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Thousands of lives were saved during the war by advances in medical science; Polly Groom, from Cadw, pays tribute to Welsh orthopaedic surgeon Hugh Owen Thomas (1834-91) and his invention of the Thomas splint - a device that went on to save thousands of lives during and after WWI...

"SPLINTS are required for the treatment of broken limbs. They are made of any unyielding substance, such as wood, bark, bundles of twigs, wire, rifles, bayonets, swords &c They should be bound to the limb with bandages, tapes &c". Field Service Pocket Book, 1914. General Staff, War Office.

World War I was not just fought on the battlefields.

As men were brought into casualty clearing stations shattered, bleeding and broken an equally ferocious battle was fought to save them.

The horrors of the war - the mud, the trenches and the artillery; trench foot, gas gangrene and shell shock - are well documented. Perhaps less well known are the advances in medical science and the pioneering medical treatments, still in use today, that allowed thousands of lives to be saved.

One remarkable family, whose origins are unknown, stand tall in this chapter of medical history. In around 1744, two small boys were washed up on a beach in Anglesey following a shipwreck.

One of them sadly died a few days later, but the other was adopted by a doctor.

The boy, named Evan Thomas, followed in his adoptive father's medical footsteps and specialised in bone-setting. He developed techniques never before seen in the UK.

However, it was his greatgrandson, Hugh Owen Thomas, who became known as the "father of modern orthopaedics".

Among a myriad of medical innovations, Hugh Owen Thomas is best known for the invention of the "Thomas splint".

In his lifetime the splint was used for the treatment of fractures, but it was Thomas' nephew, Robert Jones (1857-1933), who demonstrated the importance and life-saving potential of the Thomas splint amid the chaos of World War I. Originally from Wales, Robert Jones studied medicine in London and moved into orthopaedics, specialising in military surgery.

As the war relentlessly ground on, Jones became aware of needless deaths arising from injuries and compound fractures of the femur.

Trauma to the femur, the largest bone in the human body, caused severe shock and blood loss from the two broken ends of the bone moving and grating together.

Treatment was to splint the leg and evacuate the casualty to a clearing station for onward transport.

A Royal Army Medical Corps training manual from 1908 instructed that "A 'rifle splint' may be applied to a fractured thigh if an old-pattern rifle is used, see that the rifle is not loaded.

Place it on the side of the injured limb; butt in the armpit, trigger guard to the front".

However, a report by the British Medical Association in 1921 cited that the correct application of a rifle splint " is difficult, and when applied it has many disadvantages The mortality that attended cases of fractured femurs was, at this period, appallingly high". Very often, by the time the patient arrived at a field hospital, the damage was so severe that amputation was the only option.

Statistics from France in 1916 suggest that the mortality rate from this type of injury was, in fact, up to 80%.

The majority of those servicemen who died - around 50% - died in transit, or at casualty clearing stations before they ever reached a field hospital.

Believing in his uncle's invention, Robert Jones and Colonel HMW Gray, a colleague and a fellow surgeon, set out on an ambitious campaign to educate all medical staff in the use and application of the Thomas splint.

During the Battle of Arras - a period of six weeks of intense fighting in 1917 - over 1,000 compound fractures of the femur were recorded. All were treated with the Thomas splint and as a result, the mortality rate fell to around 16%, with only 5% dying at casualty clearing stations.

It is, of course, too simple to say that this huge drop in the death rate was due solely to the adoption of the Thomas splint.

Other advances in military surgery had also taken place, allowing complex and severe wounds to be treated more efficiently than ever before.

But it is worth repeating this remarkable statistic: if you suffered a broken femur in 1916, you had (approx) an 80% chance of dying; in 1917 this had been reversed, giving you more than an 80% chance of survival.

Gunner William Towers, writing of his experiences in 1917, was one of these survivors: 'I was one of fifteen drivers taking thirty horses to try and get ammunition through to our battery's guns just after we set off the Germans dropped a shell right by us and that was it. I remember going up in the air and landing on the floor. They took us to a hospital in Etaples and then put me in a bed and fitted me with a Thomas splint, a round wooden ring with iron bars and a footrest".

