Connally Thoracic Operative Record
Dr. Robert Shaw’s operative record dated 11-22-63 documents Governor John Connally’s thoracic surgery in Room 220. The pre-operative and post-operative diagnoses were gunshot wound of the chest with comminuted fracture of the fifth rib, with post-operative findings adding laceration of the right middle lobe and hematoma of the lower lobe. The operation (thoracotomy, removal of rib fragment, and wound debridement) ran from 1335 to 1520 under general anesthesia administered by Dr. Giesecke. In the emergency room, a sucking right chest wound had been partially controlled by occlusive dressing, and a tube had been placed through the second interspace in the mid-clavicular line connected to a water-seal bottle to evacuate the pneumothorax and hemothorax. Examination revealed the entrance wound just lateral to the right scapula near the axilla, with the missile shattering approximately ten cm of the lateral and anterior portion of the right fifth rib before exiting below the right nipple. The ragged fifth rib ends were cleaned with a rongeur, and the pleural cavity was opened widely with a self-retaining retractor. Approximately 200 cc of clot and liquid blood were removed. The middle lobe had a linear rent with an open bronchus; this was repaired with running sutures of #000 chromic gut rather than removing the lobe. A laceration in the engorged lower lobe was closed with a single suture of #3-O chromic gut. Drains were placed in the second interspace midclavicular line and through a stab wound in the eighth interspace posterior axillary line, both connected to water-seal bottles. The diaphragm was found uninjured, with no evidence of mediastinal injury. Penicillin and Streptomycin were instilled into the wound before closure with chromic gut sutures and black silk skin sutures. Patient condition was satisfactory.
Connally Wrist Operative Record
Dr. Charles Gregory’s operative record dated 11-22-63 addresses Governor Connally’s orthopedic surgery for comminuted fracture of the right distal radius, open secondary to gunshot wound. The operation (debridement of gunshot wound and fracture reduction) ran from 1600 to 1650 under general anesthesia. The dorsal wrist entrance wound measured approximately two cm with tissue loss and contusion at margins, while the exit wound was on the volar surface about two cm above the wrist flexion crease. The wound was developed through muscles and tendons from the radial side to the bone, revealing a transected abductor pollicis longus tendon. Two small bone fragments were removed, along with various small bits of metal submitted to Pathology. Throughout the wound, particularly in superficial layers and tendon sheaths on the radial side, fine bits of cloth consistent with Mohair were identified, corresponding to the patient’s Mohair suit. After thorough debridement and irrigation, the volar exit wound was closed primarily with wire sutures, while the radial entrance wound was only partially closed and left open for drainage due to the Mohair contamination. The radial artery was found intact and pulsating normally; median and ulnar nerve integrity was presumed but not clearly established. A long arm cast was applied with skin tape traction to the thumb and index finger, with the limb suspended from an overhead frame postoperatively. A handwritten note adds a partial transection of the superficial radial nerve or extensor pollicis brevis.
Connally Thigh Operative Record
Dr. Tom Shires’s operative record dated November 22, 1963, documents the exploration and debridement of Governor Connally’s left thigh gunshot wound, running from 16:00 to 16:20 under general anesthesia. A 1 cm punctate missile wound was located over the juncture of the middle and lower third, medial aspect of the left thigh. X-rays revealed a bullet fragment embedded in the distal third of the femur. The wound was excised and the bullet tract explored, showing the missile coursed through subcutaneous fat into the vastus medialis. Necrotic fat and muscle were debrided down to the femur. The wound’s direction was judged not to be in the course of the femoral vessel, as it was distal and anterior to Hunter’s canal. Following complete debridement and saline irrigation, the wound was closed using three simple through-and-through stainless steel Aloe #28 wire sutures encompassing skin, subcutaneous tissue, and muscle fascia. The dorsalis pedis and posterior tibial pulses in both legs were quite good. This soft tissue repair was completed while the chest procedure had already concluded and the compound fracture debridement of the arm was still in progress.
The original text of this work is in the public domain. This page focuses on a guided summary article, reading notes, selected quotes, and visual learning materials for educational purposes.