Case of Private Julius Fabry
Private Julius Fabry, K Company, 4th U.S. Artillery, age 38, was shot in the left knee at the battle of Deep Bottom, Virginia, on Aug.16, 1864. His leg was amputated just above the knee on the following day. The thigh bone became infected and Fabry's pain was treated with morphine for the next 6 years. Pus drained regularly from the infected bone. In 1870, the infected bone was remove at the hip joint. In 1878, Fabry reported no trouble with the stump, but he was unwilling to use an artificial limb. Fabry died in 1894.

Amputation

Surgeons frequently treated arm and leg wounds by amputating. The grisly wounds caused by bullets and schrapnel were often contaminated by clothing and other debris. Cleaning such a wound was time-consuming and often ineffective. However, amputation made a complex wound simple. Surgical manuals taught that an amputation should be performed within the first two days following injury. The death rate from these so-called primary amputations was lower than the rate for amputations performed after the wound became infected. Union surgeons performed nearly 30,000 amputations.

Patients undergoing amputation were first anesthetized. A tourniquet was applied above the site of the proposed amputation. The skin and muscle were then cut with amputation knives several inches above the fracture site. The muscles were pulled up to expose the bone. An amputation saw was used to cut through the bone. Once the cut was completed, large arteries were pulled out from the stump tissue with a tenaculum and tied off to prevent bleeding. The skin muscle was then released and the tissue sutured. Two types of amputation were commonly used. A circular amputation involved cutting straight through the skin to the bone and resulted in a stump that was circular in appearance. A flap amputation required the tissue to be cut leaving two flaps of skin that were used to create a stump. Fingers and other small bones were amputated using the smaller metacarpal saw.

Prosthetic limbs were designed and built to help amputees regain some of their former capabilities. Some of these devices were custom-made while others were mass-produced.

The Case of Private Columbus Rush
Private Columbus Rush, Company C, 21st Georgia, age 22, was wounded during the assault on Fort Stedman, Virginia, on March 25, 1865 by a shell fragment that fractured both the right leg below the knee and the left kneecap. Both limbs were amputated above the knees on the same day. He recovered quickly and was discharged from Lincoln Hospital in Washington on Aug. 2, 1865. In 1866, while being treated at St. Luke's Hospital in New York City, he was outfitted with artificial limbs.

The results of the double amputation.	Using his prosthetic legs, Rush could walk with the aid of two canes.

Excision

Surgeons treated some shoulder wounds with a technique known as excision, also termed exsection or resection. The fractured bone was removed, the tissues sutured, and the limb left to heal. Excision gave the patient limited use of the arm and usually full use of the hand. Prosthetic braces worn over the shoulder allowed nearly normal function of the limb for some patients.

The Case of Private J.P. Kegerreis
Private J.P. Kegerreis, Company B, 2nd Pennsylvania Heavy Artillery, was wounded at Petersburg, Va. on June 17, 1864 by a minie ball. The ball entered his neck, punctured his windpipe, and passed through his right shoulder joint and out his back. Keggereis was tagged for amputation at the field hospital but tore off the tag and crawled among the less seriously wounded. Three days later, while at City Point Hospital, his wound was treated and found filled with maggots. His neck wound healed in a month, but his shoulder wound was infected. In the winter of 1865, the infected bone was removed by excision. The wound healed slowly, and he was discharged in May of 1866. In December of 1867, a surgeon removed a large piece of bone from the joint and the bones of the arm later fused on a semi-flexed position. He was able to lift 135 pounds with his injured arm.