The essentials of bandaging: $b including the management of fractures and dislocations, with directions for using other surgical apparatusHill, Berkeley
Science
The essentials of bandaging: $b including the management of fractures and dislocations, with directions for using other surgical apparatus
Hill, Berkeley
Bandages and bandaging; Dislocations -- Treatment; Fractures -- Treatment; Surgery, Minor
Fixed deformity opposite the wrist is usually present from impaction
of the fragments; moderate extension may be employed to remove this,
but forcible or continued efforts give great pain and do harm,
by further straining the already wrenched ligaments. After these
preparations the splints are applied.
Step 2. Put a very little cotton wool in the palm and across the
root of the thumb, before the roller is begun, lest it chafe the
carpus in front. The curved splint, with the barrel or longer part
inclined downwards below the forearm, is next attached to the back of
the hand by a roller carried in figures of 8 round the hand and root
of the thumb, but not above the wrist (see fig. 29). This is made
fast by a pin.
[Illustration: Fig. 29.—Fracture of the Radius.]
Step 3. Raise the straight part of the outside splint till parallel
to the forearm, thus adducting the hand to the ulnar side; and fix
the splint by a strap of plaster an inch wide carried round it and
the forearm below the elbow.
Step 4. Apply the inside straight splint next, keeping the front of
the carpus and of the lower fragment exposed. Draw the two splints
together by simple spiral turns of a roller, begun just below the
elbow and carried down to the lower end of the inside splint, there
fasten it off.
Step 5. Put a narrow sling under the forearm between the elbow and
the wrist to support the limb comfortably.
When the apparatus is finished the position of the broken fragments
should be visible (see fig. 29) and not concealed by bandage. The
hand should also be quite free of the sling, lest it be drawn from
its proper adducted position. The fragments are in good position
when the hollow on the anterior aspect of the wrist and the
prominence on the corresponding posterior surface are removed.
=The Gutta-percha Gauntlet= is another plan of treating fracture
of the lower end of the radius that may often be adopted from the
first, and may always replace the wooden splints and bandage when
the swelling has subsided. It was contrived by Mr. Heather Bigg, and
permits the patient to use his hand to some extent while the bone is
uniting.
_Apparatus._—1. A piece of gutta-percha ¼ inch thick, wide enough
to enwrap the metacarpus and wrist, and long enough to reach up the
lower half of the forearm. Two thirds across the width, and about 1
inch from the lower end, a small round hole is punched. The sheet is
then softened in hot water, and applied to the hand, the thumb being
thrust through the hole punched to receive it, which rapidly enlarges
when soft. The gutta-percha is then adjusted to the hand and forearm,
its borders meeting at the ulnar side of the limb, rather nearer the
inner border of the arm than is depicted in fig. 30.
[Illustration: Fig. 30.—Gutta-percha Gauntlet for Colles’ Fracture.]
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