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
From twenty-six to thirty days are sufficient for the reunion: this was
the term commonly required in the Hotel-Dieu.
11. If judiciously managed, art readily removes all the accidents
attendant on this fracture; but, if otherwise, the consequences are apt
to prove troublesome. It is here, much more particularly than in other
places, that all deformity of the part ought to be prevented; because,
the neck of the humerus being near to the centre of the motions of the
arm, will very essentially impede those motions if it be not properly
reunited. A deformed callus has been known to produce, in the hollow of
the arm-pit, a protuberance, which has, in part, prevented abduction,
and appeared to keep up an habitual swelling in the limb.
It is, then, from the perfection of the apparatus, and not from the
vicinity of the injury to a joint, that the prognosis is to be formed,
both as to the consequences, and as to the duration of the fracture.
Keep the fragments in exact and regular contact, and there will be no
obstacle to that success which seldom forsook Desault.
§ V.
OF THE REDUCTION.
12. The reduction in this case is usually attended with but little
difficulty, and the great multiplicity of means hitherto used for that
purpose, demonstrate only the barrenness of the art.
Most of the machines destined to reduce the luxation of the humerus,
have been applied to this fracture. Thus the ladder,[11]* the door,†
and the club,‡ placed under the arm-pit, served at once the
purposes of counter-extension, and conformation, while the powers for
producing extension were applied to the elbow, and more rarely to the
wrist. Thus Hippocrates recommended a wooden cross, the effect and
mode of action of which are nearly the same. These means, in general,
besides being insufficient, are liable to a further objection, in
consequence of their acting on the edges of the pectoralis major,
latissimus dorsi, and teres major, which being thus forced upwards,
draw the fragment to which they adhere in the same direction, and
thereby constitute an obstacle to the reduction. (See what will be
advanced on the subject of luxations of the humerus.)
[11] (* L’echelle, † la porte, ‡ le baton.) These pieces of
machinery, though formerly in use, are now, I believe, in all parts
of the world, laid aside. It would be superfluous, therefore, to
consume time in describing either them, or their mode of operation.
TRANS.
13. To machines succeeded the use of straps, weights suspended to the
limb, &c. These processes were entirely useless, in as much as they
were intended only to increase the natural powers of the operator,
which are already more than sufficient of themselves. They will,
therefore, in a short time, exist only in the history of surgery.
Public-domain text, read in full here on John Shaqi.
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