NEW LIMBS FOR OLD.

Pukekohe & Waiuku Times, Volume 5, Issue 205, 1 September 1916, Page 2 (Supplement)

NEW LIMBS FOR OLD.

SURGERY MIRACLES. (By A Physician in the "Daily Mail".? The most terrible aftermath of former wars has always been the thousands of permanently crippled and deformed men, who, although"they have escaped with their lives, nevertheless are doomed to-tarry with them to the end of the : r days the last effects otf wounds received in battle, Thanks to the indefatigable energy and resource of the modern surgeon, there are already mnnv signs that after this/the greatest and most sanguine of all wars, the percentage of irremediable deformities is to be reduced to what even a decade ago would have been considered an impossible minimum. Exponent* has shown that the great proportion of serious, while not fatal, wounds are received in the arms or legs. Naturally, therefore, it is in these regions that what may be culled "reconstructiona'l surgery" finds its greatest scope. A recent article in the "Practitioner" by Lieut-Col. Openshaw on the prevention of amputations shows by its verv title how far we have ad vanced from the not very distant day when the military surgeon's chief duly was the immediate amputation of shat tered Vmbs, which, if not treated m this terribly radical manner, too often cost their o"wners their lives. 'Whereas 2o or 30 years ago" writes Col. Openshaw " I used to do one excision at the hip joint every .week of my life, I have during tho last ten years practically never excised one. The number of amputations in peac e times, owing to asceptic surgery and the advances ot medical knowledge, lhas consideramV decreased, in fact practically vanished." But in war time, and particularly in this war, the number of limbs cut off jr. tragical!.' large. Tins is unavoidable owing to the conditions in which the wounded have to b.e treated, and thus the necessity has arisen for supplying large numbers of men with artificial limbs. For Briton wounded soldiers about 3000 artificial limbs have been required up to th,e present. At Queen Mary's Hospital 'or the Limbless, Roeham'pton, 8(J0 limbs have been supplied, while 1900 are waiting to be fitted. So perfectly constructed are> these legs arms, and hands that the wearers can often perform all the operations ot da'lv life, and even do useful work. "The main requirements are strength md Tghtness. The science of artificial limb-making at the present day has become well-night perfect. The artificial leg must be sufficiently strong to stand the wear and tear of a working man's life. It must be sample and not constantly requiring repairs. A gentleman with both legs artificial has been wearing h. ; s present pair for eleven years."

"DO PRACTICALLY ANYTHING. The range of usefulness of the hand will depend very largely on the amount of. the natural limb that tljfi operator has been able to preserve. If the carpus (small bones of the wrist) is left an artificial hand can be fitted allowing verf considerable movement. If the limb has been amputated at the wrist joint the artificial hand may be pronated and supinatcd—that is, turned with the palm downward or upwardWhen the operation has to be performed in the forearm m.en do exceedinglv well with au artificial arm with a ring or hook at the end. Hut it when the arm is cut off from a point not far from the shoulder that the perfection that has been reached in the construction of artificial limbs is sren With what is known as a Carnes arm "the wearer can open and close the fingers, can pick up a sixpenny piece, shake hands, write raise his hat. carry a book, strike a match, and do practically anything." But what is to lve done, for a man, .such as the German officer who came under Colonel Opcnshaw's care at Roehampton. with the complete loss of both arms from the shoulder joint?. One arm amputated at the shoulder 5s Dad enough, but when both anus are off the man is practically incapacitated and is dependent upon other people for everything. No Carnes arm is any use unless the patient has at least four and a-half inches of the bone left. By a scries of operations tins unlucky German's shoulders are being prepared for the reception of pieces of bone to which the artificial arms will be attached and Colonel Opensjiaw hopes, in about five months' tune, to fit a Carnes arm which will enable the paUent to perform -ill the actons enumerated above. Sir Arbuthnot Lane, in a recent article "on ''The Operative Treatment of Fractures in War Time,'' describes a new method by which the shortening of limbs after wounds in which the bone is badly broken up can be entirely prevented. This shortening has heretofore been the rule, in such cases, with consequent serious disability to the patient. Some months after the beginning of the war Sir Arbuthnot noted thp large number of cases of fractune of the femur (the tlvgh bone) ii» which the wounds had healed with great shortening of the limb. Most of these limbs weive perfectly useless for any form of military service.

LAME NO LONGER. •Some- new method had to l>o found to restore these shortened and deformed fcmur> to their normal length. Sir Arbtttimot worked out such a method, and describes n number of eases in which it lias been used, w.'th striking resulU. Tlie method, although too technical for description here, can readily be grasped by any surgeon. The point for emphasis here is the remarkable results attained. The lirst case quoted was n prisoner, captured by the Germans who hai been sent back to England since they considered that he was a helpless eivpple and unfit for any form of military service. His femur had been broken oy a rifle bullet on 31st October, 1914. The limb was four and a-lialf filches shorter than its fellow. He was operated on in King Edward's Hospital on l'7th March, l'.»l". The operator, after certain manipulations, was able to place the ends of the fragments in accurate apposition and to restore the femur to its original length, form, and funct'on. Here is a striking instance of a man who ;i decade ago would hav.e been condemned to lifelong serious lameness restored by modern surgery to what is practically hi.-, normal condition. Another case iu which practical!? complete restoration of the limb to its normal form has been effected is that of a wounded Brili'sh officer taken prisoner b ythe Germans in August, 19M He sustained a comminuted fracture of the right femur (this is a fraycture in which the bone is broken up : nto a number of pieces). Alter being detained n (iermany for ten months he was sent back to England, being considered lotatlly unfit fors ervice. He was ruimitteil to King Edward's Hospital wil!i four inches of shortening, and only «•)•■> to get about on crutches. He now ha" less than thrc/'-quarter- of iVn inch shortening, and w.ll soon be able to return to duty. Such surgical achievements as those show what great strides wo are making in the wonderful art of 'rendering maimed men whole and sound again.