255. Severe Shrapnel Wounds, Both Feet, Right Hand

Leeper, Charles F., Sgt. 33689304 Age 19 180th Inf.
Injured 0845 hrs. 18 Dec. 44 H.E.S.F.
1st Bn Aid Sta 180th Inf 0915 hrs.   M.S. gr. ¼
Coll Co C 120th Med Bn 0930 hrs.    
Clr Sta 120th Med Bn 1130 hrs.   T.T 1 cc
57th Field Hosp 1440 hrs.    

Gen’l condition on admission poor. B.P. 80/60. P 108. Able to move left leg and thigh and foot. No dorsales pedes or posterior tibial artery pulsation felt on left side.

Diagnosis: SFW multiple perf pen. Left leg, left foot, right hand. FCC right hand, 2nd, 3rd, 4th metacarpals. FCC os calcis, cuboid talus, cuneiform right foot. FCC 1st metatarsus left foot.

Pre-op Rx B.P. 80/60. P 180. Blood 200 cc. Got severe reaction to this. 500 cc plasma

1230 hrs. B.P. 120/70    
1530 hrs. B.P. 130/80 P. 94 200 cc plasma. 1000 cc 8% glucose in saline.
1700 hrs. B.P. 142/118   Atropine gr. 1/100 IV


1800 hrs. B.P. 114/70 P. 176 Anesthesia (N.S. & G running)
1830 hrs. B.P. 90/50 P. 144 Turned onto abdomen. Blood 500 cc
1900 hrs. B.P. 100/60 P. 134 Operation. Plasma unit 7
1930 hrs. B.P. 100/60 P. 130  
2000 hrs. B.P. 90/60 P. 134 Turned to back
2010 hrs. B.P. 100/60 P. 120 End operation

Pt. lying face down. Left popliteal space exploration through a mid line incision. Posterior femoral cutaneous nerve retracted laterally. Considerable extravasation of blood through tissues. Popliteal artery at bifurcation exposed. Anterior and posterior tibial arteries were found severed below the bifurcation of the popliteal artery. Both doubly ligated with silk. Accompanying veins were partially lacerated. Debrided and ligated with silk. Tibial nerve intact. There was hemorrhage beneath the sheath. Sheath was slit to “decompress” the nerve. Tourniquet removed. Both arteries pulsated vigorously to site of tie. Fasciotomy done on fascia of calf. Sulf. crystals dusted into wound. Wound partially closed. Complete closure would have made for too great tension. Wds of exit and entrance debrided. Minimal muscle damage. Wd of left foot debrided. Incomplete fracture of 1st metatarsal. F.B. removed through counter incision on plantar surface of foot. Left leg placed in posterior shell. Wd of right foot debrided. FCC of os calcis, talus, cuneiform, and cuboids. Short leg plaster cast. Wds of right hand debrided. Extensor tendon 4th digit and profundus flexor tendon index finger both completely lacerated. FCC 2nd, 3rd, 4th metacarpals. Short arm plaster cast.

Parasympathetic block. L1, L2, L3 novocain by Capt. Brown

Dec. 19 Parasympathetic block L1, L2, L3.
Dec. 20 Arrangements made for evacuation.
Dec. 21 Evacuated.
Feb 7, 1945 Letter received today. Had foot amputated just above ankle. Condition good when he wrote.
Back to All Surgical Cases