The Case of the Clever Clinician With an Eponymous Injury

Albert Lowenfels, MD; Patrick Maisonneuve, Eng

Disclosures

July 08, 2009

Introduction

The patient was a 42-year-old male surgeon who was thrown from his horse to the street while riding one icy January morning. He experienced intense pain in the lower leg and foot, which was visibly deformed, and he recognized that he had sustained a serious compound fracture of his ankle. Not wishing to aggravate the injury, he wisely asked that a stretcher be improvised from a tavern door and 2 poles, upon which he was carried a distance of about 2 miles to his home. He then requested that a fresh cake of cow dung be placed on the wound as a poultice to provide warmth and comfort.[1] Today this dangerous procedure would be considered outrageous. He consulted with several specialists and eventually decided against amputation -- the recommended "best evidence" approach at the time. Despite an unorthodox conservative treatment plan, the ankle healed without incident.

While slowly recuperating over the course of the next year and a half, the patient initiated a productive medical writing career. After a complete, uncomplicated recovery, the patient resumed a full, active career treating patients with a wide variety of surgical problems. He also continued to write, and the thoughtful observations of the patients who he had encountered in his busy practice formed the basis of 14 widely read surgical monographs published over the next 3 decades. He continued to be active and productive until dying from pneumonia at age 74.

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