On fractures and dislocations of the vertebral column.

  • Hulke, J. W.
Date:
1892
Catalogue details

Licence: Public Domain Mark

Credit: On fractures and dislocations of the vertebral column. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    stimuli are transmitted, and consciousness of the state of the bladder is evoked. It remains for me to notice, and it can be only very briefly, the treatment of these injuries. This falls naturally under two heads. 1. Their general care and management. 2. Operative procedures. 1. The principles governing the measures comprised under the first head—general care and management—are so fajniliar to all, and there is such complete accord in regard to them, that it is unnecessary, and, indeed, it would be out of place to enlarge on them here; but I would state my conviction that no class of cases demands of the surgeon closer direct supervision, and in none is there greater necessity for his close personal attention to details of nursing, too frequently esteemed trivial and relegated to subordinate attendants; and tliis conviction is my apology for touching briefly on a few topics to which otherwise, in this theatre and before this audience, I should not refer. In other fractures, as in the limbs, after restoration of normal figure by approximation of fragments, the endeavour is to retain these in proper position, and ensure them rest by the supply of external support, and by a suitable posture of the injured member. If similar measures are applicable to fractures of the vertebral column, how is it that they seem so often to receive so little attention ? Yet fixation of a broken backbone should certainly be the endeavour of the surgeon, even although it may be but im]3erfectly attainable. Even in fractures in the mobile cervical segment of the spinal column, much can be done towards ensuring fixity, so important for the prevention of additional damage to the cord through movements of the outer parts. Here the adaptation of a gutta-percha shield, embracing the occiput and scapulae, has certainly appeared to me useful, and it may be supplemented by a long partially-filled sandbag, arrai^ged in the figure of a horseshoe, the loop of which encircles the