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
[36] For a view and description of an excellent form of apparatus
for oblique fractures of the leg, constructed on the principles of
that here described, see article III. plate III. of the Appendix.
TRANS.
On the same day the patient was bled copiously; a low diet was
prescribed; some diluting drinks were administered; and the whole
apparatus was frequently wet with vegeto-mineral water.
Next day, fever; restlessness; blood-letting repeated; the extending
rollers, having become relaxed, were tightened. Third day, evidently
better. Fifth day, a new application of the apparatus; some swelling
of the foot; a few small blisters on the leg; these were opened and
dressed with cerate spread on linen. Eighth day, the patient easy and
tranquil; a little shortening of the limb; a third application of
the bandage. Twelfth day, bilious symptoms appear. Thirteenth day,
an emetic given in solution; symptoms decline. Twentieth day, the
fractured limb in a favourable state; the roller for extension laid
aside; that formerly described employed in its place. Thirtieth day, an
appearance of consolidation. Thirty-fourth day, bilious symptoms recur;
further evacuations. Forty-third day, consolidation perfect; scarcely a
vestige of the fracture remains. Exercise is repeated for several days.
Fiftieth day the natural strength and motion of the part completely
restored.
11. The general end to be answered by every bandage intended to retain
a very oblique fracture of the leg, is evidently, 1st, to hold the
knee up, and with it the superior fragments; 2dly, to draw the lower
fragment down: from this twofold effect arises a twofold resistance
diametrically opposed to the powers of displacement, which are; 1st,
the slipping down of the trunk, which pushes the thigh before it, and
with it the upper fragments of the leg; 2dly, the action of the muscles
of the leg, drawing the foot upwards, and the lower fragment along with
it.
12. But, if to these indications we compare the bandage described in
the foregoing case, we will perceive that they are perfectly fulfilled
by it. Indeed the splints forming a kind of pullies which change the
direction of the rollers, we must count on the action of these rollers
only from the part of the limb which they surround, to the ends of the
splints over which they are reflected: whence it follows, that the
two ends of the upper roller, reflected over the superior extremities
of the splints, cannot be drawn down along each of these splints,
without that part of the rollers, which reaches from the leg to these
extremities, being drawn up, and with it the knee and the upper
fragment. In like manner, the ends of the lower roller cannot be drawn
up towards the ends of the upper one, without those portions of them
which run from the sole of the foot, being drawn down and pulling the
foot and the inferior fragments along with them.
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