With Compliments of the Author. 
FRACTURES 
AT THE 
RHODE ISLAND HOSPITAL, 
1868-1878. 
BY 
EDWARD T. CASWELL, M. D. 
SURGEON TO THE HOSPITAL. 
[Reprinted from the Boston Medical and Surgical Journal.] 
CAMBRIDGE: 
IBrtntct) at iStfcemae 
1880. FRACTURES AT THE RHODE ISLAND HOSPITAL 
By EDWARD T. CASWELL, M. D., Providence, R. I. 
The Rhode Island Hospital was opened for the ad- 
mission of patients on October 1, 1868. When it had 
completed the first ten years of its existence, I thought 
I would collect and publish some statistics of what had 
been done during those years by my colleagues and 
myself. The laborious undertaking of going over the 
hospital records and other engrossing duties bave post- 
poned the publication of this, which may be considered 
a first contribution, until this late day. I greatly re- 
gret the inaccuracy of the records, and their failure in 
a large majority of cases to supply precisely the most 
important information, as, for example, the side of the 
body which sustained injury, and the length of limb 
in fractures of the lower extrenqity, both on admission 
and discharge. Nothing can be more unsatisfactory or 
more worthless for all purposes of comparison than to 
have the result of treatment of a case of fracture en- 
tered as “ good,” or “ well,” or “ recovered.” But 
such, I regret to say, has frequently been the entry. 
In spite of these failures, however, I venture to pre- 
sent the following tables, hoping that they may not be 
without some interest. They represent all the fract- 
ures admitted to the wards of the hospital for ten 
years ; they do not include fractures treated in the out- 
patient department. 
I find recorded 185 cases of fracture occurring in 
167 persons. There have been 152 cases of single 
fracture, 12 in which there were two different fract- 
ures, and 3 in which there were three different fract- 
ures. Each of tlie-e are entered under their tespect- 
ive sections. Of course this does not apply to ihe 
case of fractured ribs, where one, two, or more may be 
broken, nor to that of a leg or fore-arm where both 
bones are broken. Just as these sheets were nearly 
ready for the press, I find that one case of fracture of 
both thighs and one of compound fracture of both 
legs have each been entered as one fracture. So that 
there are actually 187 cases of fracture in 167 individ- 
uals. Fractures of the foot and hand have not been 
included. A separate list has been added of injuries 
rapidly fatal, although they have been included in their 
appropriate sections. I have also appended the statis- 
tics of the very small number of dislocations that have 
been admitted to the wards of the hospital for the 
same period. 
From the summary we see that of all the fractures 
nearly one half were fractures of the lower extremity, 
and of these more than half were fractures of the leg. 
Of the latter more than half were fractures of both 
bones. According to frequency, these fractures would 
be arranged as follows : Leg, thigh, fore-arm, arm, 
ribs, clavicle, skull, vertebra?, scapula. No fractures 
of the pelvis are recorded. The relative frequency of 
the fractures of the different sides of the body will be 
referred to further on. 
MORTALITY. 
Of the 167 individuals who were admitted for fract- 
ures, 25 died, or 15 per cent. Of these, 15 died in the 
course of twenty-four hours, and of this number, 11 
were caused by railroad accidents. These deaths, al- 
though not so stated in the record, are without doubt 
to he ascribed to shock and the loss of blood attendant 
upon the accidents. Of the remaining 10 cases, 2 died 
from intemperance, 1 from pneumonia following a 
fracture of the ribs, 1 from pyaemia, 1 from convul- 
sions on the third day after a compound fracture of the 
skull, 1 suddenly, without cause ascertained, on the 
second day after a simple fracture of the thigh ; and in 
the remaining 4 cases death ensued from the injury, at 
intervals varying from thirty-six hours to six days, as 
follows: (1) vertebra and compound fracture of tibia, 
six days ; (2) vertebra, three days; (3) skull, three 
days ; (4) base of skull, thirty-six hours. 
REVIEW OF FRACTURES IN GROUFS. 
I now propose to pass in review the different groups 
of fracture, stating such points as are the most salient 
in the tables. 
CRANIUM. 
There were ten cases, all in males, of which seven 
were compound. All died except two of the latter. 
Of these, one was a compound comminuted fracture of 
the left orbital region, accompanied with the loss of 
brain substance. The accident happened six weeks be- 
fore his admission to the hospital, and was occasioned 
by a heavy piece of machinery falling upon him while 
erecting the engine at the pumping station at Sock- 
anossett. Pieces of bone were removed at the time. 
He remained in the hospital one hundred and fifty-two 
days, and left entirely restored, with the loss of the 
left eye. He has continued to be perfectly well, and 
still fids the post of engineer at the station. The other 
successful case was caused by a pistol-shot in the front- 
al and parietal region. The trephine was used, the 
bullet extracted, and the patient left the hospital in 
twenty-three days. 
MAXILLJE. 
There were nine cases, all in males. One died from 
delirium tremens. One was a compound fracture of 
both bones, and left the hospital at the expiration of 
twenty-six days. Of the seven simple cases, the aver- 
age residence was twenty-six days. Wiring the teeth, 
pasteboard and gutta-percha splints, were the methods 
of treatment. 
RIBS. 
There were thirteen cases, of which ten were males 
and three females. Of these three died, two from other 
serious injuries, and one from pneumonia, in twenty 
days. Of the remaining ten, the average residence in 
the hospital was thirty-three days. In seven cases more 
than one rib was broken. The majority of cases were 
treated by strips of adhesive plaster. 
SCAPULA. 
Of only four cases recorded, all of males, one died 
from fracture of the skull. In two cases the left is 
specified. The average residence of three was thirty- 
three days. 2 
Fractures at the Bhode Island Hospital 
FRACTURES OE THE HEAD. 
Sex. 
Age. 
Nativity. 
Date of Admission. 
Cause. 
Definition of Fracture. Treatment. 
Date of Discharge. 
Result. 
Remarks. 
I. CRANIUM. 
Simple. 
l 
M. 
25 
American. 
October 23,1873. 
Railroad accident. 
October 26, 1873. 
Died. 
2 
M. 
27 
English. 
December 7, 1874. 
Railroad accident. 
Base. 
December 8, 1874. 
Died. 
Thirty-six hours after admission. 
3 
M. 
Irish. 
September 24, 1875. 
Thrown fr. carriage. 
Left supra-orbital arch. 
September 25,1875. 
Left hospital next morning. 
Compound. 
1 
M. 
50 
Irish. 
April 2, 1875. 
Brick falling. 
“ No depression.” 
April 5. 1S75. 
Died. 
Twenty-six convulsions April 5th. 
2 
M. 
36 
Irish. 
October 16, 1875. 
Fall from house. 
Comminuted. 
October 16, 1875. 
Died. 
Died on day of admission. 
3 
M. 
45 
English. 
October 29,1875. 
Heavy castings fell 
Comminuted, left frontal 
March 30, 1876. 
Good. 
Accident six weeks before admission. Attended with 
on him. 
bone. 
laceration and loss of brain, loss of left eye, and 
fracture orbital plate. 
M. 
33 
June 15, 1876. 
Left ant. surface depressed. Fragm'ts removed, depressed 
June 15,1876. 
Died. 
Comatose on admission. Died in six hours. 
bone elevated. 
5 
M. 
38 
German. 
August 7,1876. 
Gun-shot, suicidal. 
Frontal and parietal. August 19th, trephined ; bul- 
August 30,1876. 
Good. 
Bullet lodged in bone. Accident two weeks before 
let removed. 
admission. 
6 
M. 
13 
Scotch. 
May 16, 1878. 
Fall from third story. 
Depressed behind left ear. 
May 16, 1878. 
Died on admis- 
Compound dislocation right radius, fracture left ulna 
sion. 
and right tibia and fibula. 
7 
M. 
45 
Irish. 
