PRIMARY CLOSURE OF WOUND WITHOUT DRAINAGE IN USUAL COMPOUND FRACTURE OF LEG

The most common site of compound fracture is the leg, because of the unusually scanty covering of the fragments. The ideal treatment is that which prevents suppuration and converts the compound into a simple fracture. This has been accomplished rarely in civil life under favorable circumstances and occasionally, during the recent war, under most difficult conditions. These successful results were due partly to good treatment but chiefly to the particular nature of the causal accident or injury. In civil life, with which alone I am concerned, there is a marked difference in the prognosis of a case in which the fracture has been made compound by the protrusion through the skin of the sharp end of a tibial fragment and one in which a heavy, contaminated object has produced the fracture and the wound over it, thus devitalizing the neighboring soft tissues and carrying into the wound dirt and other