261. Land Mine: Amputation of Shattered Leg

Holcomb, Manuel, T/4 38012858 Age 27 A Co 120th Engs.
Injured 1600 hrs 24 Dec 44 Mine
Coll. Sta. 120th Med Bn 1630 hrs. Sulf. dressing M.S. gr 1/4
Clr. Sta. 120th Med Bn 1730 hrs.   T.T. 1 cc
57th Field Hosp. 1745 hrs. 24 Dec 44  

Gen’l condition on admission extremely poor. B.P. 64/48 P. 110. Multiple wds. of right thigh and leg. Right foot was almost off. Right femur was obviously fractured. Color was poor.

Diagnosis: 1) Mine wds., multiple pen and perf thigh and leg, right, sv; 2) Traumatic amp. incomplete foot right; 3) F.C.C. femur, middle third, right, sv; 4) Lac wds scrotum; 5) wd pen hand right.

Preop Rx

1745 hrs. B.P. 64/48 P. 110 500 cc blood. 500 cc plasma
1800 hrs.   P. 106 25,000 units Penicillin
1815 hrs. B.P. 80/50 P. 104  
1830 hrs. B.P. 90/50 P. 98  
1930 hrs.     500 cc blood. Xray revealed comminuted fracture of middle third right femur and severely comminuted fracture fibula right. Numerous large F.B.'s scattered throughout soft tissues of both thigh and leg.
2000 hrs. B.P. 70/30 P. 160 Plasma ui. N.S.G. 1000 cc
2030 hrs. B.P. 80/40 P. 160 Plasma ui
2045 hrs. B.P. 90/40 P. 160 Anesthesia Endotracheal E & O2. Blood 500
2130 hrs. B.P. 70/30 P. 154 Amputation leg
2200 hrs.   P. 128 turned on face. Blood 500 cc
2300 hrs. B.P. 70/30 P. 124 Blood 500 cc + 500 cc blood
2330 hrs. B.P. 54/20 P. 136 Turned on back--to Hawley table
2345 hrs. B.P. 60/20 P. 136 O2 internasal catheter
2355 hrs. B.P. 70/40   returned to ward.
Dec 25     500 cc blood
Dec 26     500 cc blood. Hematocrit 33.5

Pt. on back. Leg prepped and guillotine amputation thru proximal 1/3 done. Pt. turned on back and debridement of thigh wds. started. After the multiple wds were exposed and the extensive muscle damage was seen, it was obvious that amputation thru the middle 1/3 of the thigh was indicated. A debridement guillotine amp. was carried out therefore. Buttock wd and wd on anterior surface of thigh debrided. A large collection of F.B.’s was removed from the thigh. Skin traction with a single hip spica. 10 gms sulf to stump.

Dec 27 Evacuated in good condition.

Temple, Texas

To Capt. PA Kennedy
“ CR Brott

Dear Sir:

Here I am in Texas. Maybe you have forget me for its been so long since I was there. Sir I hope you can read my writing, I am not much of a guy to write a letter, but I’ll try my best to let you know how I am getting along. I am come along very good. I can jump around with crutches now. Befor I go on any farther I let you know who I am. I am one of your patients who you work on Dec 24th night Chief Holcomb the Indian boy.

I want to thank both of you, I really dont know how to really thank you for saveing my life. I wish to thank the nurses who help me while I was there. I can think of any more to say. So I guess I’ll now closed this note. With the best of my Luck to both of the capt’s and all your staff of hosp.

I’ll sign off as one of your patients
W.Manuel Holcomb

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