Before the World War the treatment of fractures of the shaft of the femur was always regarded as somewhat difficult, and some degree of permanent disability following this injury was not infrequently observed. The chief causes of disability were faulty alinement of the fragments and shortening, the latter being especially common. Pearson and Drummond in "Fractured Femurs" emphasize this point when they quote from Treves's Surgical Anatomy, 1915 edition, "Recovery without shortening of the affected limb was the exception." It was also customary to regard the result as fortunate if union in good alinement was secured without more than an inch of shortening. The results obtained, therefore, left much to be desired.
Methods varied considerably in detail and in the type of splint employed, but most surgeons agreed on the fundamental principles of treatment: namely, the provision of traction and counter-traction. The former was obtained by the application of adhesive
ABBOTT LC. FRACTURES OF THE FEMUR: WITH SPECIAL REFERENCE TO THE TREATMENT OF UNUNITED AND MALUNITED CASES BY MANIPULATION AND CALIPER EXTENSION. Arch Surg. 1924;9(2):413–437. doi:10.1001/archsurg.1924.01120080181009
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