Among the most fiercely fought battles of the war were those which took place in tented hospitals, in clearing stations and on ambulance trains.

These were battles against dirt, disease and blood loss; battles to find new ways of treating new injuries on a scale never seen before.

World War I saw huge medical advances in fields like plastic surgery, anaesthesia and X-rays as well as orthopaedics.

It is impossible to say how many lives were saved by Hugh Owen Thomas's invention and by his nephew's introduction of the Thomas splint to the army.

However, it is clear that it transformed the treatment of a common injury. It was used to great effect during World War II, and a version of it is still in use today.

The darkness of World War I should not be forgotten, but neither should the shards of light within it.

RESTORATION GRANTS To mark the centenary of World War I, the Welsh Government Historic Environment Service (Cadw) is offering grants for the restoration and conservation of war memorials.

We have also produced a free guidance document - Caring for War Memorials in Wales - aimed specifically at helping communities care for these important monuments and safeguarding their longterm future.

The grant scheme application form and guidance is available on the Cadw website - gov.wales/ cadw For more information, please email cadw@wales.gsi.gov.uk or tel. 01443 336065.

NEIGHBOURS KILLED ON GREAT WAR BATTLEFIELD Our website, WalesOnline, features a great new tool which enables you to find family members or people who lived in your street who died in World War I. Today Jessica Flynn has searched for fallen servicemen who lived in Clive Street (continue next week). Here is who she found...

Clive Street John Marshall Isaac Son of William Marshall Isaac and Eliza Isaac, of 30, Clive Street, Grangetown, Cardiff. Born at Tetney, Lincs.

Rank: Private Regiment: Royal Engineers Age: 32 Date of death: 28-11-1918 Buried at: Port Said War Memorial Cemetery George Robert Porteous Son of George and Annie Porteous, of 218, Clive Street, Grangetown, Cardiff.

Rank: Private Regiment: Welsh Regiment Age: 18 Date of death: 5-5-1915 Buried at: Le Touret Memorial Philip Edward Jones Son of Mr and Mrs G Jones, of 100, Clive Street, Grangetown, Cardiff. Rank: Private Regiment: South Wales Borderers Age: 19 Date of death: 2-9-1918 Buried at: Vis-En-Artois Memorial H F Hayes Son of Henry and Emily Hayes, of 30, Clive Street, Grangetown, Cardiff.

Rank: Private Regiment: South Wales Borderers Age: 19 Date of death: 5-10-1918 Buried at: Tincourt New British Cemetery George Okey Tarr Son of Margaret Margate (formerly Tarr), of 143, Clive Street, Grangetown, Cardiff, and the late William Tarr.

Rank: Private Regiment: Durham Light Infantry Age: 19 Date of death: 27-5-1918 Buried at: Soissons Memorial Richard Jones Son of Mrs Jane Davies, of 7, Clive Street, Senghenydd, Cardiff. Rank: Private Regiment: Royal Defence Corps Age: 47 Date of death: 20-5-1918 Buried at: Caerphilly (Penyrheol) Cemetery G R F Rees Son of James Francis and Kate Elizabeth Rees, of 169a, Clive Street, Grangetown, Cardiff. Rank: Leading Seaman Regiment: Royal Naval Volunteer Reserve Age: 21 Date of death: 1-10-1918 Buried at: Sunken Road Cemetery, Boisleux-St.

Marc Awards: Military Medal Gunder Martinius (Martin) Espeland Son of Gunborg Espeland (nee Olsen), of 136, Clive Street, Cardiff, and the late Ole Larsen Espeland. Born at Newport, Mon. Rank: First Mate Regiment: Mercantile Marine Age: 30 Date of death: 24-3-1916 Buried at: Tower Hill Memorial

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Hugh Owen Thomas was the creator of the Thomas splint which |has helped save thousands of lives

Hugh Owen Thomas was the most active scientist in orthopaedic history. After breaking bones with the special key to correct broken bones, every limb was equipped with a special device to set it in required position
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Publication:South Wales Echo (Cardiff, Wales)
Date:Oct 28, 2015
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