Surgical cases and essays / by Rushton Parker.

  • Parker, Rushton, 1847-
Date:
1883
Catalogue details

Licence: Public Domain Mark

Credit: Surgical cases and essays / by Rushton Parker. Source: Wellcome Collection.

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    pinned to the other (3). It is well to place a soft pad behind and in front of, or even all round the leg, as a protection to the skin in contact with the tibia and fibula, before applying the wide bandage. The thigh is separately supported by a hollow firm splint of padded sheet meta} (zinc or iron), or wood, as in Gooch's material, or even thickly folded paper, closely fitting the limb, reaching from the ring at the buttock to a little way below the knee (2). Contact should be secured behind the knee-joint by interposing, if required, a small mass of extra padding slipped in to relieve the soft parts behind the knee from the irksome strain of supporting the bones. This splint behind the thigh is now slung to the side bars by strips of bandage two or three in number, suitably adjusted and knotted. Other short hollow splints, of the material that may be chosen, or that comes most handy, are now placed so as completely to encircle the thigh, and strips of bandage tied moderately tightly around them and the included thigh, inside and out- side the iron bars according to fitness (2). The extension straps are tightened up from day to day, if slack, so that the full length of the limb is, if possible, secured within a week or so, especially in children, whose bones so quickly unite. When the length is secured, all that is required is a vigilant maintenance of immobility and correct line, by tightening the encircling bandages as they become slack during the wasting of the limb, and by such other adjustments as common sense demands. In case the skin of the perineum becomes tender, apply grease, and so prevent or allay excoriation. By this mode of treatment shortening may be more often prevented than is generally imagined, and in a good proportion of cases can easily be averted. I have left a case now in hospital where a fracture of the tibia, fibula, and femur in the same limb, managed chiefly by the house- surgeons of the Liverpool Royal Infirmary, in one of the splints here named, has resulted in a perfect union without deformity in the leg, and an almost inappreciable shortening of the thigh; though here the diffi- culties were really great, in spite of which the patient has had less than the average discomfort attending either one of these fractures; to say
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