Blcnkins nf the. Guards operated on the next case, and has been good enough to send me the following notes of it: " Private Charles Monsterey, aged 24, third battalion adier Guards. Brought from the trenches at midnight with a severe shell wound on the outer side of the.initiation showed the thiirh-lxuie to be extensive it the upp -r part, in the situation of the trochanters and neck, t vren much commiii', surrounding mu-cles greatly lacerated. recognized as an appropriate case for flion, -n was performed half an hour after his arrival in camp. The worn: [tended in a longitudinal d Etenl nearly <t'<ivc inehes. and through at the junction f tinupp-t nf the shaft. The muscles weiv. aiifl the capsule divided.
It was int'-ndrd 1 nf the Ix.ne in the sn.-ket, but the was 80 CX! bl 1. it 1 MM lost diirin-tlie operation. Examination afterwards of the excised bone showed it to be fractured in fourteen pieces. The trochanter minor formed three, trochanter major three, shaft five, the neck three, besides numerous smaller fragments. The case continued to do well for the first three weeks; healthy granulations sprang up, both from the end of the divided shaft, and the surrounding cavity and acetabulum. At this period pain and swelling of the knee joint of the same limb supervened, the capsule of that joint became filled with purulent matter, the cartilages eroded, and he sank gradually, worn out with hectic symptoms, at the end of the fifth week, in spite of every effort to support him.
The case was doing remarkably well, and I had every hope of his recovery, until empyema came on." Staff-surgeon Crerar operated on the third case, a private of the first battalion of the Royals, who was wounded in the Greenhill trenches at mid-day on the 6th of August. The wound, in this case, was slightly posterior to the great trochanter, and was not larger than a shilling. It had been caused by a piece of shell, which, before it entered his thigh, had first struck a water canteen that hung by his hip. A comminuted fracture high up was clearly ascertained; but its exact position or extent was not defined previous to operation, although it was supposed to implicate the head and neck of the bone.