A woman, aged 21, admitted to Roosevelt Hospital, Feb. 16, 1929, immediately after an automobile accident, had sustained a compound comminuted fracture of the left femur at the junction of the middle and lower thirds of the shaft with such extensive destruction of the soft parts and avulsion of the skin that there was little, if any, circulation below the site of injury. The muscles and fat were ground in dirt which I learned later came from the bridle path in Central Park.
The patient was in severe shock, and the first treatment was directed toward this condition. She reacted well, and in two hours the systolic blood pressure had risen from almost nothing to 110. She had already been given the usual prophylactic dose of 1,500 units of tetanus antitoxin. She was taken to the operating rooms, and under ether anesthesia the wound was carefully cleansed and debrided of