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
[25] (_Drap-fanon._) This is a piece of linen or muslin (Desault
appears to have used flannel, which is not however so good) spread
under the broken limb, reaching in length from one end of it to
the other, and wide enough to go about twice round it. It is to
be folded at its edges several times round the internal and the
long external splints, in order to retain them the better, and
make them bear with more steadiness and advantage on the limb. The
junk-cloth and these two splints, when properly applied, form a
kind of soft elastic case, in which the limb rests. This case is of
service in securing the bolsters in their places. The junk-cloth is
the outside piece of the apparatus, except the bits of tape which
go round and secure the whole. In arranging the different pieces,
therefore, on the bed or mattress, where the patient is to lie, the
surgeon places the tapes first, the junk-cloth next, the bandage of
strips next, and so on, in an order the reverse of that in which he
afterwards applies them on the limb. TRANS.
61. Every thing being ready, previously to putting the patient to bed,
the pieces of apparatus are to be arranged on that part of the bed
corresponding to the fractured thigh, in the order in which they are
to be successively applied. If the patient has been already laid in
the place where he is to remain, the limb must be raised with great
caution, and, during the extension, each piece gently slipped under it,
or the whole must be passed under at once, being first rolled round the
several splints, in such a manner, that the apparatus requires only to
be opened.
62. Extension is now made in the mode already pointed out (29 and 30),
and then the application of the apparatus is begun, for which the
surgeon must be situated on the external side of the fractured thigh,
while an aid, placed on the other side, gives him assistance.
1st, On the thigh, next to the skin, are first applied the long and
circular compresses, accurately spread out so as to have no wrinkles
in them, and previously wet with vegeto-mineral water. Around it are
then applied, in succession and from below upwards, each strip of the
bandage (EE) moderately tight.
2dly, The lower end of the leg is now covered with a thick compress,
intended to prevent the impression of the roller (L), which is fixed
in such a manner, that its middle is first laid on the tendo Achillis,
a little above the heel, while its two ends, crossing each other on
the upper part of the foot, are carried on each side to its sole,
where crossing again, they are then laid down till the close of the
application of the apparatus.
3dly, Along the thigh are placed laterally two bolsters, which, from
their thickness being easily increased or diminished in consequence of
the moveable nature of the chaff, mould themselves to the inequalities
of the limb.
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