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The Ford Fracture

This Model T Touring is being crank started by a  man dressed in jodhpurs and riding boots. This horse associated dress is better seen in the picture enlargement.

Physicians of the early 20th century recognized new and varied forms of wrist fractures. The backfire, Ford, or Chauffeur's fracture, was "extremely common in these days of voluminous traffic" according to Harold C. Edwards who described 42 fractures sustained from the impact of the downward swing of the automotive crank handle. 

Before starting a Model T with the hand crank, you had to retard the spark - an action performed with a lever mounted on the steering wheel. If you forgot, as some did, you stood a good chance of breaking your arm or wrist if the engine "kicked back" as a result of backfiring. Doctor's often called this the 'Ford fracture.'

The crank handle should be cupped in the palm, rather than grabbed with the thumb over the top of the handle as the gentleman in the photograph is doing. That is so that if the engine does kick back, the rapid reverse motion of the crank will throw your hand away from the handle, rather than violently twisting the wrist. Most Model T Fords had the choke operated by a wire emerging from the bottom of the radiator where it could be operated with the left hand while cranking the engine with the right hand. Most cars sold after 1919 were equipped with electric starting reducing the source of this accident.

Check here to see the correct starting the procedure in more detail.