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
116. We discover, in general, that the cure is complete, from a
disappearance of the signs of the fracture, more particularly from the
motions of the great trochanter, in which circumduction[28] succeeds to
rotation on its own axis, when the limb is made to move on itself, that
is, to rotate outwards or inwards. The power of standing and walking
is an infallible evidence of this reunion; nor are these exertions
practicable, till the expiration of some time after it is completed;
this circumstance is owing to a stiffness remaining in the parts
around the joint, occasioned by long extension and a want of motion,
and which exercise alone can effectually remove. (See what has been
already said on this subject, in several parts of this work.)
[28] A motion or sweep describing the arch of a circle. TRANS.
117. Numerous cases may be adduced in favour of the doctrine laid down
in this memoir. But a sufficient number have been already published in
the Journal of Surgery. I shall subjoin only two, drawn up by Manoury
and Seveille.
CASE VIII. Maria ***, aged forty, falling on the great trochanter,
experienced a sudden pain, and heard a considerable report: she rose,
however, and with difficulty made her way home. On the day following, a
shortening of an inch was perceived in her thigh: the great trochanter
was drawn backward and upward: walking was now impracticable, the foot
remained turned inwards. Notwithstanding this latter circumstance,
Desault, being called to the patient, declared that a fracture existed,
which was evidenced in particular by a rotatory motion of the great
trochanter on its own axis. The necessary apparatus being applied,
was carefully examined every day by Manoury, to whom the patient was
intrusted. No shortening of the limb occurred, nor did any unfavourable
accident supervene, and, by the thirty-ninth day, the fracture was
exactly and firmly united; on the forty-third, the splints were
removed; and on the fiftieth, the patient could walk without assistance.
CASE IX. John Rignal fractured the neck of the os femoris by falling,
not as in the preceding case, on the great trochanter, but on the knee,
which was bent at the time of the fall, while the shoulder of the same
side supported a heavy load. He was brought to the Hotel-Dieu, where
the same signs, as in the preceding case, (except that here the foot
was turned inwards) furnishing ground for the same diagnosis, gave rise
to the same treatment, which, in fifty days, was followed by a result
equally favourable.
FRACTURES OF THE LOWER EXTREMITY OF THE OS FEMORIS.
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