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
58. The intention of this additional piece of apparatus, was to draw
down the superior fragment, to prevent the circular casts of the roller
from separating by their relaxation, and, by that means, to retain the
fragments in apposition. But, on the one hand, may not the superior
fragment be drawn by the hand, as well as by a roller employed for
the purpose? And, on the other, if the circular casts of the roller
be liable to become relaxed, why not the strip of linen also? These
considerations induced Desault to lay it aside, and use the bandage in
the form just described.
59. The advantages it offers are far from being equivocal. 1st, The
limb is kept in a state of invariable extension by the anterior splint,
and, on this account, there can be no displacement on the part of the
inferior fragment. 2dly, The bandage, which accurately envelopes the
whole limb, restrains the action of the muscles by compressing them,
and prevents in part the contractions of the triceps; while the casts
in the form of the figure of 8, applied with skill and precision,
hold down the superior fragment, and render it difficult for it to be
displaced. 3dly, Without the application of a roller over the whole
limb, a swelling, more or less considerable, would probably be the
effect of the constriction at the elbow, which must necessarily be
somewhat tight, because, as the turns of the roller, in form of the
figure of 8, act on the olecranon obliquely, if they be too loose, they
will slip and not perform the office of retention.
60. Like all kinds of apparatus composed of rollers, this ought to be
frequently examined, lest, by becoming relaxed, it should not make
sufficient resistance to the triceps, which is always disposed to draw
itself upwards. There can be no period fixed on for the reapplication
of the apparatus; the moment it begins to become slack, it ought to be
renewed: three or four times during the course of the treatment are
generally sufficient. Should a considerable swelling give reason to
suspect that the constriction is too great, it will be necessary to
remove the bandage in order to apply it anew.
61. The period necessary for the reunion of fractures of the olecranon
varies, according as the bandage is more or less exactly kept in its
place. Among ten cases of this kind, collected in the Hotel-Dieu,
four united in twenty-four days, three in twenty-eight, and three in
thirty-two. Hence, taking the mean term, all other circumstances being
alike, the process of cure requires about twenty-six days.
62. When this is completed, it is necessary to impress on the limb
motions of flexion and extension, gradually increased every day. This
is, as David properly observes, the most certain method of avoiding a
stiffness, and even an anchylosis, too often the consequence of this
fracture.
Public-domain text, read in full here on John Shaqi.
Reviews
Reviews
No reviews yet
Be the first to share your thoughts on this work.
Elsewhere in the archive
Join the Discussion
Join the discussion
Sign in to leave a comment or review.
Sign InorCreate an account