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
Perhaps the bolster of tow proposed by Moscatti, would have surpassed
all these means, in the advantages it offered, had it not, by leaving
the arm moveable below, and the shoulder above, still favoured a
displacement.
Le Dran has also advised the use of a bolster composed of that of
Moscatti, and bole Armenian. It fixed the arm more firmly against
the trunk and in this respect, certainly approached nearer to the
attainment of the object in view.
19. It is obvious, from this comparison between the indications of
cure (17), and the means hitherto employed for the fulfilment of them
(18), that nothing satisfactory had yet been done, and that a proper
apparatus was still a desideratum. The success experienced by Desault,
in the use of that which we are about to describe, has perhaps proven,
that this desideratum exists no longer.
20. The pieces which compose it, are, 1st, Two rollers, the one from
five to six, and the other from eight to ten yards long, each one about
three inches wide: 2dly, Three strong splints, of different lengths,
each about two inches broad: 3dly, A small bolster made of linen,
from three to four inches thick, at one end, tapering like a wedge to
the other, and of a sufficient length to reach from the arm-pit to
the elbow; 4thly, A sling for the purpose of supporting the fore-arm;
5thly, A piece of linen to surround the whole apparatus.
Every thing being properly arranged, the reduction, effected in the
manner already stated (14), and the assistants still continuing the
extension:
1st, The surgeon takes the first roller, wet with vegeto-mineral water,
fixes one end of it by two circular turns on the upper part of the
fore-arm, and carries it up along the arm by oblique turns, moderately
tight, and overlapping each other about two-thirds of their breadth.
Having reached the upper part of the limb, he makes some reversed turns
to prevent the wrinkles that would be caused by the unevenness that
occurs in this place. He then passes two casts of the roller under the
opposite arm-pit, and bringing the ball to the top of the shoulder
again, gives it into the hand of an assistant.
2dly, The first splint is then placed before, and reaches from the fold
of the arm, to a level with the acromion. The second on the outside,
reaching from the external condyle to the same level. The third behind,
reaching from the olecranon to the fold of the arm-pit. The bolster
placed between the arm and the thorax is a substitute for a fourth
splint, which is by that rendered unnecessary. An assistant now secures
them, by grasping them with his hand towards the curvature of the
elbow, so as not to hinder the application of the remaining part of the
bandage.
3dly, The surgeon takes hold of the roller again, descends by oblique
and reversed turns along the splints, which he fixes by binding them
moderately tight, and terminates the bandage at the upper part of the
fore-arm, where he had commenced.
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