Buck’s Extension Saved Confederate Officer’s Leg

Confederate bullets felled Capt. Edward R. Washburn and Brig. Gen. Halbert E. Paine at the Civil War battle of Port Hudson, La.

Both were shot in the leg. Both languished on the battlefield all day.

Gurdon Buck, MD, was a military plastic surgeon during the Civil War.

Gurdon Buck, MD, was a military plastic
surgeon during the Civil War.

Image: National Library of Medicine

Paine lost his shattered limb. Doctors saved Washburn’s leg through an innovative new traction technique called a Buck’s Extension for its inventor, Gurdon Buck, MD, a famous New York City plastic surgeon.

Buck’s Extension “combined adhesive bandages with a weight and pulley system connected by an elastic band,” Ronald S. Coddington wrote in The New York Times.

Doctors still use the procedure.

Buck’s Extension was used in the New York Hospital, where he was on staff, and in Army general hospitals to treat fractures of the femur, according to the second volume of Ira M. Rutkow’s book, The History of Surgery in the United States, 1775-1900, Periodicals and Pamphlets: “Buck’s device applies tensile force on the leg by means of a tape on the skin; friction between the tape and skin permits application of force, which is mediated through a cord over a pulley, suspending a weight.”

The bullet that hit Washburn in the right leg broke the upper third of the femur and tore completely through his thigh, Coddington wrote. “An assistant surgeon removed a fragment of bone and lead from the wound, and placed Washburn in traction to prevent extreme shortening of the leg.”

Union assault

Washburn was an officer in the 53rd Massachusetts Infantry. His regiment was part of an ill-fated, pre-dawn Union assault on heavily-fortified Port Hudson on June 14, 1863. At the time, Port Hudson and nearby Vicksburg, Miss., were the only Confederate strongpoints left on the Mississippi River.

The Union Army commander, Maj. Gen. Ulysses S. Grant, was determined to capture both bastions. He led the bulk of his army against Vicksburg, the larger and stronger of the two enemy positions, while his other troops moved on Port Hudson. He ended up besieging both strongpoints, beginning in May 1863.

Vicksburg and Port Hudson crowned high bluffs furrowed with deep trenches and bristling with large cannons. Thousands of Confederate troops defended both towns.

Vicksburg and Port Hudson ultimately fell to Grant’s besieging troops; Vicksburg on July 4 and Port Hudson 5 days later.

Yet the June 14 assault on Port Hudson ended in bloody failure. Kept at bay by withering enemy fire, Union soldiers were not able to rescue Washburn and Paine until after nightfall. A blazing sun and lack of water had added to the suffering of the two wounded officers.

The surgeon who applied the Buck’s Extension to Washburn’s leg began with “half a pound and gradually increased the weight to 18 pounds,” Coddington wrote. “His body acted as the counterweight.”

Gradually, Washburn’s condition improved.

“On July 30, 1863, seven weeks after the wound occurred, the doctor described Washburn’s condition as ‘strong,’ and reported that his leg had shortened by only one-half inch,” Coddington wrote. “Washburn was discharged from the hospital and sent home to Massachusetts with a prognosis for a full recovery.”

Buck’s paper

Buck wrote about his extension in an 1863 paper titled “An Improved Method of Treating Fractures of the Thigh.” It included an illustration of the procedure in use on a patient.

The physician explained: “extension, maintained as it is by a weight and pulley, with elastic bands interposed, is continuous and self-sustaining; constantly antagonizing the contract of the muscles, thereby preventing the rough extremities of the bone fragments fretting the soft parts.” He added that “if applied immediately after the injury, as it may be, the spasmodic twitchings, which are so excruciating, are prevented, and the patient made comfortable from the outset.”

Although the Buck Extension saved Washburn’s leg, his health gradually failed. He returned to his insurance business in Worcester, Mass. and planned to go back to the Army after he fully recovered from his wound. “But his health was never fully regained, and he continued in rather a delicate condition until August 1864, when his wound again broke out, and the alarming indications of pyemia [blood poisoning] at once appeared,” First Lt. Henry A. Willis wrote in the 53rd Massachusetts regimental history book.

Washburn, who was born in Lancaster, Mass., volunteered for the Army in 1862. He was a company commander at Port Hudson. He died in Lancaster “after 10 days of intense suffering,” Willis wrote.

The author added that Washburn “had never belonged to any military organizations before the war, nor was there anything in his natural taste or inclination to lead him in that direction, but from motives of purest patriotism he entered the service of his country. As an officer he was dignified in bearing, courteous to all, and secured in the love and respect of his men, while he held them in strict discipline. His life was full of promise, and his death from the mortal stroke received one year before, was a great grief to a large circle of relatives and acquaintances. He had never married.”

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