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
In doing this the roller is passed inside the screw, should that be
placed underneath the splint, as in fig. 43 page 65, and not at the
side as in fig. 41, for the screw will be wanted free for further
adjustment.
[Illustration: Fig. 42.—McIntyre’s Splint slung in Salter’s Cradle.]
Step 4. An assistant grasps with both hands the foot and foot-piece,
and pulls them downwards until the shortening is removed. While doing
this, he tilts the foot up or down as the surgeon finds necessary
for adjusting the fragments, who also bends the knee and raises or
lowers the foot until a good position is attained. The general rule
is to keep the great toe in a line with the patella. This done, the
surgeon tightens up the screw-pin of the foot-piece, and completes
the attachment of the foot by continuing his roller with figures of 8
round the foot and ankle; these turns should not however pass above
the fracture, and be no more than sufficient to secure the position
of the foot and of the lower fragments (see fig. 42).
Step 5. The bandaging usually ceases with what has been already done;
but if the limb swell, a separate roller may be carried along the leg
to support the muscles and restrain œdema, otherwise the leg is best
left bare, that the position of the fragments may be watched, and
evaporating lotions applied.
[Illustration: Fig. 43.—McIntyre’s Splint raised on a Block.]
Step 6_a_. This consists in slinging the limb, for which Salter’s
Cradle is very convenient (see fig. 42), or an ordinary bed cradle
answers very well, from which the limb can be slung on pieces of
bandage carried underneath the splint at the knee and ankle.
_b._ Instead of elevating the limb by a sling, it is also customary
to raise and fix the splint on a block (fig. 43), 6, 8, 10, or even
12 inches high, as may be necessary; this block slides in a groove
on a board 3 feet square, put between the mattress and bedstead, to
afford a firm support for the block.
In ordinary cases the limb is kept on the splint three weeks, until
the irritation has subsided, and partial union is attained; the
splint may then be replaced by a starch bandage, and the patient may
leave his bed.
=Transverse Fracture= of the _tibia_ alone, or even of both bones,
when the displacement is small, is very well treated by a hollow
splint on each side. Both splints are cut away opposite the malleoli,
and the foot-piece of the inside one should not extend beyond the
tarsus; that of the outside passes to the toes. The splints reach on
each side to the head of the tibia, but ought not to extend above the
knee-joint (see fig. 44).
[Illustration: Fig. 44.—Outside lateral Splint for the Tibia.]
Step 1. They are padded lightly and evenly along their whole length,
and applied to the limb on each side.
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