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
There is, in the application of this bandage, an essential precaution
to be observed; which is, that as each turn of the roller passes
over the graduated compresses, the surgeon ought to press on these
compresses with the thumb and fore-finger of his left hand, in order
that the muscles, by being forced into the interstice between the
radius and ulna may prevent their approximation, which would produce an
inequality in the compression made by the apparatus.
21. After the application of the apparatus, if the patient be obliged
to keep his bed, the fore-arm is to be extended on a pillow, taking
care to keep it always half-bent, and guarded by hoops from the weight
of the bed-clothes. But if the fracture be not a compound one, and if
the fall has done no injury to the system in general, it is unnecessary
to confine the patient to a position wearisome, and oftentimes
insupportable to many persons. Then the limb is to be suspended in
a sling, which is always sufficient to support it, without having
recourse to the kind of hollow case recommended by Bell, which is
seldom at hand, and the use of which must be extremely inconvenient.
22. The subsequent treatment to be adopted in such fractures is
simple and easy: to wet the apparatus daily, for a few days, with
vegeto-mineral water, to obviate, by proper means, the accidents that
may occur; to renew the application of the roller at the end of eight
days, or perhaps later, according to the degree of its relaxation; to
repeat this application two or three times during the course of the
treatment; to allow, at first, but light diet, which may be afterwards
more solid, and given in larger quantity, and to admit finally of a
return to the patient’s usual mode of living: such was, in cases of
fracture, the practice of Desault, which was always attended with happy
effects.
23. Sometimes a considerable swelling occurs, after the application of
the bandage, on the back and face of the hand; small blisters appear
between the fingers; the patient experiences sharp pains along the
fore-arm; and other small blisters rise on its surface. It is then
necessary to remove the apparatus, to open the blisters by pricking the
cuticle, and dress the part with cerate spread on linen rags; replace
the apparatus, making it less tight than before, taking care to renew
it every day, till the excoriation be entirely gone. This accident, of
no great consequence in itself, has frequently occurred to Desault,
although the rollers were applied at first with but a moderate degree
of tightness.
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