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
As to what remains, it will be sufficient to show the insufficiency
of the process of reduction (22), by means of the knee placed between
the shoulders, in order to demonstrate the existence of a like
insufficiency in all those forms of apparatus, which, as Brasdor
remarks, have for their object a continuance, during the treatment, of
the effect produced by that process.
31. On the other hand, those indications will be fulfilled with
exactness, by such a form of apparatus as will render permanent the
action of the means of reduction which were employed by Paul of Egina,
by certain Arabian physicians, and by Pare; which have been renewed by
Desault, and tend to draw the shoulder upward, backward, and outward
(23 and 24).
Pecceti appears, in the last century, to have had a faint view of
the proper indication on this subject, when, under the article of
fractures, he advises the ball to be suffered to remain under the
arm during the treatment of the injury. But the figure of 8 bandage,
united to this expedient, counterbalances its effect, rendering it of
no avail, and Pecceti was therefore no more successful than others, in
obtaining a cure of the fracture, unaccompanied by deformity.
32. An overlapping more or less perceptible never failed to accompany
the consolidation or knitting of the bone, and here, as in many other
cases, practitioners laboured to explain what they knew not how to
prevent. The impracticability of surrounding the part, as in other
fractures, with a circular bandage, appeared to Heister, Petit, and
Duverney, to be the cause of this deformity. They supposed that to be
a superabundant callus, which was nothing but a displacement of the
fragments. These visionary hypotheses ceased to exist, as soon as this
displacement was prevented by a proper apparatus.
Desault sought for this form of apparatus, as well as for his other
bandages, in the multiplied application of means already known, without
inventing new ones. Bandages and compresses, easy to be procured, and
already rendered familiar to surgeons by daily use, served him for the
construction of his apparatus, for which several machines had been
already proposed.
33. The pieces of which this apparatus is composed, are,
1st. Three rollers, three inches broad; the two first, six, and the
other eight, ells long, each one rolled up separately.
2dly. A bolster or pad (a, b, Fig. 1), made in the form of a wedge,
out of pieces of old linen. Its length should be equal to that of the
humerus, its breadth four or five inches, and its thickness at the base
(a), about three inches.
3dly. Two or three long compresses.
4thly. A small sling for the arm, (Fig. 5).
5thly. A piece of linen large enough to cover the whole bandage.
Every thing being properly arranged, the following is the mode of
applying the apparatus, which of itself reduces the fracture.
Public-domain text, read in full here on John Shaqi.
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