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
Step 2. The elbow is elevated by an assistant, who keeps the arm
vertical and lays the fingers on the breast bone. A roller attached
to the arm by a couple of turns is carried behind the back round the
trunk, and over the arm above the elbow, drawing that close to the
side.
Step 3. To support the elbow, the longest border or base of a
three-cornered handkerchief is carried under it, one end passes in
front, the other behind the body; both are then drawn tightly and
crossed over the opposite shoulder, where one end is taken under the
axilla, and tied in front. In giving this direction the ring-pads
shown in the figures are supposed not to be at hand. Lastly, the
loose corner at the wrist is folded neatly and pinned up (see fig.
39).
[Illustration: Fig. 39.—Apparatus for broken Clavicle finished.]
This apparatus must be watched from time to time, and re-adjusted if
any part slips. The sling and pad are to be worn for four weeks.
Union sometimes takes place in three weeks or less, in which case the
pad may be removed so much the earlier; but a sling should be worn
for a fortnight after the bandage and pad are laid aside. In children
the pad must be very much thinner and shorter than that described;
the sling should be replaced by a bandage carried alternately round
the body, and over the opposite shoulder. After it is put on the
turns should be well stitched together, and smeared over with stiff
starch. In bandaging children, great care must be taken to protect
with wool the parts likely to be chafed.
_Figure-of-8 bandage._—Many surgeons still employ a figure-of-8
bandage carried under each axilla and crossed behind the back.
Under any circumstances this is exceedingly irksome to the patient,
but is least so if two silk handkerchiefs be substituted for the
bandage, one being passed round each shoulder and the ends of both
braced tightly together behind the back. The wedge-shaped pad may be
dispensed with if the shoulders are braced back, but the elbow must
still be raised and drawn to the side.
The American surgeons have a very good plan for attaching the sling
to the sound shoulder. Instead of carrying the ends of the sling
round the shoulder and under the axilla, they pass over the shoulder
a loose but well-stuffed collar or ring-pad (see fig. 38), to which
they fasten the ends of the sling in front and behind; this prevents
all cutting or chafing under the armpit, and distributes the strain
evenly.
LOWER EXTREMITY.
=Ruptured tendo Achillis= is treated by extending the foot and
flexing the knee; for this purpose the patient wears a high-heeled
slipper. A band is sewn to the heel, drawn tight, and fastened to a
buckle and strap round the thigh, just above the knee. The patient
should not walk for a month unless he will use a wooden leg on which
he can kneel, with the knee bent.
=Separation of the Epiphysis of the Calcaneum=, which sometimes
occurs instead of rupture of the tendo Achillis, is treated in the
same way.
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