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
4thly, Around the two lateral splints, the surgeon and his assistant
roll, each on his respective side, the two edges of the junk-cloth, so
that both splints, by being accurately applied on the bolsters, may
make a uniform compression on the whole part.
5thly, The third bolster (d d d d) is then applied on the anterior part
of the limb, and over it the splint (CC).
6. The bits of tape passed under the apparatus to the number of four
for the thigh, and three for the leg, are tied in succession on the
external splint, lest the knots, should they correspond to the thigh,
might, by their contact, prove troublesome. That one next to the
fracture is tied first, and they are all drawn as tight as the patient
can bear them without uneasiness.
7. The body-bandage is now fixed on the pelvis, in such a manner, as
to secure laterally the external splint, and is itself retained by the
sub-femoral bandage (H), that is, the bandage passing under the thigh.
8. A thick compress placed beneath the tuberosity of the ischium,
serves as a cushion or bolster to protect the part from the pressure
of the roller (g g) which, being passed first under the apparatus,
and drawn afterwards obliquely from within outwards, and from above
downwards, takes its points of bearing or action, in one part, on the
tuberosity of the ischium, and in the other, on the upper end of the
external splint, and is tied in the fold or hollow of the groin.
9. The two ends of the bandage (L) previously made to cross each other
on the sole of the foot, are passed the one through the mortise, and
the other through the hollow or notch in the lower end of the same
splint, and then, being drawn forcibly, are tied in a firm knot, so as
to act as a substitute for the hands of the assistant, who now lets go
the patient’s foot.
10. If the roller (g g) become relaxed, it is tightened again, and the
patient being laid in a suitable position, the limb is protected from
the pressure of the bed clothes, by a kind of basket placed over it.
11. A roller (K k) laid first on the sole of the foot, and then brought
across over its upper side, and fastened laterally to each splint,
serves to secure that part from turning outward or inward, and thus
prevents the rotation of the limb.
63. If the mode of operation of this bandage be compared with the
general indications formerly established (38) for all oblique fractures
of the os femoris, it will be easy to perceive that, conformably
to those indications, it tends, 1st, to draw the inferior fragment
downward; 2dly, to retain the superior one up; 3dly, and to prevent the
rotation of the lower fragment, and secure the immobility of the limb.
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