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
14. Our forms of apparatus are nothing but means of continuing, for
a long time, that state of things, which extension and the process
of conformation temporarily produce at the time of reduction. This
principle, though generally acknowledged, was particularly neglected
in such fractures, as that now under consideration, till the time of
Petit, who made it the basis of his practice. Before him, there was
a common inconvenience attached to every kind of bandage. The two
bones being pressed against each other, by circular rollers applied
externally, were thus drawn in that very direction, in which the action
of the pronator muscles already tended to displace them; because, the
form of the fore-arm being irregular, made these rollers act more
powerfully on its lateral parts, where it is very convex, than either
behind or before, where it is very flat. It is well known that bandages
will make the greatest pressure on the most projecting parts of the
limbs round which they are applied; so that, if the fore-arm be bound
or pressed on behind and before with a force equal to one, it will
sustain laterally, that is, on its sides or edges, a pressure equal to
two. Hence results, not only a tendency in the radius to approach the
ulna, but also, a want of resistance in the muscles situated on the
posterior and anterior sides of the fore-arm. For these muscles being,
from their flatness, less compressed than the bones, give way, and do
not, by forcing themselves between them, oppose the approach of the
bones to each other.
15. Such was the disadvantage of the apparatus of Hippocrates,
consisting of one roller applied immediately on the skin, of a
many-tailed bandage intended to retain this, and of four splints,
applied on the seventh day, and secured by another roller. Such
was also the inconvenience of several bandages, proposed after the
time of Hippocrates, by different authors, who modified his without
improving it, and who, in attempting to alter it, even added to its
imperfections. Thus, the compresses with which the limb was first
covered, previously to the application of the rollers, served only,
by becoming wrinkled, to render the compression unequal, fatiguing,
and even painful to the patient. In like manner the pasteboard, which
many authors, particularly Duverney, have substituted for splints,
and which a majority of practitioners employ, even at the present
day, soon becoming softened by moisture, bends without resistance,
becomes incapable of preventing a displacement, and has at least the
inconvenience of being useless.[18]
[18] On this point Desault is certainly mistaken. Paste-board, when
of a proper thickness and well applied, makes an excellent splint
for fractures of the fore-arm. It moulds itself to the form of the
arm, sits easy, and retains the fracture extremely well. TRANS.
Public-domain text, read in full here on John Shaqi.
Reviews
Reviews
No reviews yet
Be the first to share your thoughts on this work.
Elsewhere in the archive
Join the Discussion
Join the discussion
Sign in to leave a comment or review.
Sign InorCreate an account