Kuz Julian E
Michigan Hand Center, 1111 Leffingwell NE Grand Rapids, MI 49525, USA.
Clin Orthop Relat Res. 2004 Dec(429):306-15.
War, considered to be one of the greatest causes of human suffering, often spurs some of the greatest advances in medical treatments. In the United States, the Civil War was a catalyst for the development of trauma management, including general wound management, amputation techniques, triage, and transportation of wounded soldiers. The War, by necessity, also accelerated surgical knowledge and treatment of gunshot wounds of the extremities more than any previous event. The War also served as the impetus for the specialization of surgical skills, hospital systems, and medical data collection. Orthopaedic surgery, at the time of the War, was not as yet a recognized specialty in the United States. However, the Civil War played an important role in the specialty's heritage and the creation of specialty orthopaedic and prosthetic hospitals. Although many discoveries in the area of orthopaedic surgery were not discovered until the 20th century, many basic orthopaedic procedures and techniques were developed during this war that continue to be used today, including Buck's traction, plaster splints, and open treatment of contaminated wounds. The first recorded attempts at open reduction-internal fixation techniques for gunshot fractures occurred during the War. Resection arthroplasties, shell and bone fragment extraction, and various types of amputation were improved because of the large numbers of casualties.
战争被认为是人类苦难的最大根源之一，但它往往也会推动一些医学治疗方面的重大进步。在美国，内战是创伤管理发展的催化剂，包括一般伤口处理、截肢技术、伤员分类以及受伤士兵的运输。这场战争还必然地加速了外科知识以及四肢枪伤治疗的发展，其程度超过以往任何事件。战争也推动了外科技能专业化、医院系统以及医疗数据收集的发展。在内战时期，整形外科在美国尚未成为一个公认的专业领域。然而，内战在该专业的传承以及专门的整形外科和假肢医院的创建方面发挥了重要作用。尽管整形外科领域的许多发现直到20世纪才被发现，但这场战争期间开发了许多至今仍在使用的基本整形外科手术和技术，包括巴克氏牵引、石膏夹板以及污染伤口的开放治疗。战争期间首次有记录尝试对枪伤骨折进行切开复位内固定技术。由于大量伤亡，关节切除成形术、弹片和骨碎片取出术以及各种截肢手术都得到了改进。
