Civil War Washington

CASE 689.—Private S. McNitt, Co. D, 4th Delaware, aged 23 years, was accidentally shot in the left leg, while in camp near Fairfax Court House, October 22, 1863. Surgeon D. S. Hopkins, 4th Delaware, reported: "The ball entered the limb posteriorly, at the junction of the upper with the middle third, passed directly through, causing a compound comminuted fracture of the tibia and fibula, and came out anteriorly, carrying with it fragments of bone. Comparatively slight hæmorrhage ensued, and that principally of a venous character. An examination showed that although extensive laceration of the soft parts had taken place, yet the arteries were found entire and pulsation at the extremities very perceptible. The leg was, therefore, placed in a horizontal position and loose spiculæ of bone were removed. Cold-water dressings were applied, and the patient was made as comfortable as circumstances would permit. Solution of morphia, two grains to an ounce of water, was administered at intervals of an hour until the patient became quiet. Next morning, October 23d, his system seemed to have suffered but little from the shock, he being comparatively comfortable. More minute examination revealed the fact that a number of pieces of bone still remained in the wound, which it was deemed necessary to remove. Accordingly a longitudinal incision was made along the crest of the tibia, the patient being under the influence of chloroform, and several spiculæ of bone were taken out varying in length from one to two and a half inches. The largest, from the crest of the tibia, included in its thickness much of the cancellated structure of the bone, as was the case with each piece removed; the average breadth was three-fourths of an inch. After the fragments had been removed the parts were coaptated, the limb was adjusted in a fracture-box, and cold-water dressings were reapplied. The patient was comparatively comfortable during the night." Some months after the reception of the injury the patient was admitted from the field into hospital at Alexandria, and lastly he was transferred to Tilton Hospital, Wilmington, where he was discharged June 19, 1865, Surgeon E. I. Baily, U. S. A., certifying to the shot fracture resulting in "necrosis and shortening of the leg." The Wilmington Examining Board, in describing the injury,December 6, 1871, reported: "Large and irregular cicatrices in front and rear of the limb; unnatural condition of skin; shortening of leg by an inch and a half. On account of occasional suppuration and exfoliation the limb has become much weakened and the convexity of it more marked. The disability is permanent in its present degree." After another inspection two years later the pensioner was exempted from further examinations. He was paid September 4, 1880.