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
Desault ordering extension to be again discontinued, recommenced the
motions of the os femoris, and even increased their force, changing
them in every direction, for the purpose of lacerating the capsule.
After this, extension was again renewed, with better success than
before. Indeed, on the very first effort, the head resumed, of itself,
its natural situation, without any further assistance on the part of
the surgeon.
The sufferings of the patient ceased almost instantaneously; towards
evening a slight swelling appeared around the joint, over which
an emollient cataplasm was applied. On the day following, all the
unfavourable symptoms were gone, and in about a fortnight the patient
was able to return to his usual exercises, which, however, he was
directed to pursue, for some time, with moderation.
2. There are, in this case, two circumstances, on which the
practitioner should fix his attention, and which may throw great light
on the reduction of all luxations of the os femoris, as they will be
found applicable to most accidents of the kind. These are, 1st, The
narrowness of the opening in the capsule. 2dly, The inutility of the
motion or process of conformation, when that opening has been enlarged.
3. We formerly observed, when treating of luxations of the humerus,
that one of the obstacles to reduction was, the narrowness of the
opening in the capsule; the same circumstance occurs here. That
membrane, lacerated at the time when the head of the os femoris is
driven against it, is dilated sufficiently to let the head escape:
but, the edges of the lacerated membrane, coming together again, and
being thus drawn tight around the neck of the bone, retain it in that
position, and prevent the head from re-entering the acetabulum. Thus,
in a fracture, where one of the extremities of the bone is protruded
through the integuments, the opening in the skin, by closing tightly
round that extremity, sometimes prevents its reduction.
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