Orthopaedic surgery advances resulting from World War II.

Abstract

The United States' effort in World War II was of unprecedented scale in both human endeavor and cost. United States Army hospitals treated 599,724 patients who were wounded in action, and approximately 67.1% of them had extremity wounds1. In addition, 68,207 members of the United States Marines and 37,778 members of the United States Navy were reported as wounded in action2. As a result of the tremendous number of casualties, this war provided a catalyst for advancements in medical care. Advancements in the specialty of orthopaedic surgery came with a heavy price. Some lessons were hard learned in the hostile environment of the battlefield and were intensified by a paucity of medical supplies and limited experience. Other advances emerged from timely prospective analysis and retrospective review. We present a representative summary of major orthopaedic surgery advancements in fracture care, wound management, amputation rehabilitation, antibiotics, and leadership, all of which were the consequence of World War II and continue to influence patient care. External fixation was developed during the 1930s as a method to stabilize fractures3. During the early part of the war, American casualties treated with this technique in a stable environment had favorable outcomes. Shaar et al.4,5 treated patients (ninety-one closed fractures and seventeen open fractures) in the United States Navy with the Stader external fixator and reported good results. These results could not be duplicated, however, among war casualties treated overseas in an austere environment. Hampton6 reported that external fixation was used for a small number of patients in a relatively stable environment of general hospitals in the Mediterranean theater of operations. Of twenty-five patients with fractures that were treated with external fixation at the Seventeenth General Hospital in Italy, five (20%) had complications. The initial use of …