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
40. The casts of the rollers, thus surrounding the thorax, however
well they may be secured, are yet liable to be displaced, particularly
when the patient is in bed. This inconvenience may be avoided, by
surrounding the whole with a piece of linen, leaving nothing uncovered,
but the sound arm, which is at liberty to perform its usual motions.
The arm of the diseased side, being thus fixed in such a manner, as
to constitute a whole or entire body with the thorax, follows its
movements, without producing any displacement. It is thus, that by the
apparatus for a continued extension of the thigh, the fragments of
the _os femoris_, forming an immoveable whole with the pelvis, cannot
change their situation, even in following the motions of the trunk.
Hence arises, in fractures of the clavicle, this advantage, that the
patient is not obliged to keep his bed, but is able even to attend to
his business, during the progress of the cure.
41. I will not dwell on the numerous objections urged by different
authors against the bandage which has just been described. What answer,
indeed, can be given to those writers, who fancy that they behold the
patient in the greatest danger of immediate suffocation; who dread an
approaching mortification of the arm of the diseased side; who allege,
contrary to the rules of the art, that there is no impression made
immediately on the clavicle, but on a neighbouring bone; who, &c. &c.?
Twenty times in a year, has experience answered those objections, in
the Hotel-Dieu; and there is not a pupil of Desault, who has not, as
well in this, as in many other cases, seen that objections, plausible,
indeed, when considered in the closet, or at a distance from a sick
room, dwindle to nothing at the bed-side of the patient.
42. In those cases (which, as Hippocrates remarks, very rarely occur)
where the external fragment projects over the internal one (12),
the bandage must be somewhat varied, although the two principal
indications, of drawing the shoulder backward and outward, must still,
as in other cases, be fulfilled. The only additional circumstance,
therefore, necessary to be attended to here, is, not to elevate the
shoulder, by pushing it upwards. This may be easily avoided, 1st,
by omitting to raise the elbow, when applying the bandage; 2dly, by
drawing the third roller a little tighter than usual.[3]
[3] This paragraph is so obscure in the original, that a
translation of it would be scarcely intelligible. Instead of a mere
translation, therefore, I have given rather a comment on what I
believe to be its true meaning. TRANS.
The fragments, being reduced to the same level, and brought into
apposition, by this two-fold attention, will unite as in ordinary cases.
Public-domain text, read in full here on John Shaqi.
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