July 15,1878. 
Mining accident. 
Depressed. Trephined; piece of bone re- 
July 15, 1878. 
Died 8 hours 
Fracture left acromion, comminuted fracture left 
moved from between dura 
after admission. 
tibia. 
mater and inner table. 
II. SUPERIOR AND INFERIOR MAXILLA (COMPOUND). 
1 
M. 
35 
Irish. 
July 18, 1877. 
Struck by derrick. 
Super., entire length hard pal- Inferior teeth wired, and 
August 13,1876. 
Good. 
Fracture of clavicle, No. 10. 
ate in median line ; finger pasteboard splint. 
could be laid in cavity. 
Infer., left of symphysis. 
III. INFERIOR MAXILLA. 
1 
M. 
26 
Irish. 
November 4, 1868. 
Blow. 
(1) In left of symphysis and Teeth on left side wired ; 
December 8,1868. 
Good. 
Small spicula of bone discharged from an abscess 
(2) front of angle, right side. four-tailed bandage. 
which formed on inner surface, right side. 
2 
M. 
— 
— 
August 16, 1869. 
Near symphysis. Four-tailed bandage. 
August 21,1869. 
Died. 
Delirium tremens. 
3 
M. 
26 
American. 
October 2,1871. 
Run over. 
At lateral incisors, alveolar Pasteboard splint. 
October 21, 1871. 
Good. 
process not ruptured. 
4 
M. 
24 
Irish. 
February 1,1872. 
Blow. 
Gutta-percha splint. 
February 27. 1872. 
Good. 
5 
M. 
30 
Portuguese. 
July 10,1873. 
Struck by hawser. 
At symphysis. Gutta-percha splint ; teeth 
August 8,1873. 
Good. 
wired. 
6 
M. 
8 
American. 
March 6,1874. 
Fall. 
Each side median line. Gutta-percha splint. 
March 26,1874. 
Removed by friends. Fracture left femur, No. 9. 
7 
M. 
42 
American. 
April 20, 1877. 
Fall. 
Between canine and first bi- Pasteboard splint. 
May 28,1877. 
Good. 
Small pieces of bone discharged May 23d and 
cuspid; not oblique. 
24th from abscess on inside over seat of fract- 
8 
M. 
50 
Irish. 
July 15, 1878. 
Blow. 
Right, half an inch anterior Pasteboard splint. 
August 8, 1878. 
Union. 
Discharged because he refused to submit to wiring 
to angle. 
fragments. 
FRACTURES OF THE VERTEBRiE. 
1 
M. 
28 
French Cana- 
September 15, 1869. 
Struck by a beam 
Spinous process of one of 
September 21,1869. 
Died. 
Paralysis of lower extremities and bladder. Com- 
dian. 
falling. 
lower dorsal wauting. 
pound fracture of tibia and fibula. (No. 1.) 
2 
M. 
58 
American. 
October 21, 1869. 
Fell 8 ft. on back. 
Seventh dorsal vertebra. 
October 24, 1869. 
Died. 
3 
M. 
34 
English. 
February 22, 1871. 
Railroad accident. 
Fourth cervical, also dislo- 
February 22,1871. 
Died. 
Shortly after entrance, twenty-four hours after acci- 
cated. 
dent. 
4 
M. 
24 
Irish. 
April 20,1875. 
Railroad accident. 
Eleventh dorsal vertebra, and 
April 10,1875. 
Died in 9 hours. 
Fracture of ribs and acromial end of clavicle. 
dislocation of tenth. 
5 
M. 
35 
American. 
January 11,1876. 
Struck by h’vy stone. 
January 11, 1876. 
Died. 
In an hour after admission. 
6 
M. 
42 
English. 
January 16,1878. 
Struck by falling 
Last dorsal and first lumbar. 
September 11,1878. 
Improved. 
Had paralysis of lower extremities and bed sores. 
timber. 
Latter healed, and able to walk well when dis- 
- 
charged. 
FRACTURES OF THE RIBS. 
1 
M. 
13 
American. 
February 17. 1872. 
Railroad accident. 
Four lower, near vertebrae. 
February 17,1872. 
Died in J hour. 
2 
F. 
60 
Irish. 
April 19,1873. 
Railroad accident. 
Pad and bandage. 
May 11,1873. 
Died. 
Compound fracture of leg. 
3 
M. 
46 
Fr. Canadian. 
August 20,1873. 
Run over. 
Sixth and seventh, near ster- Many-tailed bandage. 
September 2, 1873. 
Good. 
Pneumonia. Fracture of tibia and fibula. (No. 8.) 
4 
M. 
40 
Irish. 
September 20,1873. 
Stamped upon. 
Eighth, ninth, and tenth. Broad swathe. 
October 28,1873. 
Good. 
Accident two weeks before admission, followed by 
cough and expectoration. Fractures at the Rhode Island Hospital. 
3 
6 
6 
7 
8 
9 
10 
11 
12 
13 
M. 
M. 
M. 
M. 
M. 
M. 
F. 
F. 
M. 
50 
24 
42 
43 
35 
67 
63 
40 
25 
Irish. 
Irish. 
Irish. 
Scotch. 
Irish. 
Portuguese 
English. 
Irish. 
American. 
January 9, 1874. 
April 20, 1875. 
May 5,1875. 
October 25, 1875. 
October 29, 1875. 
January 5, 1876. 
July 13,1877. 
January 16, 1878. 
March 5, 1878. 
Fall. Eighth and ninth. 
Railroad accident. 
Fall. Seventh. 
Fall. Several. 
Fall. Eighth. 
Several. 
Fall. Right side, two ribs. 
Struck by fall. timb. Fourth, near sternum. 
Fall. Sixth, three or four inches 
from sternum. 
Adhesive strips. 
Adhesive plaster. 
Adhesive plaster. 
Adhesive plaster and band. 
Bandage. 
Adhesive plaster. 
Adhesive strips. 
Adhesive strips. 
January 30, 1874. 
April 2,1875. 
May 24,1875. 
December 31, 1875. 
November 8. 1875. 
March 28, 1876. 
August 11, 1877. 
February 7, 1878. 
March 16, 1878. 
Good. 
Died in 9 hours. Dislocation tenth dorsal vertebra. Fracture of elev- 
enth and acromial end of clavicle. 
Good. 
Good. 
Good. 
Good. 
Eloped. Complicated with fracture of tibia and 
Good. fibula. No. 13. 
Good. 
FRACTURES OF THE SCAPULA. 
1 
M. 
60 
Irish. 
August 23, 1871. 
Blow. 
Neck. 
Pad in axilla, arm across 
September 28,1871. 
Unrelieved. 
Accident two months prior to admission. When dis- 
chest. 
charged, no union. 
2 
M. 
44 
American. 
April 15, 1872. 
Fall. 
Neck. 
Pad in axilla and sling band- 
May 14, 1872. 
Discharged at his own request. 
age. April 22dad. strips. 
3 
M. 
49 
Irish. 
June 15,1875. 
Kick of horse. 
Left. 
Adhesive plaster, Sayre’s 
July 21,1875. 
Good. 
Fractured clavicle. No. 5. 
method. 
4 
M. 
45 
Irish. 
July 15, 1878. 
Mining accident. 
Left acromial process. 
July 15, 1878. 
Died 8 h’rs after Depressed fracture of skull. Comminuted fracture of 
admission. left tibia. 
FRACTURES OF THE CLAVICLE. 
1 
M. 
30 
Irish. 
September 11,1871. 
Fall. 
Pad in axilla and bandage. 
October 10,1871. 
Good. 
2 
M. 
26 
Irish. 
April 19, 1873. 
Railroad accident. 
Right, two and a half inches 
Pad in axilla and over fract., 
June 11,1873. 
Good. 
from acromion. 
and figure-of-eight band. 
3 
M. 
40 
Irish. 
3Iarch 5,1874. 
