, to the discharges from the wound, and preserving
favorable position, occupied much time and care daily, and caused
many changes in the appliances for these objects to be from time to
time necessary. On November the 4th, union had so far taken place
that he was able to raise his body from the knee upward while in bed,
without apparent motion at the seat of fracture. On November 15th, in
consequence of the great explosion at the right siege–train, he had to
be carried to another division of the camp; this was effected without
harm. In the middle of January he was able to sit in a chair without
inconvenience; and on February 22d he left the Crimea for England,
being able to walk with the assistance of crutches. Union was then
firm; but a slight serous oozing continued from the wound of exit,
and there was much stiffness of the ankle and knee joints from the
long–continued constrained position to which he had been subjected. In
July, 1856, after his arrival in Ireland, indications of pus collecting
manifested themselves at the wound of exit; and Professor Tufnell,
on passing a bougie about seven inches in the course of the wound,
evacuated a small abscess, and felt a piece of bone trying to make its
way to the surface. This was subsequently removed, and, under Mr.
Tufnell’s able care, the stiffness of the joints gradually disappeared,
and he was enabled to return to duty.
Dr. Macleod says that, after many inquiries respecting cases of this
nature in the hospitals of the other armies engaged in the war,
excepting one presented by Baron Larrey to the Société de Chirurgie
in 1857, he never could hear of any other but that of a Russian whose
greatly shattered and deformed limb he often examined.[13] It had
united almost without treatment. Two cases of united fractures of
the femur in the upper third have arrived from the late mutiny in
India, and in both, Dr. Williamson records, a good and useful limb had
resulted, one with shortening of 1–1/2, the other 3–1/2, inches. Still
more recently, M. Jules Roux, of the St. Maudrier Hospital, at Toulon,
has given a list of no less than twenty–one cases of gunshot injuries
of the upper third of the femur, which he had examined on their return
from the Italian war of 1859, in all of which consolidation of the
fracture had taken place. We have no data by which we can estimate the
proportion of these cases of union to those in which other results
ensued.
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