Stannington Sanatorium Project

Fractures

06/01/2015 by Stannington Sanatorium Project

Several of the patients from Stannington suffered from fractures, identifiable in the radiographic images.

Case Study 1

Patient 132/1951 is one such patient with a fracture to the distal right femur (thigh bone just above the knee joint). The patient’s file states that the fracture was caused by a fall in a corridor at the Sanatorium, where the individual was being treated for tuberculosis of the hip.

Figure 1 - HOSP/STAN/7/1/2/2046 (19) — Figure 1 – HOSP/STAN/7/1/2/2046 (19)

Figure 1 shows the fracture around the time of breakage, with displacement in alignment of the bone shown particularly in the anteroposterior image on the right.

Figure 2 - HOSP/STAN/7/1/2/2046 (21) — Figure 2 – HOSP/STAN/7/1/2/2046 (21)

Figure 2 shows the fracture whilst the patient was in plaster, identified by the thick white line surrounding the leg and the distorted quality of the image. Despite this poor quality, healing of the fracture can be seen in the slight bulge surrounding the initial breakage just above the knee, this is due to new bone growth during the remodelling stages of healing.

Figure 3 - HOSP/STAN/7/1/2/2046 (24) — Figure 3 – HOSP/STAN/7/1/2/2046 (24)

Figure 3 was taken some months after the trauma occurred. At this point the fracture is fully healed. Periosteal thickening (new bone growth) can be seen surrounding the location of the fracture, but it is unlikely the individual suffered any visible deformity or any mobility issues.

Case Study 2

Patient 90/44 was admitted to Stannington Sanatorium with tuberculosis of the bones and joints, specifically involving the spine. However, one of the radiographs was taken of their leg and identifies a fracture.

This is an oblique fracture, caused by indirect or rotational force, and is seen as a diagonal break to the bone. For this individual the fracture has affected the distal mid-shaft of the right tibia (lower leg), there appears to be no fibulae involvement.

In Figure 4, the image on the left is an anteroposterior (frontal) view of the tibia, where the fracture appears approximately two thirds of the way down the shaft of the bone. The right hand image is a lateral (side on) view of the tibia, however in Figure 4 the image on the right has been taken upside down showing the knee joint at the bottom of the image and the foot at the top, this can be seen the correct way round in Figure 5. The fracture is less clear in this image, identifiable by the slight curve in the lower part of the mid-shaft and a thin line showing the actual fracture through the bone.

Fractures and Tuberculosis

The individuals mentioned here were both being treated in Stannington Sanatorium for tuberculosis of the bones and joints, the first TB of the hip and the second Pott’s disease (TB of the spine). Tuberculosis of the bones is considered to cause weakening, which makes bones more susceptible to fractures and deformities. This increased susceptibility may, therefore, have contributed to the trauma causing the fractures in these cases.

It is also noteworthy that tuberculosis of the bone can also be contracted as a result of a fracture. Trauma, including fractures, can cause reactivation of latent bacteria already dormant within the individual at a focal site with disseminated seeding at the fracture site causing ‘TB complicated fractures’ (Sanjay et al, 2013).

Sources

Meena, S; Rastogi, D; Barwar, N; Morey, V and Goyal, N (2013). ‘Skeletal Tuberculosis following Proximal Tibia Fracture’ in The International Journal of Lower Extremity Wounds. http://ijl.sagepub.com/

Christmas in Stannington Sanatorium

19/12/201419/12/2014 by Stannington Sanatorium Project

Many of the children in Stannington Sanatorium were patients there for many years and would have spent several Christmases in the sanatorium away from their families. However, by all accounts great efforts were made by the staff and the local people to ensure that the children had an enjoyable time and didn’t miss out on the Christmas spirit. A report from the Morpeth Herald and Reporter of 1916 recounts the occasion as such:

A most enjoyable time was spent by the children at Stannington Sanatorium during the festive season. The rooms were gaily decorated for the occasion. On Christmas morning each child had his or her stocking well filled with toys and other suitable gifts. Special fare was provided.