Jammed. 
I.ett, middle. 
Adhesive strips. 
April 4, 1874. 
Good. 
February 27th, large callus. 
4 
F. 
38 
English. 
3Iarch 30,1874. 
Railroad accident. 
Left, middle, two fractures. 
liand'ge. April 1st, adhe- 
April 27, 1874. 
Good. 
When discharged, ends overlapped one half to three 
sive plaster. 
lourths of an inch. Scalp wound and loss of two 
5 
M. 
24 
Irish. 
April 20,1875. 
Railroad accident. 
Acromial end. 
April 20, 1875. 
Died in 9 hrs. Fracture of ribs and eleventh dorsal vertebra, and 
dislocation of the tenth. 
6 
M. 
49 
Irish. 
Jure 15. 1875. 
Kick of horse. 
Left, acromial end. 
Adhesive plaster (Sayre’s). 
July 21, 1875. 
Good. 
Fracture of scapula. No. 3. 
7 
M. 
28 
Irish. 
October 29, 1875. 
Earth caved in. 
Right, inner third. 
Fox’s apparatus. Novem- 
December 31,1875. 
Good. 
ber 6th, bandage. 
8 
M. 
30 
Irish. 
November 23, 1875. 
Fall. 
Right, two in. from acromion. 
Bandage. 
December 31,1875. 
Good. 
9 
M. 
38 
Irish. 
February 24, 1877. 
Fall. 
Right, outer third. 
Pad in axilla, bandage, arm 
March 29, 1877. 
Good. 
in Siing. 
10 
M. 
35 
Irish. 
July 18, 1877. 
Struck by derrick. 
Right, junction middle and 
Pad in axilla and bandage. 
August 13,1877. 
Good. 
Fracture of superior and inferior maxilla. No. 1. 
outer thirds. 
11 
M. 
3S 
Irish. 
July 21, 1877. 
Blow. 
Near outer extremity. 
Adhesive plaster and band. 
July 25, 1877. 
Left the hospital. 
12 
M. 
30 
Irish. 
January 3, 1878. 
Jammed. 
Left, acromial, end. 
Adhesive strips (Sayre’s). 
January 24, 1878. 
Good. 
FRACTURES OF 
THE UPPER EXTREMITY. 
HUMERUS. 
1 
M. 
60 
German. 
June 19,1869. 
Fall. 
Middle and lower thirds. 
No treatment.. 
June 22,1869. 
Died. 
Effects of intemperance. 
2 
M. 
29 
German. 
Jauuary 10,1870. 
Wrench. 
Left, just above middle, 
Extern il and internal an- 
February 24, 1870. 
Slight deform- Union firm. Motion imperfect. 
transverse. 
gular splints. 
ity. 
3 
F. 
64 
Irish. 
J uue 30,1871. 
Fall. 
Just below surgical neck. 
Gutta percha splint and 
July 29,1871. 
Discharged by request. 
shoulder ap. 
4 
M. 
40 
Iri-h. 
September 30, 1871. 
Fall. 
Internal angular splint. 
October 30. 1871. 
Good. 
Fracture occurred one week before admission. 
5 
F. 
11 
American. 
January 29, 1872. 
Fall. 
Upper third. 
April 1. 1872. 
Good. 
t> 
31. 
37 
Irish. 
June 7, 1872. 
Machinery accident. 
Lower and middle thirds. 
Internal angular and exter- 
July 1, 1872. 
Good. 
Fracture a little more than one week prior to admis- 
nal splints. 
sion. 
7 
31. 
68 
American. 
February 25,1873. 
Fall. 
Left, two in. above elbow. 
Plaster Paris at angle. 
May 4,1873. 
Good. 
8 
M. 
15 
Irish. 
September 24, 1873. 
Fall on elbow. 
External condyle, involv- 
internal angular splint. 
November 19,1873. 
Good. 
Seven-pound weight, November 5th, to hand to over- 
ing joint. 
come flexion. November 10th, ten pounds. 
9 
M. 
25 
Colored. 
August 17, 1874. 
Fall from scaffold. 
Left, internal condyle. No 
Internal angular splint. 
October 27,1874. 
Di“d. 
Pyaemia. Abscesses, both elbows. 
crepitus. 
10 
M. 
37 
American. 
September 3, 1874. 
Fall. 
Internal condyle (?). No 
Rectangular splint. 
September 19,1874. 
Good. 
crepitus. 
11 
M. 
21 
Irish. 
November 17,1874. 
Fall. 
Left, internal condyle. 
Internal angular splint. 
December 21,1874. 
Gonl. 
Motion almost perfecf. Accident four days before 
Crepitus. Pain. 
. admission. 
12 
31. 
31 
Irish. 
January 5, 1875. 
Fall. 
Right. 
Ant., post., and lat. splints. 
February 18, 1875. 
Good. 
13 
31. 
34 
Engli h. 
June 14, 1875. 
3Iachinery accident. 
Right, upper third. 
L tteral splints. 
July 19,1875. 
F’racture of ulna and radius two inches from wrist. 4 
Fractures at the Rhode Island Hospital. 
FRACTURES OF THE 
I UPPER EXTREMITY (continued). 
Sex. 
Age. 
Nativity. 
Date of Admission. 
Cause. 
Definition of Fracture. 
Treatment. 
Date of Discharge. 
Result. 
Remarks. 
14 
M. 
American. 
November 18, 1875. 
Fall. 
External condyle. 
External angular splint, 
January 2,1875. 
Good. 
Discharged for drunkenness before treatment ended. 
int. below elbow. 
Fracture of ulna “ above corotioid process.” 
15 
F. 
42 
Irish. 
December 9,1875. 
Lower third. 
Plaster Paris. January 9th, 
February 7,1875. 
Good. 
inter, and exter. Splints. 
16 
F. 
70 
English. 
January 1, 1876. 
Fall. 
Left. High up. 
Plaster Paris. 
February 26,1876. 
Good. 
17 
M. 
42 
French Cana- 
June 8, 1876. 
Fall. 
Left. External and internal 
Internal angular splint. 
July 8,1876. 
Good. 
dian. 
condyles. 
ELBOW-JOINT. 
1 
M. 
23 
American. 
January 25,1869. 
Railroad accident. 
Left, compound. 
Resection. 
June 16,1869. 
Wound nearly 
Left without permission. Said to have been ampu- 
healed. 
tated subsequently. 
2 
M. 
28 
German. 
July 5, 1S76. 
Railroad accident. 
Right, comminuted. 
Internal ang. splint. July 
February 2,1877. 
Good. 
Compound comminuted fracture of right tibia and 
12th, straight splint. 
' 
fibula. 
RADIUS AND ULNA. 
1 
M. 
8 
American. 
December 12, 1870. 
Fall. 
A little above wrist. 
Ant. and post, splints. 
January 3, 1871. 
Good 
2 
M. 
27 
American. 
April 7, 1871. 
Machinery accident. 
Radius, lower part. Ulna, 
Bond’s splint. 
May 15,1871. 
Good. 
Lacerated wound wrist. 
December 17,1873. 
upper part. 
3 
M. 
14 
American. 
Fall. 
Right, middle arm. 
Straight splints; plast. Paris. 
January 15. 1874. 
Good. 
4 
M. 
34 
English. 
June 14, 1875. 
Fall. 
Right, two inches above wrist. 
Light side splints. 
July 14, 1875. 
Fracture right humerus (No. 13). Discharged for 
drunkenness before treatment ended. 
5 
F. 
15 
Irish. 
January 12, 1878. 
Fall. 
Left, middle and lower thirds; 
Ant. and post, splints. 
February 12,1878. 
Good. 
Union and position good. 
transverse. 
6 
M. 
13 
Pole. 
June 4,1878. 
Machinery accident. 
Just below elbow. 
Straight ant. splint. 
August 17,1878. 
