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
1st, The fore-arm being placed in the position already directed (53),
two assistants retain it in that situation, while the surgeon applies
on its lower part the end of a roller five or six yards long, and about
four inches wide, wet with some discutient liquid, making with it, at
first, one or two circular turns to fasten it. Then ascending from
below upwards, he covers the whole of the fore-arm with oblique and
reverse turns moderately tight.
2dly, Having arrived at the joint, he stops, and makes an assistant
draw the skin of the elbow upwards, lest, being loosened and wrinkled
by means of the extension, it might get between the fragments, and
create an impediment to their reunion. Then, taking hold of the
olecranon, he draws it down towards the ulna, and passes behind it, as
a substitute for his fingers which have hitherto kept it firmly fixed,
a cast of the roller, which he brings from the anterior part of the
fore-arm above the elbow. Descending again with the roller along the
external side of the arm, and returning across the anterior part, he
pursues again the same course, so as to make the casts of the roller
lie on each other, and surround the elbow like a kind of figure of 8.
3dly, The surgeon proceeds now by oblique turns, to the upper part
of the arm, where he fixes the roller, by a circular turn, and gives
it into the hand of an assistant. He next applies along the arm and
fore-arm, a splint very strong, but a little bent at the place which
corresponds to the joint, in order to prevent too great an extension
of the limb: then, resuming the roller, he employs it, in a descending
direction, to secure the splint.
4thly, The apparatus being applied, the limb is placed on a pillow, so
as to be equally supported throughout its length, and is protected by
hoops from the weight of the bed-clothes.
57. To the bandage which we have just described, Desault added formerly
a strip of linen, to be placed all along the posterior part of the arm,
secured first at its upper end by circular casts, which began above;
this strip was secured afterwards by oblique casts, as far as to the
place where it met the olecranon, separated from the ulna. Here, the
surgeon quitting the roller, took hold of the bit of linen, and drew
it downwards, and along with it the circular casts of the roller,
together with the muscles on which these casts were applied, and also
the fragment which the muscles drew upwards. An assistant then secured
it here, while the surgeon, after having made some casts in form of the
figure of 8, descended to the inferior part of the fore-arm, where the
end of the strip was made fast by tight circular turns. (See fracture
of the rotula.)
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