Surgery : its theory and practice / by William Johnson Walsham.

  • William Walsham
Date:
1889
Catalogue details

Licence: Public Domain Mark

Credit: Surgery : its theory and practice / by William Johnson Walsham. Source: Wellcome Collection.

    200/864 page 184
    associated -with other injuries of the part, as fractirre of a bone, laceration of a large blood-vessel, &c. !Z'Ae treat- ment consists in keeping the part at rest with the muscle as much as possible relaxed, and in preventing inflamma- tion by cold, lead and opium lotions and the like. Sham- pooing, massage, and galvanism may subsequently be necessary to restore any loss of po-wer that may ensue. Woi^NDS OF MUSCLES may be incised, lacerated, punc- tured, or contused. When the woimd is made trans- versely, the divided ends, which gape widely, miist be approximated by placing the limb in such a position as will relax the muscle, and then sutm-ed by animal ligature. When the wound is deep or parallel to the fibres a drainage tube must be inserted to prevent the retention of the discharge by the bulging of the muscle. LTuion takes place by fibrous tissiie. EuPTUEE OF MUSCLE may occur from a sudden and violent spasmodic action, or dming vomiting, tetanus, or delirium. As examples may be mentioned rupture of the rectus abdominis in labour, the biceps in raising weights, the supinator longus and gastrocnemius in lawn-tennis, the quadriceps extensor at football, and the adductors of the thigh in riding. A sensation of tearing is often felt at the moment of rupture, followed by pain and, if the rupture is complete, by loss of function. The ruptiu-e is indicated by a gap, above and below which is felt a hard swelling formed by the ends of the retracted nuiscle; or blood is extravasated between the ru]itured ends occasioning a htematoma. The treatmvni consists in approximatuig the divided ends as much as possible by position and by suitable bandages and sidints, and in ajiplying ice and evaporating lotions to control the blood-extravasation and to prevent inflammation. If a blooil-tiimour forms it should not be opened, unless suppuriition occurs. Wounds of tendons mny be divided into the sub- cutaneous and the open. Tlie former ■.wc discussed under TcNctomy. When a tendon is divided m an open wound, its cut ends sliould bo iipproximated by placing the ]iarts on a splint in such n position th.'it the muscle is as much as possible relaxed, and the divided ends then sutured by animal lignture. in long-stimdiiig cases an attem]>t may also 1)0 made to unitethecut tendon if the iiatient's genernl state of health is favourable, and there is no evidence ni extensive destruction or of adhesion of the tendon to the neighbouring strucfnrcs liaving occurred.
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