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
97. What shall we say respecting the idea of the synovia wetting the
divided surfaces, and by that means preventing their reunion? The
history of fractures communicating with joints, better known at the
present day, answers this objection, which is indeed nothing but the
offspring of mere hypothesis. To these considerations, which are
dictated by reason, and to which many more might be added, let us unite
the proofs derived from experience, and we will find numerous examples
of cures actually performed, particularly in latter times; the truth
of this is attested by many cases collected by Desault, both at the
hospital of Charity and the Hotel-Dieu. Bruninghausen and Siebold,
have had equal success. Many analogous facts have been presented to
the Academy of Surgery. In the cabinet of the School of Health, are
deposited some preparations obtained from the cabinet of Desault,
calculated to remove all difficulties and doubts from this subject.
98. We must acknowledge, however, that in persons advanced in years,
the cure is always difficult, often very tedious, and sometimes
impracticable, however carefully the treatment may be conducted. But
this is only a necessary consequence of the laws of ossification,
which, constantly accumulating in the bones too great a quantity of
calcareous matter, seems to deprive them by degrees both of life and
all its properties. Yet Lesne laid before the academy a case of reunion
obtained in a subject at the advanced age of eighty-four.
99. The observations of some modern practitioners seem to prove, that
the reunion here is not produced by a substance similar to common
callus, but by a kind of ligamento-cartilaginous tissue, in like manner
as in the rotula, and the olecranon. But why need we inquire after the
means employed by nature? those of art must be the same. It will be
always necessary to favour the reunion, by bringing the fragments into
contact, and maintaining them so. Without this contact, either a cure
will never be obtained, or the substance destined to effect a reunion,
becoming deformed and too bulky, will impede motion.
100. Lameness has been long considered as the inevitable consequence
of fractures of the neck of the os femoris. Ludwig, professor of
surgery at Leipsick, has particularly advocated this opinion, which is
supported by Sabatier, and Louis, who considered the total destruction
of the neck of the bone, as the cause of the lameness. But few such
examples are to be found on record. Ruisk has given an engraving of
one. Lameness when it does take place, depends, as it does in oblique
fractures of the body of the bone, on the overlapping of the fragments,
to which no opposition has been made; so that the insufficiency of our
means, and not the nature of the disease, gives rise to this accident,
which Desault seldom experienced in his practice.
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A Treatise on Fractures, Luxations, and Other Affections of the Bones — John Shaqi
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