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
16. It appears from what has been just advanced (13 ... 15), that the
following are the three ends to be attained by every bandage, intended
to retain the divided ends of the tendo Achillis in contact; 1st, the
immobility of the foot in a state of permanent extension on the leg;
2dly, the immobility of the leg, in a state of semiflexion, on the
thigh; 3dly, a judicious and well directed compression made on the
whole leg and foot, but bearing on the tendon with only sufficient
force, to keep it from moving backward or laterally. Let us compare the
methods of authors with these indications.
§ V.
OF THE DIFFERENT METHODS OF CURE.
17. The treatment recommended by authors may be reduced to three
general methods. The first consists in rejecting all artificial aid,
and leaving the cure to nature and the position of the limb. To the
second belongs the use of sutures, intended to retain the edges of the
division together. The third includes the different kinds of apparatus
employed for the same purpose.
18. _First method._ Chronological order places this method after the
others. But this order must be disregarded by him, whose object is
things rather than time. The history of the sciences calls sometimes
for the approximation of distant periods, and, at other times, for the
separation of those already approximated.
19. Several practitioners, in France and England, have lately
proscribed the use of all external means. Pibrac and Dupouy were of
opinion, that the mere precaution of the patient not to flex the foot,
assisted by constant rest, was sufficient. Hoin and Gauthier mention
many cases in confirmation of this doctrine. M. J. Rodbard, surgeon at
Ipswich, having ruptured his own tendon about three inches above the
heel in leaping over a little rivulet, instead of confining himself to
bed, continued in the exercise of his profession. He walked every day,
without any other precaution than that of not flexing the foot, and
five years afterwards, he was able, as he mentions, “to walk, run,
mount or alight from his horse, without pain, in a word, the affected
leg performed its functions as well as the other one.” We have an
account of a patient who was cured without a bandage by A. Petit.
Public-domain text, read in full here on John Shaqi.
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