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
The McIntyre’s Splint may be used either bent or straight, whichever
position of the knee most relaxes the tension of the muscles on the
fragments. As a general rule the straight position is best if the
fracture is high up, and the bent one, when near the ankle joint.
Step 1. A splint of suitable length is selected, by measuring the
sound leg. The joint of the splint should be put opposite the
patella, and space be left below the foot for the foot-piece to slide
along the slot when extension is made.
The splint is next padded, the hollow where the lower part of the
calf and small of the leg will come being well filled, that the leg
may be thoroughly supported; but the space behind the heel and tendo
Achillis must be left quite clear. A small pad is then fastened by a
strip of strapping or by needle and thread to the foot-piece.
Step 2. The limb having been first cleaned and dried, the dorsum of
the foot and ankle are wrapped in an even layer of cotton wool. A
sock or boot made of flannel is next put on the foot. This may be
readily extemporised by cutting off the foot of an angola stocking,
slitting it up along the back to the toes, and sewing on to the
sole, one inch in front of the heel, the middle of a piece of tape ¼
inch wide and 18 inches long. The foot is then wrapped in the sock,
the edges drawn together by a needle and thread, care being taken
that the sock fits closely round the ankle and dorsum of the foot.
A little wool having been wrapped round the knee, the limb is next
raised, while the splint is placed under it; the screw is turned
until the inclined planes are at an angle suited for the maintenance
of the fragments in position, and the foot-piece is pushed up to
the foot with its screw-pin loose, that it may be adjusted to the
amount of flexion or extension necessary for the foot; this being
ascertained, the screw is tightened to keep it so while the foot is
fastened to the foot-piece. For this the strings of the sock are
brought over the top of the foot-piece, and drawn tight before tying
them.
[Illustration: Fig. 41.—McIntyre’s Splint. The thigh fixed ready for
extension of the leg.]
The position of the heel is very important. It should not sink below
the splint, or it will rest on the bandage; neither should it be
drawn up too high, or the weight of the leg will hang on the sock,
instead of resting on the pad; both frequent causes of pain at the
heel. When the proper position is obtained, the strings are made fast
to the pin behind the foot-piece, and the foot is steadied by two or
three turns of a roller carried round it and the foot-piece (fig. 41).
Step 3. The thigh is next fastened to the thigh-piece by a roller
carried from the top of the splint downwards along the thigh to the
knee, or below that joint if the fracture is near the ankle.
Public-domain text, read in full here on John Shaqi.
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