On the occurrence of non-union after fractures : its causes and treatment / by George W. Norris.

  • Norris, George W. (George Washington), 1808-1875.
Date:
[1842]
Catalogue details

Licence: Public Domain Mark

Credit: On the occurrence of non-union after fractures : its causes and treatment / by George W. Norris. 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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    Another well described case, in which a fracture received during pregnancy did not unite till after delivery, was observed by Dr. Bard of New York, and is to be found in the Philosophical Transactions, (xlvi, p. 397, 1750.) In this instance the left fore-arm was fractured obliquely in the third month of pregnancy; rinding the arm continued flexible at the end of seventy-five days, though the ends of the bones were in perfect apposition, Dr. B. applied an apparatus to keep the limb in a good position, and gave encouraging hopes to the patient that after her labour, the economy of nature would be more immediately directed to the recovery of the use of her arm. In less than a month after her delivery, the callus was fully formed, and the patient recovered the use of her arm. The following case, kindly furnished to me by Dr. Condie of this city, also strikingly shows the influence that may be exerted by a state of pregnancy upon the consolidation of fractures. S. R. set. 36, on the 13th of October 1820, being then in the eighth month of her third pregnancy, fell in going up stairs and fractured her right humerus immediately below the insertion of the deltoid muscle. The fractured bone was carefully adjusted within half an hour after the accident, and the patient being to all appearance in perfect health, a speedy union was anticipated. No union occurring, Dr. Physick saw the patient on the 13th of November, and carefully examined her arm. He remarked, that according to his expe- rience, fractures occurring in pregnant females often remained ununited until after parturition, when union very generally and rapidly took place, and believed this would be the case with S. R. provided motion at the seat of injury was guarded against. On the 27th of November, the patient was delivered of a healthy child, rather above the common size, and by the 31st of December, the bone had become firmly united. Whether the states of pregnancy, or of suckling, have any direct effect in preventing union of the bones, or whether this is only in consequence of the debility which these conditions of system often induce, is undetermined. I am myself inclined to adopt the latter supposition, and in support of it will adduce the cases reported by Sir Stephen Love Hammick. I have seen, observes this author, (Practical Remarks on Amputations, Fractures, &c. p. 121,) three cases of this sort, one of the leg, in a woman in the first months, who was extremely debilitated from an incessant irritability of stomach, causing her to reject all her food, but as the pregnancy advanced her stomach became tranquil, when on recovering her strength the bone united. Another had a fracture of the humerus in the latter months; the patient was in a state of great exhaustion; after her delivery she would per- sist in nursing the child, which continued her weakness, and it was not till two months after she consented to wean it that the bone united by the vigour of the system having returned. The third was in the last months of preg- nancy, and after delivery, not attempting to nurse the infant, she rapidly improved in health, and the limb quickly got well.