Bone Graft

This is a pencil, ink and watercolour illustration by Mollie Lentaigne of a procedure undertaken at the Queen Victoria Hospital, East Grinstead during World War 2.

It depicts a procedure to restore a lost portion of shattered jawbone (mandible) with a bone graft. The required length of bone is being harvested from the left side of the patient’s pelvic rim (iliac bone). This is a convenient, near like-for-like replacement for the thickness, shape and type of missing bone. In this period, bone grafts like this would have been harvested from the pelvis using a hammer and chisels. It would then be attached to the two freshened and squared ends of jaw using the sutures drilled through the bone and depicted in the image being held by artery forceps. Later wires would be used instead of sutures. Post operatively, it is likely that the jaw would have been supported and rendered immobile by a frame attached to dental splints, or the upper and lower jaw wired closed.

Lentaigne’s illustrations are often more diagrammatic, and perhaps more informative than by comparison to some of her peers. She usually sketched quickly in theatre, dodging around the surgeons in order to see what they were doing. Later, she would have gone back over the lines, enhancing the drawing using inks and watercolour before adding annotations. This would have both formed part of the patient’s operative record and acted as a teaching resource for other surgeons.

This illustration is reproduced by kind permission of the East Grinstead Museum who hold the complete archive of Mollie Lentaigne’s works at the Queen Victoria Hospital.