By December 1914, overwhelming numbers of soldiers with infected
musculoskeletal wounds had filled hospitals in France and Britain. Frequently initial
management had been inadequate. In 1915, patients with orthopaedic wounds were
segregated for the first time when Robert Jones established an experimental
orthopaedic unit in Alder Hey Hospital, Liverpool. In 1916 he opened the first of
17 orthopaedic centres in Britain to surgically treat and rehabilitate patients. Henry
Gray from Aberdeen emerged as the leading authority in the management of acute
musculoskeletal wounds in casualty clearing stations in France and Flanders. Gray
had particular expertise in dealing with compound fractures of the femur for which
he documented an 80% mortality rate in 1914–15.