Good, 
7 
M. 
19 
Irish. 
September 23, 1878. 
Machinery accident. 
Ant. and post, splints. 
» 
October 10,1878. 
Discharged at request. 
RADIUS. • 
1 
M. 
12 
American. 
October 13,1868. 
Fall ton feet. 
Right lower end, carpus driven 
Ant. and post, splints. 
October 25,1868. 
Good. 
backward. 
2 
M. 
52 
American. 
November 5, 1868. 
Fall. 
Left lower end. 
Ant. anil post, splints. 
December 18,1868. 
Good. 
3 
1'. 
34 
Irish. 
February 10, 1872. 
Fall. 
Guiles. 
Bond’s splint, short dorsal. 
Pistol-shaped splint. 
March 27,1872. 
Good. 
4 
F. 
55 
Irish. 
February 2, 1876. 
Fall. 
Right, Colles. 
March 28,1876. 
Good. 
5 
M. 
52 
American. 
April 4, 1877. 
Fall. 
Colles. 
Pasteboard splints. 
May 14,1877. 
Good. 
Good motion, radius straight. 
6 
M. 
45 
Nova Scotian. 
May 4, 1877. 
Fall. 
Just below tubercle. 
Int. ang. splint. 
July 3,1877. 
Good. 
7 
M. 
29 
Irish. 
May 14,1878. 
Blasting accident. 
Right, Codes. 
Ant. splint. 
June 29,1878. 
Good. 
Dislocation left wrist. Comp, fract. third finger right 
hand. Loss of second finger of left hand, with 
first metacarp. Face and eyes burned with powder. 
ULNA. 
1 
M. 
15 
American. 
January 13, 1872. 
Fall. 
Olecranon. 
Plaster Paris (straight). 
March 30,1872. 
Good. 
Abscess over eye, February 20. 
2 
M. 
65 
Irish. 
July 11, 1872. 
Machinery accident. 
Bond’s splint and short dors. 
August 13, 1872. 
Good. 
3 
1'. 
41 
American. 
April 3, 1873. 
Fall from window. 
One inch below elbow. 
Pasteboard splints. 
May 9,1873. 
Good. 
4 
F. 
18 
Irish. 
April 19, 1873. 
Railroad accident. 
Straight splint. 
May 10,1873. 
Good. 
No crepitus; preternatural mobility. 
5 
M. 
33 
Irish. 
August 7, 1874. 
Ilorse-car. 
A little above middle. 
Extern, and intern, splints. 
September 7,1874. 
Good. 
6 
M. 
30 
Portuguese. 
November 3,1875. 
Blow. 
December 8,1875. 
Good. 
Accident some time before admission, and treated in 
November 18,1875. 
out-patient department. 
7 
M. 
— 
American. 
Fall. 
Left, “above coron. process.” 
Int. splint and ext. ang. 
January 12,1876. 
Good. 
Fracture condyle hum. (14) 
8 
M. 
13 
'Scotch. 
May 16, 1878. 
Fall from 3d story. 
Left. 
May 16,1878. 
Died on admis. 
Depressed fracture skull. Compound dislocation 
right radius. Fracture right tib. and fib. 
FRACTURES OF 
THE LOWER EXTREMITY. 
FEMUR. 
* 
Simple 
(1. 
) Neck op Femur. 
1 
M. 
79 
Irish. 
February 27,1872. 
Fall. 
Ext. and count, ext. March 
June 26,1872 
Unrelieved. 
One inch shortening; bear no weight. 
27, Plaster Paris. 
2 
M. 
40 
Irish. 
April 19, 1872. 
Fall. 
Ext. 25 lbs.; long side splint. 
May 7,1872. 
Good. 
No shortening ; union firm. 
3 
F. 
53 
English. 
December 19,1872. 
Fall on ice. 
Right. 
Weight and pullevs; re- 
April 4,1873. 
Good. 
60 
moved February 1. 
4 
M. 
Irish. 
December 25, 1872. 
Fall on ice. 
Long splint, Jan. 5, weight 
March 25,1873. 
Good. 
Erysipelas face, March 2. 
and pulleys. 
5 
M. 
21 
American. 
April 21, 1873. 
Thrown from stage. 
Buck’s ext. April 26, nlas- 
April 29,1873. 
Left without permission. 
ter Paris. Fractures at the Rhode Island Hospital. 
5 
6 
M. 
61 
English 
July 29, 1873. 
Fell off a load. 
One inch shortening. 
Buck’s ext. 15 lbs. Aug. 1, 
Plaster Paris. 
September 26,1873. Shortening J to 
J inch. 
Accident happened a week before admission. Dis- 
charged, walking with one crutch. Crepitus on ro- 
tation. 
7 
M. 
17 
Irish. 
November 29,1873. 
Fall. 
No shortening; eversion. 
Ext. and counter ext. Bed 
raised. Feb. 27, Plast.Par. 
March 17,1874. Shortening | in. 
Left without permission. Fell again May 29, and re- 
admitted. See No. 10, below. 
8 
F. 
56 
Irish. 
February 27,1875. 
Fall. 
R. Extra capsular. 
Sand bags. Buck’s ext. Re- 
moved March 8. 
April 24,1875. Shortening, 
March 10, J inch 
9 
F. 
75 
Irish. 
January 30,1877. 
Fall. 
One inch shortening. 
Buck's apparatus, 7 lbs. Re- 
moved March 28. 
April 28,1877 
Ligam. union, so that she can move trochanter in arc 
of a circle. 
10 
F. 
72 
Irish. 
July 9,1877. 
Impacted. 
Buck’s apparatus. 
(2.) Shaft. 
July 23,1877. Discharged. 
Entirely unmanageable, remov’g dressings frequently. 
1 
M. 
69 
American. 
January 8, 1870. 
Thrown from wagon. 
Left oblique ; upper and mid- 
dle thirds. 
Buck’s extens. 
February 26,1870. Union firm. 
Removed by friends. 
2 
F. 
65 
American. 
November 5, 1870. 
Fall. 
Lower third. 
Buck’s apparatus. Dext., 
February 17, 1871. 
April 13,1871. Good. 
Fracture existed two weeks before admission ; had not 
been diagnosed. 
3 
M. 
26 
Irish. 
February 10,1871. 
Fall. 
Just above knee. 
Buck’s extens. Plast. Paris, 
March 12. 
April 21, 1871. Good. 
4 
M. 
21 
American. 
November 2,1871. 
Railroad accident. 
Left, comminuted. 
November 2,1871. Died in few hrs. 
Compound fracture right femur. 
5 
M. 
11 
Irish. 
November 13,1871. 
Fall. 
Middle third. 
Modified Liston’s splint. 
January 11, 1872. Good. 
Union firm. 
6 
M. 
9 
American. 
July 15, 1873. 
Run over. 
Left, middle, transverse, two 
inches shortening. 
Buck’s 10 lbs. July 22, 
plast. Par. with strips. 
August 30, 1872. Good. 
7 
M. 
50 
Irish. 
August 21,1873. 
Knocked down by 
pole. 
Left, middle, and at junct. 
middle and upper thirds. 
Buck’s. September 15, plast. 
Paris; Oct. 7, rem’d ; Oct. 
13, long side splint; ext. 
and count, exten., No- 
vember 22, removed. 
February 27,1874. Good. 
September 15, half inch shortening. October 13, fell 
and broke thigh again in same place. 
8 
M. 
— 
Irish. 
October 4, 1873. 
Pole fell on him. 
Lower third ; one and a half 
inches shortening. 
Buck’s 20 lbs. October 21, 
straight splint. 
January 6,1874. Good. 
Shortening, one inch. 
9 
M. 
37 
Nova Scotian. 
October 7,1873. 
Staging broke. 
Both, lower thirds, left half 
inch shorter. 
Buck’s 14 lbs. 
December 16,1873. Good. 