We find similar accounts of Christmas in Stannington year after year throughout its operation. In1931 one of the children even described Christmas in her own words in the Sanatorium’s in-house children’s magazine. (see below) The magazine was created by the children themselves and contains many accounts of life in Stannington as well as some of the children’s own stories and poems.

Merry Christmas!

The Opening of Stannington : the First Children’s TB Sanatorium

12/12/2014 by Stannington Sanatorium Project

This week we have another guest post kindly provided by Dr Hazel Jones-Lee on behalf of Children North East detailing the establishment of the Sanatorium by the Poor Children’s Holdiay Association, the predecessor to Children North East:

The opening to patients on 15 March 1908 of the first Children’s Sanatorium in Great Britain at Stannington, Northumberland, was the culmination of a lengthy and tireless process by the Poor Children’s Holiday Association to improve the health and wellbeing of poor children by taking them out of the fetid air of the slums of Newcastle to the fresh air of the seaside or countryside.

Against a background of a national Fresh Air Movement, the PCHA’s founders, J.H.Watson & J.T.Lunn, began work in 1891, by taking 120 poor children for a day at the seaside in Tynemouth. Supported by the generosity of local people, this modest scheme expanded rapidly in 1894 to include country holidays of two-three weeks for those sickly or weak children who needed a longer period of fresh country air. By 1901, 8796 children a year went on day trips and 214 on country holidays: even so, it was soon clear that more was needed.

At least as early as 1903, the charity’s honorary physician, Dr.T.M.Allison, was calling for separate treatment to be available for the many consumptive children in the region, whose condition might be improved significantly by a prolonged stay in the country with “food and fresh air, shelter and sunshine’ , but who could not be sent into the country homes where they might infect others.

Accordingly, a small sub-committee of the PCHA was set up in 1903, and having established that there was no conflict with the focus of the existing County of Northumberland Sanatorium Committee chaired by Lord Armstrong, produced a plan at the AGM of 1904 proposing an interdependent three-part scheme: a farm on which to train rescued street boys who were not suited to city life; a Boys’ Convalescent home and finally a Children’s Sanatorium.

White House Farm at Stannington, with 173 acres, had already been found by the time the formal appeal for the £11,000 needed to fund the scheme was launched on 28 April 1905. Thanks to the generosity of one of the Charity’s supporters, Mr. Roland Philipson, £5000 was promised to add to the £3500 already available from the Trust Fund of another supporter, the late Mr.Robert Scott. These gifts, together with further donations or low interest loans, meant that the plans could go ahead. (Their magnitude is apparent if we compare the ‘pleasant surprise’ at the donation of £500 to a rival southern scheme felt by Rev. Edward Bedford of Great Ormond Street, writing to Dr. Allison on October 6, 1905 )

The tenant farmer, Mr. Atkins was retained as farm manager to train young boys in farm work to produce the high quality food and milk needed for the future Sanatorium and by the autumn, 6 boys were already at work, with a further 14 to follow.

The design of the Sanatorium was heavily influenced by Dr. Allison, who insisted on the inclusion of many French windows topped with fanlight arches to let in as much light as possible (see photograph below) and on occasion the architect, W.T. Spence, was asked to modify his design to suit. Finally, on October 5, 1907, the building was opened by the Duke of Northumberland and the first of the 50 patients admitted on March 15 1908.

There is an early example of the effectiveness of the simple regime of ‘food and fresh air, shelter and sunshine’ on the patient to the left of the photograph (left), taken in 1908. ‘M__J__S came to us from a Workhouse. She was in the last stages of consumption, having a cavity in both lungs, and was terribly wasted and thin. In a month’s time she put on 6 1/2 lbs. weight…her cough has now almost gone, all spitting has ceased, and we are hoping that instead of an early death there is a long and useful life before her.’

Between March 15 and October 31, there were 52 patients, of whom 10 left with the disease ‘arrested’, 2 very much improved, 3 went home to die and 37 remained under treatment. Given that there was no attempt to select only the ones most likely to thrive, this was a remarkable achievement. More was to follow.

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