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October 26, 1940


Author Affiliations


From the Fracture Service of the Cook County Hospital. Dr. Fox is resident physician in the Fracture Service and Dr. Apfelbach is assistant professor of surgery, Northwestern University Medical School.

JAMA. 1940;115(17):1438-1439. doi:10.1001/jama.1940.02810430028009

Decubitus is a major problem of a fracture service having an annual turnover of 1,400 patients. In spite of prophylaxis, its incidence is such that it frequently over-shadows the original surgical condition requiring hospitalization. Bedsores often prevent open reduction.

The foreign and American literature offer little truly investigative work regarding etiology or prophylaxis. We here report a newly developed technic in the prophylaxis and treatment of decubitus.

A series of 232 cases were followed over a period of three months. The average age was 51 years. There were seventeen patients with fractured hips, from 60 to 95 years old, ten who were diabetic, six with fractured pelves, and one who had a compression fracture with paraplegia. Of the original fifty-five patients six had simple decubitus while twenty had deeply necrotic bed-sores (chart 1).

Pressure is recognized as the chief cause of decubitus. It occurs usually over the sacrum, buttocks and