The resection of the wrist seen by Clémot, a surgeon of the navy during the First Empire.

In 1673 the naval hospital of Rochefort was founded by royal decree,and its school of naval surgery was created in 1689 by edict ofLouis XIV. From its opening to its closing in 1964, the school ofnaval surgery of Rochefort trained 6572 naval surgeons. Among theprofessors of this prestigious school, Jean Baptiste Joachim Clémot,professor of anatomy, skilful and inspired surgeon, described numeroussurgical techniques that have been since forgotten. Amongthese, the resection of the wrist was one of the first successes of thisdifficult surgery.We had access, at the former school of naval medicine of Rochefort,now a museum, to the original manuscript of the report draftedin 1806 by Clémot in which he described the resection of the wrist.In this museum we found the piece of resection which had beenpreserved. The report of his observation was studied and the pieceof resection X-rayed.This report mentions that Jean Prodeau, a 14-year old ship’s boyaboard the vessel of his royal majesty “the Lion”, was brought toClémot at the naval hospital of Rochefort in 1806 with an openfracture of the wrist. The lower extremity of the two bones of theforearm stuck out of the anterior part of the wrist. Clémot, afterfailure of an orthopaedic reduction, refused to amputate the hand,and attempted successfully the resection of the distal part of the twobones. The child was stretched out on a bed and immobilized withthe help of two assistants. Without any anaesthesia, Clémot performedthe resection of the two bones with a common saw, and thenreduced the deformation. The postoperative care consisted in a 15-day diet, a splint, and regular cataplasms. On the fortieth day a localsepsis was treated surgically by repeated incisions, then by theexcision of an osseous ulnar sequestration in the fourth month. Thewrist finally healed and after steam baths and rehabilitation, Clémotwas satisfied with the final result. However, Ollier, in a treatise onresection published years later, wrongly attributed this operation toSt Hilaire, one of Clémot’s competitors. He specified that this observation,then famous all over Europe, was wrongly considered asan articular resection.At a time when Dominique Larrey was famous for his amputationson the battlefield, and in spite of the absence of anaesthesia, radiography,osteosynthesis and asepsis, Clémot was one of the first surgeonsto perform the resection of the wrist successfully. He had themerit of giving a detailed description of his surgical technique.