The principles of surgery / by James Miller.

  • James Miller
Date:
1844
Catalogue details

Licence: Public Domain Mark

Credit: The principles of surgery / by James Miller. Source: Wellcome Collection.

    707/736 page 691
    ON FALSE JOIST. GDI articulation. There is neither articular cartilage, nor syno- vial apparatus. The ends of the bone taper somewhat, and are rounded off; they are invested by a dense ligamentous expansion ; and, by a similar texture, of less density, they are joined together. By such an arrangement, extent of motion is abundantly favoured ; and a limb, so circumstanced, is, if unsupported by extrinsic aid, almost wholly useless as an organ either of prehension or support. The occurrence is more frequent in military than in civil practice ; for two very ob- vious reasons first, the means for duly conducting the treat- ment of fracture are less available ; secondly, the bruising in- flicted by shot wounds is inimical to satisfactory processes of cure, both in the soft and in the hard textures. Treatment of False Joint.—The retentive apparatus of a frac- tured limb having been undone, at the usual period, and the part being found yet mobile, we are not warranted in supposing that union has altogether failed. There is evidence only of failure in the first part; the formation of the provisional callus. This is wanting, or has proved imperfect and insufficient. The definitive callus, however, may be duly advanced and in pro- gress. The limb, therefore, is to be put up, more carefully than before ; in order that our comparatively clumsy splints may atone for the want of Nature’s more skilful adaptations ; and in order that, immobility of the part being maintained, consolidation by the definitive callus may be duly favoured. All may advance prosperously, and the cure, though tedious, may prove firm and satisfactory. The first mode of treatment, then, to be adopted, is the ap- plication and maintenance of retentive apparatus, as for frac- ture at the first; only, if possible, more carefully applied, and with the certain prospect of long retention. The starch and gum adaptations are extremely suitable. At the same time, the general health is attended to ; the diet is generous and stimuli are administered, if deemed advisable, to maintain energy of system for due sustainment of local reparative action. If, however, on removal of the apparatus, after ano- ther month or six weeks have elapsed, the part be still found mobile, it is reasonable to infer that the second part of the curative process, the formation of the definitive callus, has
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