With the patient lying flat on the back and both legs together in a
straight line with the body, measurements from each hip-bone are made
with a tape to the bony prominence on the inside of each ankle, in
turn. One end of the tape is held at the navel and the other is swung
from one ankle to the other, comparing the length of the two limbs.
Shortening of less than half an inch is of no importance as a sign of
fracture. The fragments of broken bone are often jammed together
(impacted) so that it is impossible to get any sound of grating
between them, and it is very unwise to manipulate the leg or hip
joint, except in the gentlest manner, in an attempt to get this
grating. If the ends of the fragments become disengaged from each
other it often happens that union of the break never occurs.
[Illustration: FIG. 25.
TREATMENT FOR FRACTURED HIP (SCUDDER).
Note method of holding splints in place with muslin strips; one above
ankle, one below and one above knee, one in middle and one around
upper part of thigh.]
The treatment simply consists in keeping the patient quiet on a hard
mattress, with a small pillow under the knee of the injured side and
the limb steadied on either side by pillows or cushions until a
surgeon can be obtained. (See Thigh-bone Fracture.)
=THIGH-BONE FRACTURE.=
_First Aid Rule.--Prepare long piece of thin board which will reach
from armpit to ankle, and another piece long enough to reach from
crotch to knee, and pad each with folded towels or blanket._
_While one assistant holds body back, and another assistant pulls on
ankle of injured side, see that the fragments are separated and
brought into good line, and then apply the splints, assistants still
pulling steadily, and fasten the splints in place with bandage, or by
tying several cloths across at three places above the knee and two
places below the knee._
_Finally, pass a wide band of cloth about the body, from armpit to
hips, inclosing the upper part of the well-padded splint, and fasten
it snugly. The hollow between splint and waist must be filled with
padding before this wide cloth is applied._
In fracture of the thigh bone (between the hip and knee), there is
often great swelling about the break. The limb is helpless and
useless. There is intense pain and abnormal position in the injured
part, besides deformity produced by the swelling. The foot of the
injured limb is turned over to one side or the other, owing to a
rolling over of the portion of the limb below the break. With both
lower limbs in line with the body, and the patient lying on the back,
measurements are made from each hip-bone to the prominence on the
inside of either ankle joint. Shortening of the injured leg will be
found, varying from one to over two inches, according to the
overlapping and displacement of the fragments.
Public-domain text, read in full here on John Shaqi.
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