Field medicine and strange treatments

[Dr_V]

It is well known that one of the few benefits the world got from WW2 was the development of new medical techniques invented in times of crisis that have proven very useful since than.
In the orthopedic branch of surgery one of the better known inventions was the Küntcher nail for long bones fractures. But this is a scientific discovery. There were some desperate cases when doctors in front line hospitals had to improvise in order to be able to treat their patients.

Least week, my father (he’s an orthopedic surgeon) operated an old man, WW2 veteran, for knee disease (arthritis). This patient had suffered a tibia fracture on the battlefield in 1943 and was operated in an overcrowded field hospital, with rudimentary anesthetic (ether) and an original fixation device. As they had run out of purpose-made nails, they’ve implanted a piece of a gun cleaning rod, cut and shaped to fit in. Amazingly, the fracture consolidated well, with only minor rotational defects and the patient never had any problems after that, my father discovered accidentally the unusual nail on the radiographic image.

You can say that man had more than a little luck, but the interesting part is that he said he wasn’t the only one to receive such “special” treating. Did anyone heard of other cases like that?
It’s interesting how the field surgeons achieved such good results in those conditions, considering the lack of antisepsis, the primitive antibiotics they had and the huge number of cases they were treating in great hurry.

[Florin]

QUOTE

...........There were some desperate cases when doctors in front line hospitals had to improvise in order to be able to treat their patients. ....................................................Did anyone heard of other cases like that? It?s interesting how the field surgeons achieved such good results in those conditions, considering the lack of antisepsis, the primitive antibiotics they had and the huge number of cases they were treating in great hurry.

I was teenager when I spent some days in the Municipal Hospital of Bucharest. Some other patients in the room were men in their 60's, and most of them saw military service on the Russian front.

One said he saw a young German surgeon operating the head of a soldier. The soldier was tied on a tree trunk, to keep his upper body vertically and the head accessible. If I got it right, the soldier had a wound deep to the brain, but he survived.

Well, I heard it. I don't know if we should believe it. Considering that in the Romanian Military Museum there is a skull of a woman who had a deep wound through the head bones, but she lived many years after (that was 5000 years ago), we should believe it.

Florin

[Dr_V]

Brain surgery is a very delicate job, but this if you want yhe patient to recover completely (both phisically and intelectually). Otherwise the brain can be "hacked" with the obvious result that the patient will probably remain with severe handicaps, but he'll live. If a surgeon knows the brain's anatomy, he should avoid a massive hemoragy (the brain's blood vessels have regular, known trajectorys). It remains of course the risk of infection, but it can be prevented quite easely.

As barbaric as it seams, brain surgery is sometimes performed with limited anesthesia (local + sedatives, the patient is constient). That's because the patient's reactions can tell the surgeon what brain areas is he affecting during the procedure. It's not painfull for the patient, as the brain doesn't hurts, only the scull, the skin above and the meningeus lears and these are anesthetised locally.

The patient can survive (with permanent dissabilities) an "improvized" brain procedure because the vital parts of the brain are small and located very deep. Almost all the upper cortex is used for skin sensibility, movement, senses (smell, hear, sight) and intelect and are "twin" areas on the 2 emispheres, each serving half of the body. So good size fragments can be removed without major consequences (depends of the exact location).

Of course, no modern brain surgey takes such risks.

[Florin]

QUOTE

Brain surgery is a very delicate job, but this if you want yhe patient to recover completely (both phisically and intelectually). Otherwise the brain can be \"hacked\" with the obvious result that the patient will probably remain with severe handicaps, but he'll live. ..................................................................

Your comments are very interesting.
I'll try to keep my brain far from any surgical scalpel

Florin

[dragos]

Some time ago, while browsing the photo archive of the military museum, I came across a shocking photo showing the effect of a mortar shell upon a human body. Actually, it was a shot of the coat of the soldier, which was hit from the back by the blast. The left part of the coat was torn apart and riddled, with dozens of small holes. In the caption it was inscribed that the soldier survived the wound, but he suffered multiple trauma, losing the left kidney and having the spleen broke IIRC.

[Dr_V]

That's very possible Dragos, if the soldier was hit only by the shrapnells and not by the full blast itself. There's a critical distance (for every projectile, bullet or shrapnell) at wich the projectile penretrates the body at high speed, the wound being about the size of that projectile, without a big exit hole or much internal damage. A bit closer or a bit further any projectile does much more dammage, ripping the organs apart as the kinethic energy converts into heat and shock-waves.

The story suggests that the shrapnels passed the body without generating much shock-waves. The spleen and kidneys are very frail and rarely can be sutured if they're hemoraging, so they're often removed if enjuried. But a stronger shock-wave would have blasted the left lobe of the liver as well and probably even the stomack, a fatal wound in 99.9% of cases.

Another possibility is that the soldier was hit only by the explosion and not by any shrapnell. Again an isolate spleen + kidney injury (the explosion of theese organs inside the apparently intact body) is possible, but I doubt that the patient would have survived.

[C-2]

My great grand father ,had a sever leg fracture in ww1.
He lost constience and was thouht to be dead.He spent a day and a half in a field before been found by a peasant.The peasant was some kind of a paramedic in his village ,and managed to reduce the fracture(with no anesthetic exept some made from plums..).My ggf lived till 1974 aged 92 when he died cause of eating poisoned mushrums.
He walked with a stick but could live a normal life and saw some action also in ww2.
Another example in general Dicesare,,who had a broken back.He was operate with great succes and is very well today at almost 88.