Contributions to orthopoedic surgery / by Robert Jones and John Ridlon.

  • Robert Jones
Date:
[1892-1893]
Catalogue details

Licence: Public Domain Mark

Credit: Contributions to orthopoedic surgery / by Robert Jones and John Ridlon. 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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    meant that the brace is so constructed, that by manipulating the bars by means of wrenches (at first it was by hinges and set-screws), the pressure over the transverse processes of the vertebrae, composing the angle, can be adjusted to a nicety and increased or diminished at will, it being anticipated that, in certain cases and with disease in certain localities', the curve will gradually diminish, and, on rarer occasions, be entirely effaced by the leverage action It will be seen that the principle is essentially different from that upon which the plaster jacket is used. It does not suspend or partially suspend the patient, to gain the position of greatest comfort, which generally improves the curve, but applies the brace to the patient with no attempt at improvement in his posture beyond that which is gained by lying down for a short time. More often than otherwise the patient is not kept recumbent for more than half an hour, and at times when the disease is in either the lumbar, or in the upper dorsal, or the cervical region, the brace is applied with the patient standing. This, however, is con- trary to the teaching of Dr. Taylor, who never permits the patient to stand either during the application of the brace, or afterwards, until convalescence. The brace being applied the chief aim is to immobilize the area of disease until a cure is effected ; meantime, if consolidation has not already taken place, it is attempted by gradually increasing the pressure to straighten the curvature or at least check the progress of the deformity. The plaster jacket aims at preserving the reduction of deformity gained by periodical partial suspension ; the brace, by its contin- uous leverage action is used to reduce the deformity; both primarily aim at immobilization. The advantages of the leverage brace, over and above the efficiency with which it carries out the principles involved, are its comparatively small cost, its durability, and the little time and effort required of the surgeon to adjust it. A gunsmith, locksmith, or blacksmith of average ability can, under surgical supervision, be trusted to make it, and the result will be a more efficient apparatus than can be obtained from any of the great instrument shops. Braces with hard- rubber pad-plates and bearings will cost considerably more than if the rubber pieces be omitted, as the shaping of these hard-rubber pieces requires specially constructed moulds and consumes much time. The brace, except when these pads be added, can be generally fitted in a few minutes, it does not require frequent modifications when once properly fitted and rarely requires repair or material alteration; it is com- paratively light, cool, and easily kept clean and free from
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