Compound dislocations of the ankle-joints / by Frederic S. Dennis.

  • Frederic Shepard Dennis
Date:
1890
Catalogue details

Licence: Public Domain Mark

Credit: Compound dislocations of the ankle-joints / by Frederic S. Dennis. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    11/12 (page 9)
    / 9 puratlon. If the joint is not moved at this time, the adhesions become firm, and anchylosis is certain to follow, and consequently the function of the joint is destroyed. Shampooing and gentle friction are also valuable adjuvants at this period in the history of the iijjury. It is to be especially noted that the move- ment allowed to tlie joint is not active, but passive, and the former should not be permitted until six Aveeks from the date of the accident. The rule that Sir James Paget has given is here especially applica- ble. He taught that an acutely inflamed joint with heat and tenderness in it should be kept physiologi- cally at rest, and that a joint that was stiff and par- tially anchylosed, but that was free from all inflamma- tory action, should be treated by passive motion and by massage. The seveyith rule applies to movements in the joint to be made by the patient. Active motion in the joint is necessary at this period to excite the secretion of synovia, to release the tendons from any adhesions due to a thecal inflammation, to disintegrate fibrous adhesions, to restore the natural motion in the joint, to absorb any of the products of inflammation, as col- lateral oedema and ecchymoses in the surrounding soft structures. It sometimes happens that at this stage swelling occurs in the leg or in the foot from the removal of the j^laster bandage. This is, however, only temporary and will soon disappear upon the pa- tient walking about for a fcAV days. If active motion is allowed earlier than the sixth Aveek, there is danger of exciting new and suppurative inflammation in the joint; and a joint that gave every prospect of becom- ing perfect in function at the end of the second or third or even the fourth Aveek, may become totally