The mechanical treatment of compound and suppurating fractures occurring at the seat of war / by Robert Jones.

  • Robert Jones
Date:
1915
Catalogue details

Licence: Public Domain Mark

Credit: The mechanical treatment of compound and suppurating fractures occurring at the seat of war / by Robert Jones. Source: Wellcome Collection.

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    internal or external rotation of the limb, the foot being kept at right angles. Local splints can then be employed, and are made of block tin or sheet iron. They can be moulded by the hand to fit the limb, and yet, being gutter-shaped, they are rigid longitudinally (Fig. 2 e). They can be disinfected by fire or water. <A couple of transverse bandage slings suspend the limb from the side bars of the knee splint. A straight splint is placed behind the suspensory bandages of the thigh and knee. On the front of the thigh another sheet iron splint is applied, and the femur is thus kept rigid (Fig.2 7). The alignment from the hip-joint to the ankle is perfect, being dependent on a straight pull (Fig. 2g). This splint allows the patient to raise his shoulders, or even sit in bed. His other leg can be moved freely without altering the tension on his thigh muscles, and there is no reflex spasm. Even if the muscles try to contract they cannot, for the ring of the splint is firm against the tuber ischiil. ‘The muscles therefore do not remain on the alert but become quiescent, and starting pains do not occur. Such is the difference between “ fixed” and ‘“ intermittent” extension. In using this splint a ttle attention is necessary to pre- vent soreness of the perineum. The ring of the splint, being covered with smooth basil leather, can easily be kept clean, so can the skin. The nurse should also several times a day press down the skin of the buttock, and draw a fresh part of the skin under the splint. To change the point of pressure over the perineum the limb can be elevated or abducted. The dressings can be applied without in any way interfering with the work of the splint. When the fracture has occurred through the knee or upper tibia the splint is applied in the same way. It has often been a matter of astonishment to me that so simple and effective a splint has not been universally employed. It can be applied in a few minutes, usually without an anaesthetic, and one is always sure of good length and good alignment, The fractured limb can be moved in any direction without giving pain, so that trans- port is easy and safe. I have never yet had to plate or wire a femur in a recent case, and this I ascribe to using the Thomas splint.
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