=Treatment.=--To set this fracture temporarily, a board about five
inches wide and long enough to reach from the armpit to the foot
should be padded well with towels, sheets, shawls, coats, blanket, or
whatever is at hand, and the padding can best be kept in place by
surgeon's adhesive plaster, bicycle tape, or strips of cloth.[8]
Another splint should be provided as wide as the thigh and long enough
to reach along the back of the leg from the middle of the calf to the
buttock, and also padded in the same way. A third splint should be
prepared in the same manner to go inside the leg, reaching from the
crotch to the inside of the foot. Still a fourth splint made of a thin
board as wide as the thigh, extending from the upper part of the thigh
to just above the knee, is padded for application to the front of the
thigh.
When these are made ready and at hand, the leg should be pulled on
steadily but carefully straight away from the body to relax the
muscles, an assistant holding the upper part of the thigh and pulling
in the opposite direction. Then, when the leg has been straightened
out and the thigh bone seems in fair line, the splints should be
applied; the first to the outside of the thigh and body, the second
under the calf, knee, and thigh; the third to the inside of the whole
limb, and the fourth to the front of the thigh.
Wide pads should be placed over the ribs under the outside splint to
fill the space above the hips and under the armpit. Then all four
splints are drawn together and held in place by rubber-plaster straps
or strips of strong muslin applied as follows: one above the ankle;
one below the knee; one above the knee; one in the middle of the
thigh, and one around the upper part of the thigh. A wide band of
strong muslin or sheeting should then be bound around the whole body
between the armpits and hips, inclosing the upper part of the outside
splint. The patient can then be borne comfortably upon a stretcher
made of boards and a mattress or some improvised cushion. (See Figs.
24 and 25.)
When the patient can be put immediately to bed after the injury, and
does not have to be transported, it is only necessary to apply the
outer, back, and front splints, omitting the inner splint. It is
necessary for the proper and permanent setting of a fractured thigh
that a surgeon give an anaesthetic and apply the splints while the
muscles are completely relaxed. It is also essential that the muscles
be kept from contracting thereafter by the application of a fifteen-
or twenty-pound weight to the leg, after the splints are applied, but
it is possible to outline here only the proper first-aid treatment.
=KNEEPAN FRACTURE.=
_First Aid Rule.--Pain is immediate and intense. Separated fragments
may be felt at first. Swelling prompt and enormous. Even if not sure,
follow these directions for safety._
Public-domain text, read in full here on John Shaqi.
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