Dr. Boyd: A 10-year-old girl was transferred to the Massachusetts General Hospital 36 hours after the automobile in which she was riding was struck by a tractor-trailer. She had sustained multiple injuries, including fractures through the surgical neck of the left humerus, the pubic ramus, the upper third of the left tibia and fibula, and the shaft of the right femur. These were splinted in the local hospital where she was initially treated. She was observed there until her condition was considered sufficiently stable that she could be transferred safely to the Massachusetts General Hospital.
The child was alert on admission. Her chest and abdominal examinations were within normal limits. Her blood pressure, pulse, and respirations were normal. Her hemoglobin was 6.6 gm/100 cc, and her urinalysis was normal. Stool guaiacs were negative. There was no evidence of intraperitoneal bleeding. She complained of tenderness over the right iliac crest.
Aufranc OE, Jones WN, Stewart WG. Remodeling of Multiple Fractures in a Child. JAMA. 1965;192(4):316–319. doi:10.1001/jama.1965.03080170044012
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