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
6. A hook, fitted with a buckle and strap, and hinged so that, by
turning a pin, it at once disengages itself. If this is interposed
between the pulleys and the hook fixed in the wall, the limb may be
instantaneously released if desired.
[Illustration: Fig. 66.—Dislocation of the dorsum ilii.]
_Treatment._—Step 1. The patient is laid on a flat couch, and put
under the influence of chloroform. When he is narcotised, a jack
towel, or if it be at hand the pelvic girdle, is carried across the
perinæum, arranging it to bear on the tuber ischii behind and the
pubes in front, its ends being attached to one of the hooks screwed
into the wall behind, and about six inches below the level of the
patient. This towel should be put slightly on the stretch, that the
pelvis may be kept in the position first assigned to it when the
pulleys begin to draw. A wet roller is put on the lower third of the
thigh, the jack towel slipped up the leg to the bandage, and fastened
in a clove hitch. Another jack towel is then doubled and passed up
the limb to the perinæum. The patient is next turned on to his sound
side, and the belt of the thigh connected by the disengaging hook to
the pulleys, which are drawn out from each other as far as their cord
will allow, and attached to a hook fixed a little above the level of
the patient, on a line carried from the hip across the junction of
the middle and lower thirds of the uninjured thigh (see fig. 66).
Step 2. The surgeon being ready, an assistant draws on the pulley
cord, getting gradual extension of the limb as required by the
surgeon, who, keeping his hands on the hip and great trochanter,
watches the progress of the head of the bone towards the acetabulum.
Step 3. When the bone has reached the edge of the acetabulum, a
second assistant slips the doubled jack-towel over his shoulders,
and by raising his body, lifts the femur away from the brim of the
acetabulum, while the surgeon, grasping the foot and knee, makes a
few movements of rotation backwards and forwards to ease the head
into its socket.
When a reduction is effected, the limb should be put in a long
splint or starch bandage for three weeks, and the patient not allowed
to exercise the limb freely or violently for a month afterwards.
_Reduction by Manipulation._—When the patient is not very muscular,
and the dislocation recent, the bone can often be speedily returned
by movements of flexion and rotation.
Public-domain text, read in full here on John Shaqi.
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