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
In the night, pains returned; agitation; some spasmodic motions; an
anodyne draught administered in the morning. In the course of the
day, these troublesome symptoms disappear; a slight swelling at the
ancle. Third day, no pain; swelling gone; aliment increased. Sixth
day, patient permitted to return to her usual regimen; extending
rollers relaxed; lower one tightened: eleventh day, apparatus renewed;
fragments in perfect contact: thirteenth day, limb moved incautiously;
a slight shortening; apparatus reapplied; extending bandages drawn
tight: sixteenth day, a disposition slightly bilious; evacuants
administered with success: twenty-fourth day, a third application of
the bandage: thirtieth day, progress in consolidation already very
evident; the limb straight: fortieth day, extending rollers laid aside:
fifty-second day, consolidation complete without the least deformity.
70. The muscular force, in children, being weak, and the weight
of the body inconsiderable, have, in general, much less influence
in producing a displacement in them than they do in adults. When,
therefore, fractures occur in subjects under six or seven years old,
the resistance, on the part of the apparatus, need not be so great. In
general the lateral pressure which it makes, and the bearing of its
different pieces against the limb, are sufficient to prevent the return
of deformity, when this has been perfectly removed by reduction.
71. In such cases Desault covered the thigh with a circular bandage,
made of a roller seven ells long, and three inches broad. Beginning
with this below, near to the condyls, he carried it upwards, by oblique
and reversed turns, to the pelvis, round which he threw a cast; then,
giving the ball into the hand of an assistant, he applied four splints,
one before, another behind, and one on each side: directing these to
be held at their lower part near to the knee, he resumed the roller,
and secured them firmly by a second series of circular and reversed
turns, descending to the lower extremity of the thigh. The limb was
then placed in a proper position, and, in general, of whatever kind
the fracture was, whether oblique or transverse, this simple bandage,
without the aid of permanent extension, was sufficient to retain it.
72. It would be difficult to determine the period necessary for the
consolidation of fractures of the os femoris. Numerous circumstances
concur to influence this work of nature, which is, in general, extended
beyond the term of forty days, vulgarly assigned to it by the people
at large. Besides, a stiffness of the limb, the inevitable effect of
its long state of rest, still adds to the length of the patient’s
confinement, by retarding the necessary motions, the return of which,
as in other similar cases, can be accelerated only by exercise.
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