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
64. It is evident that the bandage or roller (g g) so unites the
pelvis to the external splint (AA), that the latter cannot be pushed
upwards, without drawing the former in the same direction, as well as
the superior fragment which adheres to it. But if, after this roller
is fixed, the lower one (L) be tightened, the first effect produced
is, to push the external splint forcibly upwards; the second, to draw
the leg, and with it the inferior fragment downwards; so that, by
fixing the roller (L) in the notch and mortise of the splint with the
necessary degree of tightness, extension and counter-extension are made
permanent. By this means the muscles, being kept on a stretch, lose by
degrees their power of contraction, which is still further diminished,
by the immoveable state in which they are kept, and by the compression
made on them by the bandage of strips. So that, on the one hand, the
inferior fragment will have no tendency to rise upwards, and even if it
had, it will meet with a sufficient resistance to prevent it; while, on
the other hand, the superior fragment will not be pushed downwards by
the pelvis.
65. To this advantage is added that of a state of perfect immobility.
The pelvis, the leg, the thigh, and the foot being firmly fixed on the
external splint, constitute one entire whole, all the parts of which
must retain, with respect to each other, the same relative position.
Should even a stroke be accidentally given to this assemblage of parts
now converted into a solid whole, each portion of it will move at the
same time, there will be no partial motion, and the relative position
of the parts will not be changed. Hence the advantage of being able to
raise the patient without apprehension; a most desirable circumstance
indeed, in a position so painful and so long continued (26). The
external splint, being extended beyond the sole of the foot, prevents
the lower fragment from obeying a tendency, which it sometimes has,
to displace itself by a rotation on its axis. Should this tendency
be towards the internal side, an occurrence much more rare, the
lengthening of the internal splint will effectually prevent it.
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