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War Surgery and Medicine



These constituted a very serious problem. During the First World War the Balkan frame was used as a splint and special net beds were also constructed, but neither was very satisfactory. In septic cases posterior drainage was instituted.

In the Second World War plaster spicas were utilised both for transport and for treatment. In some cases a double Hodgen splint was used in hospitals with success. In septic cases posterior drainage was used, and some surgeons provided more adequate drainage by chiselling off the great trochanter and displacing it upwards.

The sulphonamides were applied locally and given by mouth till superseded by penicillin both for the prevention and treatment of infection. The infected cases were generally very seriously ill, with marked toxaemia and anaemia, and recovery was often a hard and prolonged struggle. Skilled nursing was essential. Blood transfusions and liberal high protein diet were of great value. Adequate doses of parenteral penicillin, given from the time of wounding till all danger of infection had passed, proved the most satisfactory treatment of the hip-joint injuries.

Knee-joint Wounds Invalided from 2 NZEF
associated injuries in group (85 cases)—
Haemarthrosis joint 3
Excision patella 2
Rupture ant. crucial lig. 1
Simp. dislocation knee 1
Ligature popliteal vein 1
Inj. ext. popliteal nerve 1page 390
Suppurative arthritis knee 3
Infection patella 1
Persistent synovitis 1
Partial ankylosis 1
Bony ankylosis (PW) 2
Fibrous ankylosis (PW) 1
missile causing—
Shell 30
Machine-gun 10
Mortar 8
Gunshot 8
Bomb 6
Mine 4
Other 4
date of medical boarding—
1941 3
1942 20
1943 9
1944 31
1945 6
PW 6
Hip-joint Injuries Invalided from 2 NZEF
fracture— BC AI
With suppurative arthritis 5
Dislocation with fracture acetabulum 1 2
Dislocation hip 2
Other injuries 4
—— ——
10 4
Pelvic Injuries Invalided from 2 NZEF
fracture— BC AI
Ilium 43 2
Ilium involg sacro-iliac joint 3
Ilium involg hip joint 1
Ilium acetabulum 1
Ilium acetabulum involg hip joint 2
Sacrum 11 3
Sacrum involg sacro-iliac joint 6
Sacrum and ilium 1
Sacrum and ischium 4
Sacrum and pubis 3
Ischium and pubis 1
Ischium and dislocation hip 1
Pelvis 21 22
Pubis involg urethra 1
Ilium involg urethra 1
Sacro-iliac subluxation 3
—— ——
100 30
associated injuries—
Rupture bladder intra-peritoneal 1
Rupture bladder extra-peritoneal 1
Rupture prostatic urethra 3
Femoral thrombosis 1