Manual of Surgery Volume Second: Extremities—Head—Neck. Sixth Edition.Thomson, Alexis
Science
Manual of Surgery Volume Second: Extremities—Head—Neck. Sixth Edition.
Thomson, Alexis
Surgery
_Simple wooden splints_ of plain deal board or yellow pine, sawn to
the appropriate length and width; or _Gooch's splinting_, which
consists of long strips of soft wood, glued to a backing of
wash-leather, are the most useful materials. Gooch's splinting has the
advantage that when applied with the leather side next the limb it
encircles the part as a ferrule; while it remains rigid when the
wooden side is turned towards the skin. Perforated sheet lead or tin,
stiff wire netting, and hoop iron also form useful splints.
When it is desirable that the splint should take the shape of the part
accurately, a plastic material may be employed. Perhaps the most
convenient is _poroplastic felt_, which consists of strong felt
saturated with resin. When heated before a fire or placed in boiling
water, it becomes quite plastic and may be accurately moulded to any
part, and on cooling it again becomes rigid. The splint should be cut
from a carefully fitted paper pattern. Millboard, leather, or
gutta-percha softened in hot water, and moulded to the part, may also
be employed.
In conditions where treatment by massage and movement is
impracticable, and where movable splints are inconvenient, splints of
_plaster of Paris_, _starch_, or _water-glass_ are sometimes used,
especially in the treatment of fractures of the leg. When employed in
the form of an immovable case, they are open to certain
objections--for example, if applied immediately after the accident
they are apt to become too tight if swelling occurs; and if applied
while swelling is still present, they become slack when this subsides,
so that displacement is liable to occur.
When it is desired to enclose the limb in a plaster case, coarse
muslin bandages, 3 yards long, and charged with the finest quality of
thoroughly dried plaster of Paris, are employed. The "acetic plaster
bandages" sold in the shops set most quickly and firmly. Boracic lint
or a loose stocking is applied next the skin, and the bony prominences
are specially padded. The plaster bandage is then placed in cold water
till air-bubbles cease to escape, by which time it is thoroughly
saturated, and, after the excess of water is squeezed out, is applied
in the usual way from below upward. From two to four plies of the
bandage are required. In the course of half an hour the plaster should
be thoroughly set. To facilitate the removal of a plaster case the
limb should be immersed for a short time in tepid water.
A convenient and efficient splint is made by moulding two pieces of
poroplastic felt to the sides of the limb, and fixing them in position
with an elastic webbing bandage; this apparatus can be easily removed
for the daily massage.
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