Fracture occurred week before admission. November 
14, both legs equal length ; union firm. 
10 
M. 
8 
American. 
March 6,1874. 
Fall. 
Left, two inches shortening. 
Plaster Paris. March 24. 
Buck’s ext. 
March 26,1874. 
Removed by friends. One inch shortening; compli- 
cated fracture lower jaw, November 6. 
11 
M. 
17 
Irish. 
May 29,1874. 
Fall. 
Left, two inches shortening. 
Buck's 30 lbs. 
August 14,1874. Good. 
June 26, quarter to half inch shortening. Same case 
as No. 7, previous section. 
July 1, no shortening. 
12 
M. 
22 
Swede. 
June 2,1874. 
Fall from staging, 
three stories. 
Right, middle third, one and 
three quarters inch short- 
ening. 
Plaster Paris, flannel mould. 
June 12, Buck’s 14 lbs.; 
incr’sed June 18 to 29 lbs. 
August 13,1874. Good. 
13 
M. 
37 
American. 
August 11,1874. 
Fall from staging. 
Right, oblique, one inch 
shortening. 
Buck’s ; 28th, Dessault’s 
splint; Sept. 4, Buck’s. 
Day’s side splint; exten. on 
foot piece; short ant., 
post., and intern, splints. 
Jan. 1, plaster Paris. 
October 15,1874. Good 
September 12, one inch shortening. 
14 
M. 
19 
Irish. 
November 28,1874. 
Heavy plate boiler 
iron fell on him. 
Right, middle, and lower 
third, half inch shortening. 
April 5,1875. Good. 
February 22, fell and refractured thigh. March 30, 
can walk without crutches. Complicated on admis- 
sion, compound dislocation internal cuneiform left 
.foot. Wound one inch long. Sutures. Bone forci- 
bly replaced. Feb. 8, wound healed. 
15 
M. 
27 
Irish. 
July 20, 1875. 
Bank fell on him. 
Right, lower third. 
Buck’s; 22d, double inclin’d 
plane exten. from knee. 
Aug. 31, plast. Paris ; Sept. 
7, Dessault’s splint. 
November 17,1875. Good. 
September 18, half inch shortening. 
16 
M. 
28 
Irish. 
August 17, 1875. 
Fall. 
Left, lower third, two inches 
shortening. 
Ant., post., and lat. splints. 
August 19, 1875. Death. 
Died suddenly ; no cause found. 
17 
M. 
48 
English. 
July 25,1876. 
Fall. 
Right, middle, oblique. 
Day’s splint. Aug. 24, plas- 
ter bandage. 
November 8, 1875. Good. 
One eighth inch shortening. 
18 
M. 
38 
Canadian. 
September 21, 1876. 
Staging broke ; fell 
fifteen feet. 
Right, upper third, oblique. 
Dessault’s ; Oct. 15, plaster 
Paris 
November 11, 1876. Good. 
Accident eleven days before admission. Oct. 3, three 
quarters inch shortening. Disch’d at own request. 
19 
M. 
23 
Irish. 
December 2,1876. 
Struck by bale of 
cotton. 
Little above middle. 
Dessault’s ; .Tan. 20, Buck’s 
ext. Feb. 4, removed. 
March 30, 1877. Good. 
20 
M. 
28 
Canadian. 
April 23,1877. 
Struck by large block 
granite. 
Left, middle third. 
Buck’s; May 31, removed; 
good union ; apposit. per- 
fect. June 10, outward 
curve, coapt. splint reap- 
plied. July 18, fell and 
refractured it. Buck’s ; 
11th, plaster and extens. 
October 6, 1877. Good. 
September 11, one third inch shortening. 
21 
F. 
40 
American. 
July 7, 1877. 
Fall. 
Comminuted, lower third. 
Buck’s; Sept.5,plast. Paris 
above knee. 
September 22,1877. Good. 
September 16, measured, no shortening discovered. 
22 
M. 
21 
Irish. 
August 15,1878. 
Rock fell on him. 
Right, middle third, trans- 
verse. 
Buck’s 12 lbs. Sept. 28, plast. 
Paris down to knee. Oct. 
22, two thin splints. 
November 6, 1878. Good. 
September 28, half inch shortening. Discharged, 
walking well without crutch or cane. 
23 
F. 
80 
Irish. 
September 21,1878. 
Fall. 
Right, just below trochanter. 
Buck’s ; eight pounds. 
September 24,1878. Unrelieved. 
Removed by friends. 6 
Fractures at the Rhode Island Hospital. 
FRACTURES OF THE LOWER EXTREMITY (continued). 
Sex. 
Age. 
Nativity. 
Date of Admission. 
Cause. 
Definition of Fracture. 
Treatment. 
Date of Discharge. 
Result. 
Remarks. 
• 
FEMUR. 
Compound. 
1 
M. 
21 
American. 
November 2,1871. 
Railroad accident. 
Right femur; with commi- 
Died. 
In a few hours. 
nuted fracture left femur. 
2 
M. 
12 
American. 
February 8, 1874. 
Railroad accident. 
Comminuted left femur. 
Died, 
Compound comminuted right tib. and fib. Two 
hours after admission. 
3 
M. 
31 
Canadian. 
April 9, 1874. 
Railroad accident. 
Comminuted right femur. 
Died. 
One hour after admission. 
4 
M. 
— 
Irish. 
September 24,1875. 
Railroad accident. 
Comminuted left femur; com- 
Died. 
Half hour after admission. 
pound commin’d fracture 
fourth finger left hand; lac- 
erated wound left arm from 
, 
shoulder to wrist. 
PATELLA. 
1 
M. 
23 
American.' 
September 16,1874. 
Fall. 
Stellate. 
Fig. eight bandage ; adhesive 
December 24,1874. 
Good. 
Fragments found in good position. 
strips ; post, splint. 
2 
M. 
30 
American.' 
August 14,1876. 
Fall. 
L. transverse. 
Post splint and elastic bands. 
September 6,1876. 
Good. 
TIBIA AND FIBULA. 
Simple. 
1 
M. 
35 
Colored. 
February 22, 1869.1 
Railroad accident. 
Left tib. junct. middle and up- 
Fract. box; March 30 dex- 
May 22,1869. 
Good. 
per third; fib. 3 in. lower. 
trine band. 
2 
M. 
25 
Irish. 
July 3,1869. 
Mach, accident. 
L. tibia 4 in. above ankle, 
Fract. box; weight and ex- 
August 28, 1869. 
Good. 
No apparent shortening. 
comminuted. Fibula 1 in. 
tension 5 lbs.; Aug. 10, dex- 
lower; transverse. 
trine band. 
3 
M. 
55 
American. 
July 22, 1870. 
Buried by falling 
L. ankle, tib. and fib., com- 
Fract. box and counter-ex- 
August 4,1870. 
— 
Discharged at own request. 
wall. 
minuted. 
tension. 
4 
M. 
50 
Canadian. 
July 27, 1870. 
Earth and stones fell 
Ununited fracture. 
Fract. box; Aug. 15, dex- 
October 13,1870. 
Good. 
Fib. united; tib. considered firm. Accident 68 
on him. 
trine band. 
days prior to admis. Disch. at own request. 
5 
F. 
40 
Irish. 
December 25,1870 
Fall. 
Oblique at middle of leg. 
Fract. box; Feb. 14, 1871, 
plaster Paris splint. 
March 30,1871. 
Good. 
6 
M. 
66 
Irish. 
March 4, 1872. 
Railroad accident. 
Just above ankle 
Plaster Paris ; Anril 2, dex- 
June 7, 1872. 
Good. 
Fracture occurred six weeks before admission; 
trine band. 
union. Treated with plas. Paris before admis. 
7 
M. 
20 
Irish. 
June 24,1872. 
Earth caved in. 
Fract. box; Aug. 6, dextrine 
September 5,1872. 
