Artificial impaction in hip fracture. By F. J. Cotton, 1911

Frederic Jay Cotton (Fig. 1) was born in Prescott, Wisconsin, and educated at Harvard. After postgraduate study in New York and in Europe, he returned to Boston where he had an association with most of the important hospitals. In addition to great surgical talent, he also was an able administrator and medical politician. He is remembered primarily for his work on fractures, which is summarized in his book, Dislocations and Joint Fractures. The two editions of this book were illustrated by many of the author's own drawings. Cotton was a founder of the American College of Surgeons and served as Regent of the College as well as on the Committee on Fractures. He served in both the Spanish American War and World War I. In the summer of 1918, he was the Chief of Surgery at Walter Reed Army Hospital in Washington, D.C. This article on "Artificial Impaction in Hip Fracture" is an example of the application of a clinical observation to the development of an improvement in the care of patients. It had been known for a long time that impacted fractures of the neck of the femur healed, while displaced fractures did not. Cotton was the first to suggest that impaction, after reduction of the fracture, would be of value. Cotton published three additional papers on the use of impaction in the treatment of hip fractures, the last in 1938, the year of his death. Impaction of fractures of the neck of the femur after reduction of the displacement was rapidly incorporated into all of the procedures for internal fixation of such injuries.