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
The apparatus was applied in the following manner. The junk-cloth, the
body-bandage, and the bits of tape, were laid on the bed, in the order
already mentioned (60): the patient was then placed in such a manner
that the affected thigh corresponded exactly to the middle of them.
The reduction being effected, the two splints were applied, one on the
external and the other on the internal side of the limb; on each side,
and along the anterior part of the thigh, the bolsters were laid: three
bits of tape for the leg, four for the thigh, and the body-bandage
for the pelvis, served to secure the splints. One end of a roller,
which had been previously fixed on the upper side of the foot, passing
through the mortise on the external splint, and being tied to the other
end which passed through the hollow or notch, produced extension,
while counter-extension was made by means of another roller directed
obliquely from the tuberosity of the ischium over the superior part of
the same splint, which it drew downwards. This was the same apparatus
formerly described (60 ... 66), except as to the bandage of strips, the
compresses, and the anterior splint, which running only from the fold
of the groin, had no effect in retaining the fragments.
The treatment was simple. No general disease of the system existing,
the patient returned, in a few days, to her usual regimen. Being
visited every day, the apparatus was frequently tightened; and was
renewed six times at different intervals.
A bilious disposition shewed itself on the seventeenth day. This
was removed by an emetic given in solution, and after this nothing
remarkable occurred. On the fifty-second day the state of the parts
was examined. The consolidation was almost accomplished; by the
sixtieth day it was complete, and the patient was discharged a few days
afterwards, experiencing only a slight degree of lameness.
§ XVII.
OF THE SUBSEQUENT TREATMENT.
112. It is more essential here than in fractures of the body of the os
femoris, to keep up extension with the utmost exactness, because, in
the present case, a much greater number of muscles being attached to
the lower fragment, very greatly augment the powers tending to displace
it. Hence the necessity of examining the apparatus every day, to see
whether or not any shortening of the limb has occurred, to tighten,
if they be relaxed, the rollers that make extension, and to renew the
application of the whole, if it be in any measure deranged.
113. The proper treatment here, as well as in most other fractures,
consists more in these attentions, taken collectively, than in the use
of internal means. It is to the want or neglect of such attentions,
that we ought to attribute the little success obtained by many surgeons
from the bandage of Desault.
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