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
The patient being placed in a horizontal position, as already directed
(55), great motions were first impressed on the limb: extensions were
then commenced, first in the direction of the luxation, and afterwards
forward and backward. Vain efforts; the head remains immoveable;
new motions are again made in every direction, and afterwards, the
extensions are renewed: the same want of success. The patient being
fatigued, the reduction was deferred till the day following, when the
same trials were, after a short time, attended with complete success.
The head being at first disengaged, and afterwards drawn slowly along
the track through which it had passed in becoming displaced, at
length re-entered the capsule. The arm, being supported by the usual
apparatus, soon became œdematous, and, notwithstanding the remedies
common in such cases, the swelling continued for two months. The
motions performed by the limb in the mean time, restored to it, by
degrees, its usual suppleness; and, on the sixty-eighth day after her
entrance, the patient was discharged cured.
To this case, I might subjoin many others, and, in particular, that
of John Putot, also reported by Giraud, and in which the means just
described (69 and 70), succeeded in the reduction of a luxation at the
expiration of the fourth month. But too great an accumulation of facts
distract the attention, and add nothing to conviction, especially when
they are already so plain as those just related.
71. But further, in cases of this kind, where a very old luxation
presents great obstacles to reduction, although the attempts made
to reduce it, do not actually force the head of the bone into the
capsule, still they may not prove entirely useless. By bringing the
head nearer to the glenoid cavity, or placing it even on that cavity,
and making it form new adhesions there, after having destroyed its old
ones, the motions of the limb will be facilitated. For, in cases, where
the luxation is not fairly reduced, these motions will be always less
impeded, in proportion as the head of the bone occupies a place less
remote from its natural situation.
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