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
If the fracture is recent, it must be reduced while the splint is
soft by extending the hand and holding the parts in the required
position until the gutta-percha is set. Before removing the splints
superfluous edges should be marked, and, when the splint is off,
trimmed away with a knife. Holes must also be punched at frequent
intervals that the perspiration may escape. The splint is next lined
with wash-leather, and fitted with a pair of straps and buckles to
keep it in place.
By this plan the fingers are left free, and some motion allowed also
to the thumb. The only joints kept immoveable are those of the carpus
and wrist.
Apparatus of some kind must be worn three weeks continuously; then
for a fortnight longer, while it is removed every day to allow
passive motion of the fingers and gradually of the wrist also to be
practised. Care should be taken to warn the patient that pain and
stiffness last long in these fractures, lest he blame the surgeon
because he does not quickly recover full use of his arm.
=Fracture of the Shaft of one or both Bones of the Forearm.=
_Apparatus._—1. Two straight wooden splints.
2. Pads and wool.
3. 2-inch wide roller.
4. Sling.
The treatment is the same whether one or both bones are broken.
Caution has been already given against bandaging the forearm
underneath the splints.
Step 1. Prepare two straight wooden splints; one to go in front of,
and one behind the forearm. The posterior or outside reaches from the
external condyle to the end of the metacarpus; the anterior or inside
splint from a little below the internal condyle only as far as the
wrist, keeping clear of the ball of the thumb. The splints should be
slightly broader than the forearm, and well padded; towards the lower
end the padding should be thicker than above. The forearm is bent to
a right angle and the thumb put upwards.
Step 2. Reduce the fracture by gentle slow extension at the wrist;
this being effected, apply the splints to the forearm, and let an
assistant hold them while the bandage is rolled on.
Step 3. When a little wool has been wrapped round the hand and wrist,
fasten the dorsal splint by figures of 8 carried round those parts;
then draw the two splints together by simple spirals continued to the
elbow (see fig. 31).
[Illustration: Fig. 31.—Fracture of both Bones of the Forearm.]
Step 4. Support the forearm in a sling, to complete the apparatus.
The splints are worn three weeks; after this, passive motion may be
practised daily, and the splints finally abandoned ten days later.
But a sling is still required some ten days after the splints are
laid aside.
When the ulna alone is broken, an anterior splint reaching from the
inner condyle to the tips of the fingers often suffices without a
second one.
Public-domain text, read in full here on John Shaqi.
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