Good. 
Fractured five days before admission. 
band. 
8 
F. 
60 
Irish. 
April 19, 1873. 
Railroad accident. 
Three inches below knee. 
Fract. box; April 28, plaster 
May 11, 1873. 
Died. 
Complicated with fractured rib, No. 1. Death 
Earth fell on him. 
Paris. 
from pneumonia. 
9 
M. 
45 
Irish. 
October 11, 1873. 
Middle; shortening one half 
Fract. box ; Oct. 26, plaster 
December 15,1873. 
Good. 
inch. 
Paris band. 
10 
M. 
19 
German. 
November 6,1873. 
Caught by rope. 
Just above ankle ; shortening 
Fract. box ; Nov. 21, plaster 
January 12,1874. 
Good. 
one inch. 
Paris ; Dec. 12, gutta-per- 
cha splint. 
11 
M. 
32 
Irish. 
December 27, 1873. 
Earth caved in. 
Near knee ; shortening one in. 
Extension by wt. 12 lbs.; 
March 21,1874. 
Good. 
count, ext. Fract. box. 
Jan. 5, plaster Paris. 
12 
M. 
35 
Irish. 
January 10,1874. 
Kick. 
Four inches above ankle ; 
Plaster Paris, 23d, read- 
April 14,1874. 
Good. 
shortening one inch- 
justed ; Feb. 7, new splint. 
13 
M. 
29 
Irish. 
February 24,1874. 
Earth caved in. 
Left; middle, shortening three 
Plaster Paris ; March 10, re- 
April 4, 1874. 
Good. 
fourths inch. 
newed. 
14 
M. 
26 
Portuguese. 
May 15. 1875. 
Jumped off cars. 
Right; middle, oblique. 
Fract. box ; May 24, plaster 
July 24, 1875. 
Good. 
May 24, three eighths inch shortening. 
Paris. 
15 
F. 
63 
English. 
July 13,1877. 
Fall. 
Left; just above joint. 
Fract. box. 
August 11,1877. 
Left the hospital. Complicated with fractured 
ribs, No. 8. 
16 
M. 
39 
Irish. 
March 30,1878. 
Fall. 
Left: lower third, transverse. 
Plaster bandage, Little’s 
May 8,1878. 
Good. 
Left the hospital. Accident happened eight days 
method; May 6, pasteboard 
splints. 
before admission. Had delirium tremens. 
17 
M. 
13 
Scotch. 
May 16,1878. 
Fall from third story. 
Right. 
Compound. 
May 16,1878. 
Died on admis. 
Depressed fracture skull; compound dislocation 
right radius ; fracture left ulna. 
1 
M. 
28 
French Cana- 
September 15, 1869. 
Struck by falling 
Tibia, junct. upper and middle 
Fract. box. 
Sept. 21,1869. 
Death. 
Fract. spin, process of one lower dorsal vertebra, 
dian. 
beam ; back and 
thirds.; bone protruding ; 
No. 1; paralysis lower extremities and bladder. 
leg. 
fibula comminuted. 
2 
M. 
24 
American. 
January 31, 1872. 
Railroad accident. 
January 31,1872. 
Death in 3 hours. 
Penetrating wound thigh down to trochanter. 
3 
M. 
13 
American. 
February 17, 1872. 
Railroad accident. 
February 17, 1872. 
Died in J hour. 
Fract. four lower ribs near vertebral connection. 
4 
M. 
30 
Irish. 
May 6,1872. 
Barrel beer fell on 
Near ankle ; comminuted. 
Fract. box; June 4, dext. 
September 27,1872. 
Good. 
leg. 
band. ; removed July 1. Fractures at the Rhode Island Hospital. 
7 
M 
12 American. 
February 8, 1874. 
Railroad accident. 
Comminuted. 
February 8, 1874. 
Died in 2 hours. 
Compound comminuted fracture left femur. 
M. 
47 American. 
June 14, 1874. 
Caught in wagon 
Right, lower end comminuted. 
One half to one in. lower end 
August 24, 1872. 
Good. 
Good union anchylosis ankle; openings on both 
sides nearly healed. July 4, erysipelas in leg 
wheel. 
tibia removed ; plast. Paris 
with fenestra ; June 17, fr. 
box; July 15, side splints ; 
J uly 30, leg swung ; Aug. 
13, side splints removed. 
August 1, large slough from heel. 
Loss of toes of left foot. 
7 
M. 
57 
April 25.1876. 
Railroad accident. 
Right, comminuted. 
April 25,1876. 
Died in 1-J hours. 
8 
M. 
28 German. 
July 5,1876. 
Railroad accident. 
Right, comminuted. 
Fract. box; July 21, plas- 
February, 2, 1877. 
Good. 
Small pieces bone worked out. When discharged 
ter Paris ; Sept. 15, tibia 
sinuses still open ; could walk on leg. 
drilled, fibula firm; Sept. 
28, external splint; Oct. 8, 
internal. 
Leg dropped off. Bones removed higher up. 
9 
M. 
26 Irish. 
November 29,1876. 
Struck by a car. 
Comminuted. 
Plaster Paris; fract. box, 
May 28, 1877. 
Good. 
10 
M. 
24 American. 
August 20th, 1877. 
Railroad accident 
Comminuted, both legs. 
gangrene. 
August 20,1877. 
Died in 2 hours. 
Removed by friends. 
11 
M. 
25 Irish. 
August 2,1878. 
Kick. 
Middle third. 
Coaptation splints. 
August 23,1878. 
12 
M. 
12 English. 
August 14,1878. 
Jumping. 
Middle third ; wound in skin 
Long post, short external 
October 11, 1873. 
Good. 
Discharged at request. Dead bone could be felt. 
down to tibia. 
splint; Sept. 24, plaster 
Paris with fenestra. 
TIBIA. 
Simple. 
1 
M. 
30 American. 
June 15, 1871. 
Railroad accident. 
Right. 
Fracture box. 
August 24,1871. 
Good. 
Amputation left leg middle and lower thirds. 
2 
M. 
26 Irish. 
November 24,1871. 
Fall. 
Lower third. 
Splint and count, ext.; 30th, 
March 9,1872. 
Good. 
Plast. Paris removed Jan. 30; slough found not 
fully healed when discharged. 
fract. box ; Dec. 5, Smith’s 
ant. splint; Jan. 3, plast. 
Paris. 
3 
F. 
50 Irish. 
December 27, 1871. 
Run over. 
Oblique lower third. 
Jan. 8, plaster Paris. 
February 27,1872. 
Good. 
4 
M. 
34 Irish. 
September 17,1872. 
Iron fell on him. 
Two inches above ankle. 
Fract. box; Oct. 3, dextrine 
October 22,1S72. 
Good. 
splint. 
5 
M 
44 English. 
September 26,1872. 
Fall. 
Ext. and int. splints; Oct.2, 
February 27,1873. 
Good. 
fract. box; Oct. 11, dext. 
band. 
6 
M. 
51 Irish. 
March 18,1873. 
Run over. 
Plaster Paris; April 11, fe- 
May 23,1873. 
Good. 
Discharged for intoxication. 
nestra in consequence of 
ulcer. 
7 
M. 
18 Irish 
April 19,1873. 
Railroad accident. 
Two inches below knee. 
Fracture box; April 28, plas- 
June 11, 1873. 
Good. 
ter Paris. 
8 
M. 
35 Irish. 
June 9, 1873. 
Fall. 
Fract. box ; June 15, plaster 
August 9,1873. 
Good. 
Ulceration from bandage, fenestra. 
Paris. 
9 
M. 
23 Swede. 
July 6, 1873. 
Struck by spar. 
Right, near ankle. 
Fract. box ; July 11, plaster 
November 16,1873. 
Good. 
Fract. occurred at sea two days before admission. 
Paris ; July 19, fenestra 
Back injured. Paralysis bladder several days. 
