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
As a general rule, the joint at the lower end of the fractured bone
should always be fixed, and that at the upper end also, if the
fracture is near that point. For an example of the mode of fitting,
let us suppose the femur is broken between the middle and lower
thirds as in fig. 56.
Step 1. The limb is first measured for the splints. The length from
the top of the sacrum to the heel, from the tuber ischii to the
inside of the foot, and from the iliac crest to the outside of the
foot, should be taken, and three strips of millboard prepared of
corresponding lengths; the posterior one being 3 inches wide above
and 2 inches, or, if the limb is small, 1½ inches wide at the heel.
The inner and outer strips of similar width must be cut with side
pieces for the foot, and these side-pieces stop short of the roots
of the toes. For a child’s thigh, the foot need not be included, it
suffices for the splints to reach the small of the leg, though to
prevent shortening in an adult it is usually necessary to include the
whole limb. The splints are readily cut, by first marking on the
sheet of millboard, the required width and length of the strips, then
bending the sheet over the edge of a table along these lines. The two
lateral splints may be first taken from the sheet in one wide strip,
after allowing for the foot-piece; the two strips are separated
through a diagonal line, so that the broad end of one splint is taken
from the other (see fig. 55).
[Illustration: Fig. 55.—Diagram showing the mode of cutting out
splints from a sheet of millboard.]
When the strips are cut they should be laid on a large tea-tray,
boiling water poured over them, and a minute or two later, some
boiling hot thin starch; this soon soaks into and softens the
millboard till it is thoroughly pliant. When somewhat softened, the
edges should be thinned by peeling off little strips along them,
after which some more boiling water may be poured on and allowed to
soak in while the limb is prepared.
Two or three rollers should then be unwound, and passed as they are
rolled up again through the basin of starch; these, thoroughly soaked
in starch, are used for the first layer, dry rollers serve very well
for the second layer.
Step 2. The limb is washed and dried; a strip of diachylon plaster
one inch wide is laid along the front to protect the skin when the
case is being cut open after it is dry; the limb is next wrapped
evenly in cotton wool, putting a scrap between each toe. This is
best done by unrolling a sheet of wadding, splitting the sheet into
a layer of suitable thickness, which is torn into strips about three
inches broad, that are then wound evenly round the limb as high as
the splints will reach.
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