A Treatise on Fractures, Luxations, and Other Affections of the BonesDesault, P.-J. (Pierre-Joseph)
Science
A Treatise on Fractures, Luxations, and Other Affections of the Bones
Desault, P.-J. (Pierre-Joseph)
Dislocations; Fractures; Surgery
32. The consolidation or cure is here always more speedy than in the
preceding cases, where nature, with the same amount of means and
resources, has twice the quantum of labour to perform, and where she
supplies her deficiency of power, by the greater length of the time
which she employs. In general the bone is united by the twentieth or
twenty-fourth day.
33. When the fracture exists at the superior part of the radius, it is
essential, after the removal of the apparatus, to make the limb very
frequently perform all its natural motions. In such a case, indeed, the
parts sometimes swell, become stiff, and an anchylosis of the fore-arm
may be the consequence, as Ambrose Pare observes, in his book on
fractures, where he says he has seen many accidents of this kind. Galen
has remarked the same thing before him. The following case reported by
Jeo. Dol**, confirms the truth of it.
CASE II. Jane Rene was received into the Hotel-Dieu, in consequence of
a fracture of the upper extremity of the radius, produced by a fall
on that part, for which she was subjected to the treatment already
described (31). The apparatus being removed at the expiration of
twenty-five days, the consolidation was perceived to be complete.
The motions of pronation and supination were impracticable; those of
flexion and extension very much impeded. The patient was now ordered
to have the fore-arm moved daily, in these several directions, for
the space of an hour, and this space was even increased morning and
evening, notwithstanding the pains which, at first, accompanied the
exercise. On the eighth day pronation and supination could already
be performed in a small degree; they became more and more free, in
proportion as the exercise of the limb was longer continued; finally,
on the twenty-second day from the removal of the apparatus, the
patient was conducted, according to custom, to the amphitheatre, where
all the pupils witnessed the perfect freedom of the motions.
CASE III. A few days after this, a man, who had left the Hotel-Dieu
about eight months before, while under treatment for a similar
fracture, returned, to be the subject of a public consultation in
consequence of a different disease.
Desault, on interrogating him, learnt from him that the treatment for
the fracture had been continued at his own house (31), but that, when
the apparatus was removed, no motion had been impressed on the limb,
and that the surgeon had even kept it in a sling. The fore-arm was then
examined; it was half bent, constantly in a state of pronation, and
could not, by any force, be brought into a state of supination. The
motions of flexion and extension, were so limited as to be scarcely
sufficient for the common wants of the patient, who, under proper
treatment, might have been cured like the preceding one, as Desault
remarked to his pupils at the time.
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