A Treatise on Fractures, Luxations, and Other Affections of the Bones — John Shaqi
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
To fulfil this indication, an assistant sustains the elbow in its
elevated position, with one hand, and, with the other, supports the
patient’s hand before his breast, while the surgeon fills with lint the
hollow spaces around the clavicle. He then applies on the clavicle,
at the place where it is fractured, the two long compresses, wet with
vegeto-mineral water, or some other cooling liquid. Taking now the last
roller, he fixes the end of it under the sound shoulder; from thence
he brings it obliquely across the breast, over the long compresses,
and carries it down behind the shoulder along the posterior part of
the arm, till it passes under the elbow. From this point, he again
carries it obliquely upwards across the breast to the arm-pit, then
across the back, over the compresses, and brings it down again before
the shoulder, along the front of the humerus till it again reaches
the elbow. From thence the roller again ascends obliquely behind the
thorax, passing under the arm-pit, where the first cast of the roller
is covered, and from whence it again starts, to run the same course we
have just described. This constitutes a second round, which covers in
part the first, and forms a kind of double triangle (e, f, d), situated
before the breast, and over the circular turns of the other rollers
(c. c. Fig. 4). The remaining part of the roller, brought from behind
forward, is employed in circular turns over the arm, and round the
thorax, for the purpose of preventing the displacement of the first
part. To make it the more secure, it is fastened with pins at its
different places of crossing.
The sling (Fig. 4) is next passed under the hand, and fastened above
to the ascending turns (d), and not to the circular (c c), which the
weight of the hand would be likely to draw downward.
39. It is only necessary to examine the course of this third roller,
to see, that, united to the sling, it is well calculated to support
the external fragment, which the weight of the shoulder has a tendency
to depress, on a level with the internal one. It supplies the place
of the assistant, who raises the elbow and supports the hand of the
patient, in like manner as the second roller performs the office of the
assistant, who presses the lower part of the humerus against the side
of the thorax.
On the other hand, the circular turns, by which the application of the
third roller is finished, being directed from before backward, push
in the same direction the arm and shoulder, which have been already
carried that way, by the process of reduction, and thus retain them in
their proper places.
Hence may be inferred the truth of the proposition, which we have been
endeavouring to demonstrate; namely, that the bandage of Desault,
constructed according to the general principle formerly established
(20), for fractures of the body of the clavicle, is calculated to
retain the external extremity of the humeral fragment upward, outward,
and backward.
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