10 
for wound; Sept. 23, side 
splints. 
Wound in ankle ; spic. bone discharg’d Aug. 4. 
M. 
21 Swede. 
August 5,1873. 
Jump. 
Just above ankle. 
Fract. box; Aug. 11, Plaster 
Paris. 
Plast. Paris. 
September 28,1873. 
Good. 
11 
M. 
40 English. 
February 14,1874. 
Run over. 
No shortening. 
April 3,1874. 
Good. 
' 12 
M. 
27 American. 
October 18,1875. 
Struck against stone. 
Right, middle. 
Fract. box; Nov. 8, later. 
January 17,1876. 
Good. 
13 
splints. 
March 1, 1876. 
M. 
5 American. 
December 22,1875. 
Fall. 
Lower third. 
Fract. box; Jan. 31, gutta- 
percha splint. 
Good. 
« 
December 13,1877. 
14 
M. 
21 American. 
November 23,1877. 
Bale cotton fell on 
Left lower and middle t thirds 
Fract. box; Nov. 29, side 
Good. 
him. 
transverse. 
splints. 
15 
M. 
45 Irish. 
July 15,1878. 
Mining accident. 
Left comminuted. 
Side splints. 
July 15, 1878. 
Died 8 h’rs aft- 
Depressed fracture skull; fract. lelt acromion. 
Compounds 
er admission. 
1 
F. 
42 American. 
December 17,51869. * 
Fall. 
Left. 
Fracture box; December 18, 
December 27,1869. 
Good. 
Occurred thirteen days previous to admission. 
dextrine bandage. 
2 
M. 
28 Canadian. 
July 12,1872. 
Thrown from wagon. 
Comminuted. 
Fracture box ; August 28, 
dextrine bandage; Septem- 
September 17, 1872.’ 
Good. 
ber 3, side splints. 
* 
FIBULA. 
Simple. 
1 
M. 
23 Irish. 
July 22,1870. 
’ Fall. 
Left; lower third. 
August 20,1870. 
Good. 
2 
M. 
20 American 
June 27,1871. 
Fall. 
Lower and middle third. 
Fracture box. 
July 17,1871. 
Good.; 
3 
M. 
42 American. 
December 20,1871. 
Fall. 
Pasteboard splint. 
February 7,1872. 
Good. 
4 
F. 
50 Scotch. 
April 13,1874. 
Fall. 
Right. 
Side splint; April 25, plaster 
May 25,1874. 
Good. 
Paris. 
5 
M. 
20 American. 
April 6,1877. 
Kicked 
“ Lower fifth.” 
Int. st. splint, and, April 10, 
May 14,1877. 
Good. 
ext. 8 
Fractures at the Rhode Island Hospital. 
COMPLICATED INJURIES, RAPIDLY 
FATAL (included in 
THE PRECEDING). 
Sex. 
Age. 
Nativity. 
Date of Admission. 
Cause. 
Definition of Fracture. 
Treatment. Date of Discharge. Result. 
1 
M. 
21 
American. 
November 2,1871. 
Railroad accident. 
Comp, fract. of right femur; 
— Died in a few hours. 
commin. fract. of left femur. 
2 
M. 
24 
American. 
January 31,1872. 
Railroad accident. 
Comp, fract. of leg, and pene- 
— 
— Died in three hours from admission. 
trating wound of thigh down 
to trochanter. 
3 
M. 
13 
American. 
February 17,1872. 
Railroad accident. 
Comp, fract. of leg, and fract. 
— 
— Died in half an hour. 
of four lower ribs near ver- 
tebral connection. 
4 
M. 
12 
American. 
February 8, 1874. 
Railroad accident. 
Comp, commin. fract. of left 
femur; comp, commin. fr. 
of right tibia and fibula. 
— Died two hours after admission. 
5 
M. 
31 
Canadian. 
April 9,1874. 
Railroad accident. 
Comp, commin. fracture of 
— 
— Died one hour after admission. 
right femur. 
6 
M. 
24 
Irish. 
April 10, 1875. 
Fall of heavy timber. 
Dislocat. of tenth dorsal ver- 
— 
— Died in nine hours from admission. 
tebra ; fract. of the eleventh 
dorsal vertebra, ribs, and 
acromial end of clavicle. 
7 
M. 
— 
Irish. 
September 24, 1875. 
Railroad accident 
Comp, commin. fract. of left 
— 
— Died in half an hour after admission. 
« 
femur ; comp, commin. fr. 
* 
of fourth fing. of left hand ; 
lacerated wound of left arm 
from shoulder to wrist. 
8 
M. 
67 
— 
April 26,1876. 
Railroad accident. 
Comp, commin. fract. of right 
— 
— Died in one and a half hours after admission. 
leg, toes of left foot. 
9 
M. 
24 
American. 
August 20, 1877. 
Railroad accident. 
Comp, comminuted fract. of 
— 
— Died in two hours after admission. 
both legs, — both bones. 
10 
M. 
13 
Scotch. 
May 16,1878. 
Fall from third story. 
Depressed fract. of skull be- 
— 
— Died on admission. 
hind left ear ; comp, disloc. 
of right radius; fract. of 
left ulna ; fract. of right 
tibia and fibula. 
11. 
M. 
45 
Irish 
July 15, 1878. 
Mining accident. 
Depressed fract. of skull; fr. 
Skull 
trephined; store ex- 
— Died eight hours after admission. 
of lett acrom. ; comminuted 
tracted from ant. fragment 
fract. of left tibia. 
between dura mater and in- 
ner table. Splints to leg. 
SUMMARY. 
Head. 
Cranium. 
Simple 3 
Compound 7 
— 10 
Maxillae. Both. Compound 1 
Inferior. Simple 8 
— 9 
— 19 
Trunk. 
Vertebrae . . 6 
Ribs 13 
Scapula 4 
Clavicle 13 
— 35 
Upper Extremity. 
Arm. Simple 17 
Elbow Joint. Compound 1 
Comminuted ... . . 1 
- 2 
Fore-arm. 
Radius and Ulna. Simple 7 
Radius 7 
Ulna 8 
— 22 
— 41 
Lower Extremity. 
Thigh. Neck ...... .10 
Shaft. Simple 23 
Compound .... 4 
- 27 
- 37 
Patella 2 
Leg. Tibia and Fibula. Simple . . .17 
Compound . . 12 
- 29 
Tibia. Simple 15 
Compound ..... 2 
- 17 
Fibula. Simple • 5 
— 51 
— 90 
185 
CLAVICLE. 
There were twelve cases, of which eleven were males 
and one female. Of these, one died from other serious 
injuries, and one left the hospital four days after ad- 
mission. The average residence of the remaining ten 
was thirty-six days. Of these cases, five were on the 
right side, four on the left, and three not given. In 
eight the fracture was in the outer third, in two, in the 
middle, one in the inner third, and one not stated. The 
treatment varied, the larger number being treated by 
the axillary pad and bandage ; Sayre’s method, with ad- 
hesive strips, was used in some cases. 
HUMERUS. 
There were seventeen cases, all of simple fracture 
of which thirteen were in males and four in females. 
The right humerus was broken in two cases, the left in 
six, and in nine it is not stated. Of seventeen, one died 
from intemperance, three days after admission, and the 
average residence of sixteen was forty-four days. As 
to the location of fracture, four were in the upper third, 
one middle third, two junction of middle and lower 
thirds, two lower third, two external condyle, three in- 
ternal condyle, one both condyles, and two not stated. 
In treating these cases, angular splints, external or in- 
ternal, were used in nearly all of those of the lower 
portion. Plaster of Paris was applied in three cases. 
RADIUS AND ULNA. 
