On the mechanical treatment of chronic inflammation of the joints of the lower extremities : with a description of some new apparatus for producing extension at the knee and ankle-joints / by Lewis A. Sayre.

  • Lewis Sayre
Date:
1865
Catalogue details

Licence: Public Domain Mark

Credit: On the mechanical treatment of chronic inflammation of the joints of the lower extremities : with a description of some new apparatus for producing extension at the knee and ankle-joints / by Lewis A. Sayre. 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.

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    Her general health became much impaired, and in January, 1855, I was sent for to amputate the limb. Her suffering was most in- tense; she would not permit the limb to be handled until she was under the influence of chloroform, when crepitus was readily de- tected; several sinuses around the joint discharged quite freely a curdy pus mixed with a material very much resembling quince- jel]y- A probe passed into one of these sinuses, just posterior to the internal malleolus, went into and through the joint, making its exit at a point in front of the external malleolus. A strip of linen (in default of anything better) was torn from the child’s dress, passed through the eye of the probe, and drawn through the joint. A piece of firm sole-leather, cut to fit the front of the leg, aud dorsum of the foot, having been thoroughly soaked in cold water, was then applied over the top of the foot, and secured by a nicely- adjusted roller; the foot was firmly extended so as to separate the tibia and astragalus, and the roller then carried up the leg, over the leather, which, when dry, served to extend the joint and at the same time prevent all motion. This gave her great relief, and her limb could be moved with comparative comfort. The child was put upon the most nutritious diet, with quinine, cod-liver oil, and iron. The dressings were removed and changed as often as they became soiled with pus, and in the progress of the case, compression with sponges and cold water was resorted to. Her improvement was most marked and rapid. At the end of a few weeks the instrument was applied, as in the other cases, and with the same happy results, enabling the patient to walk with crutches and obtain the benefit of out door exercise, which added materially to the improvement of her general health. The setons were retained nearly ten months, being gradually reduced in size as the bone ceased to exfoliate and the pus became more healthy, until for a number of weeks they were hardly larger than a single thread. When they were finally removed, the sinuses healed in a few days, and passive motion was commenced as in the other cases. The patient continued to wear the instrument for nearly a year after she was perfectly well, as a meaus of prevention against accident, and then left it off' entirely. It is now eleven years since this case was operated on, and she is as well in the one leg as the other, and the motions are almost as perfect. The foot is one size smaller than the other, and the leg
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