NEW LIMBS FOR OLD.

New Zealand Herald, Volume LIII, Issue 16300, 5 August 1916, Page 4 (Supplement)

NEW LIMBS FOR OLD.

MIRACLES OF SURGERY.

TREATING WAR INJURIES

The most terrible aftermath of former wars has always been the thousands of permanently crippled and deformed men. who, although they have escaped \ ith their lives, nevertheless are doomed to carry with them to the end of their days the lasting effects of wounds received in battle. Thanks to the indefatigable energy and resource of the modern surgeon, there are already many 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.

Experience lias 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 called " reconstructional surgery" finds its greatest scope.

A recent article in the " Practitioner" by Lieut. -Colonel Openshaw on the prevention of amputations, shows by its very title how- far we have advanced from the not very distant day when the military surgeon's chief duty was the immediate amputation of shattered limbs, which, if not treated in this terribly radical manner, too often cost their owners their lives. "Whereas 25 or 30 years ago," writes Colonel Openshaw, " I used to do one excision at the hip joint every week of my life, I have during the last ten years practically never excised one. The number of amputations in peace times, owing to aseptic surgery and the advances of medical knowledge, has considerably decreased, in fact practically vanished."

Large Number of Amputations. But in war time, and particularly in this war, the number of limbs cut off is tragically large. This is unavoidable, owing to the conditions in which the wounded have to be treated, and thus the necessity has arisen for supplying very large numbers of men with* artificial limbs. For British wounded soldiers about 5-500 artificial limbs have been required up to the present. At Queen Mary's Hospital for the Limbless, Roehampton, 800 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 of daily life and even do useful work.

"The main requirements are strength and lightness. The science of artificial limb-making at the present day has become well-nigh perfect. The artificial leg must be sufficiently strong to stand the wear and tear of a working man's life. It must be simple and not constantly requiring repairs. A gentleman with both legs artificial has been wearing his 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 the operator has been able to preserve. If the carpus (small bones of the wrist) is left, an artificial hand can be fitted allowing very consider- • able movement. If the limb" has been amputated at the wrist-joint the artificial hand may be pronated and supinated that is, turned with the palm down ward or upward. When the operation has to be performed in the forearm, men do exceedingly well with an artificial arnTwith a ring or hook at the end. But it is when the arm is cut oft from a point not far from the shoulder that the perfection that has been reached in the construction of artificial limbs is seen. With what is known as a fames 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." Lost Both His Arms. But what is to be done for a man, such as the German officer who came under Colonel Openshaw's care at Roehampton, with the complete loss of both arms from the shoulder joint? One arm amputated at the shoulder is bad enough, but when both arms are off the man is practicallyincapacitated, 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 series of operations this lucky German's shoulders are being prepared for the reception of pieces of bone to which the artificial arms will be attached, and Colonel Openshaw hopes, in about five months' time, to fit a Carnes arm, which will enable the patient to perform all the actions 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 the large number of cases of fracture of the femur (the thigh bone) in which the wounds had healed with great shortening of the limb. Most of these limbs were perfectly useless for any form of military service. Lame no Longer. Some new method had to be found to restore these, shortened and deformed femurs to their normal length. Sir Arbuthnot worked out such a method, and describes a number of rases in which it has been used with striking results. The 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 first case quoted was a prisoner, captured by the Germans, who had been sent back to England since they considered that he was a helpless cripple and unfit for any form of military service. His femur had been broken by a rifle bullet on October 31. 1914. The limb was 4iin shorter than its fellow. He was operated on in King Edward's Hospital on March 27, 1915. -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 function. Here is a striking instance of a man who a decade ago would have been condemned to lifelong serious lameness, restored by modern surgery to what is practically his normal condt'iion. Restoration Almost Complete. ? Another case in which practically com plete restoration of the limb to its normal form has been effected is that of a wounded British officer taken prisoner by the Germans in August. 1914. He sustained a comminuted fracture of the right femur (this is a fracture in which the bone is broken up into a number of pieces). After being detained in (Germany for ten months, he was sent back to England. He was admitted to King Edward's Hospital with 4in shortening, and only able to get about on crutches. He now has less than Jin shortening. Such surgical achievements as these show what great strides we are making in the wonderful art of rendering maimed men whole and sound again. — From the Daily Mail.