Seven cases, of which six male and one female. Of 
these, two were of the right arm and one of the left, 
four not stated. Of these seven, one was discharged, 
at his own request, on the seventeenth day, and of the 
remaining six the average residence was thirty-seven 
days. As to location, one was in the upper third, one 
in the middle, one at the junction of middle and lower, 
two in the lower third, one in which the radius was 
broken in the lower and the ulna in the upper, and Fractures at the Rhode Island Hospital. 
9 
one not stated. Antero-posterior splints were chiefly 
used. 
Radius. Seven cases: five males, two females ; 
three of the right, one of the left, and four not stated. 
The average residence was forty-three days. Four 
were of Colles’s fracture, two of the lower end, and 
one just below the tubercle. Anterior and posterior 
splints were chiefly used. 
Ulna. Eight cases: six males, two females; two 
of the left, six not stated. Of the eight cases, one died 
immediately after admission from other severe injuries, 
and of the remaining seven the average residence was 
forty-one days. Of these fractures, one was of the 
olecranon, two of the upper third, one of the middle, 
and four not stated. In the case where the olecranon 
was fractured, the degree of separation on admission 
or discharge is not given. 
FEMUR. 
There were thirty-seven cases in all, of which ten 
were of the neck of the bone. Of these ten, there were 
six males and four females. In only one instance is 
the side given, and that was the right. Of these cases, 
one left, one was discharged for misbehavior early in 
the treatment, and one was discharged on the eight- 
eenth day with “ union firm,” so that in this case, pre- 
sumably, there was an error in diagnosis. Of the re- 
maining seven the average residence was ninety-one 
days. The amount of shortening on entrance is not 
stated in seven cases; one had no shortening, but ever- 
sion, and in two there was one inch. At the time of 
discharge the condition is not stated in five, and of the 
rest one had no shortening (not the same as on en- 
trance), one had one fourth inch, one one half to three 
fourths inch, one three fourths inch, and one one inch. 
The treatment was chiefly by Buck’s method, with the 
addition sometimes of sand bags and long splints. 
There were twenty-three fractures of the shaft of 
the femur, and of these twenty were males and three 
females. Of these, eight were of the right thigh, eight 
of the left, one of both, and six not stated. Two of 
these cases died, one on the second day after admission, 
and one in a few hours, with a compound fracture of 
the other femur. Of the remaining twenty-one cases, 
three were removed by friends, three fell while con- 
valescent, and refractured the thigh, remaining in the 
hospital respectively one hundred and twenty-eight, 
one hundred and thirty-six, and one hundred and ninety 
days, and for the remaining fifteen the average resi- 
dence was eighty-three days. On admission the amount 
of shortening is not stated in fifteen cases. Three had 
two inches, and one each had one and three fourths 
inches, one and one half inches, one inch, and one half 
inch. In the case in which both femurs were broken, the 
left was one half inch shorter. At the time of leaving 
the hospital the amount of shortening is not stated in 
nine cases; in three there was one inch, in one three 
fourths inch, in three one half inch, and in one each, one 
fourth to one half inch, one third inch, and one eighth 
inch; in three there is said to have been no shorten- 
ing. In the case of both femurs, the limbs were of 
equal length. Buck’s apparatus was very generally 
employed, followed by plaster of Paris. One case, ad- 
mitted November 28, 1874, was remarkable from the 
rare complication of a compound dislocation of the 
internal cuneiform bone, which was forcibly replaced, 
and the patient made a good recovery. 
There were four cases of compound fracture, all of 
which terminated fatally shortly after admission. 
PATELLA. 
There were two cases, both male, one stellate, and 
one of the left, transverse. The degree of separation 
is not given. The former was in the hospital ninety- 
nine days, and ihe fragments were “ fouud in good 
position ” shortly before leaving, the treatment con- 
sisting of a posterior splint, adhesive strips, and a fig- 
ure-of-eight bandage. The other was in the hospital 
but twenty-three days, and was treated by a posterior 
splint and elastic bands. 
TIBIA AND FIBULA. 
Of these there were seventeen cases of simple fract- 
ure, of which fourteen were males and three females, 
two of the right, six of the left, and nine not stated. 
Two died, one shortly after admission, and one from 
pneumonia following a fractured rib; two left the hos- 
pital ; and one was discharged at his own request on 
the thirteenth day. The average residence of the re- 
maining twelve was seventy-seven days. As to loca- 
tion, there were two in the upper third, one at the 
junction of the middle and upper, four in the middle 
third, seven in the lower third, and three not stated. 
In one case the fibula was fractured three inches, and 
in another one inch, below the tibia. The degree of 
shortening is given only in five cases on admission ; of 
these, three had one inch, one had three fourths inch 
and one had one half inch; it is given in only two in- 
stances on discharge, one having three eighths inch and 
one no shortening. The treatment in the majority of 
cases was by the fracture box, although plaster of Paris 
was used in a few cases. One case of ununited fracture 
was admitted, the fracture occurring sixty-eight days 
previous; he remained in the hospital seventy-eight 
days, and was treated by the fracture box and the 
dextrine splint. He was discharged at his own request, 
with “ the fibula united and the tibia quite firm.” 
There were twelve cases of compound fractnre of 
these bones, all in males; one was of both legs, two 
of the right, and nine not stated. Six died within a 
few hours of admission, and one was removed early 
in the treatment. Of the remaining five the average 
residence was one hundred and twenty-six days. The 
fracture box and fenestrated plaster-of-Paris bandages 
were chiefly employed. There are no statistics as' to 
shortening. 
Tibia. There were fifteen cases of simple fracture 
of this bone, of which fourteen were males and one 
female. Three were of the right leg, two of the left, 
and ten not stated. One died in a few hours after 
admission from a fracture of the skull, and of the re- 
maining fourteen the average residence was seventy- 
three days. As to location, six were in the lower 
third, one lower and middle, one middle, one upper 
third, and six not stated. The fracture box was chiefly 
used, but in a few cases plaster of Paris or side splints 
were applied. 
There were two cases of compound fracture of this 
bone, one male and one female, one of the left leg and 
the other not stated. One occurred thirteen days prior 
to admission, and after remaining ten days was dis- 
charged ; the other remained sixty-seven days. 
Fibula. There were five cases, four male and one 
female; one of the right, one of the left, and three not 10 
Fractures at the Rhode Island Hospital. 
of age, admitted November 14, 1871. Frequent efforts 
were unsuccessfully made, and in the last of these, the 
pulleys being in use, a fracture of the bone was pro- 
duced ; which bone is not stated. He, however, left 
the hospital after a stay of six weeks, with improve- 
ment in the motion of the joint. 
There was also one dislocation of the outer end of 
the clavicle in a man aged twenty-seven. 
CONCLUSION. 
Such are the somewhat meagre results that are on 
record for these first years of the existence of the 
hospital. Like all other institutions this has to grow 
into popular favor, and its second decennial will prob- 
ably witness a larger number of cases coming under 
treatment. At all events, this comparatively small 
number will, I trust, furnish some details of interest 
to the reader, and may be regarded as a simple con- 
tribution to the study of fractures. 
Providence, April 29, 1880. 
stated. The average residence was thirty-eight days. 
Three were in the lower third. 
DISLOCATIONS. 
There have been but eight cases of uncomplicated 
dislocations admitted to the wards of the hospital dur- 
ing the ten years covered by these tables. Of these, 
four have been of the thigh, all in males from twenty- 
six to forty years of age. Two were of the left thigh, 
and two not stated. Two were upon the dorsum ilii, 
one into the ischiatic notch, and one into the foramen 
ovale. All were reduced by manipulation according 
to Dr. Bigelow’s method. 
There were two dislocations of the humerus, one in 
a boy aged fourteen, “ forwards and upwards,” occur- 
ring two days before admission, and one in a man aged 
forty, upon the dorsum of the scapula, occurring eleven 
days before admission. Both were easily reduced. 
There was one dislocation of the radius and ulna 
backwards, of long standing, in a man thirty-six years