The surgical treatment of the diseases of infancy and childhood / by T. Holmes.
- Timothy Holmes
- Date:
- 1868
Licence: Public Domain Mark
Credit: The surgical treatment of the diseases of infancy and childhood / by T. Holmes. Source: Wellcome Collection.
476/700
![blest. A bag of shot, or even of stones, will serve for the weight; a pulley is easily constructed with a skewer and a reel; and a stirrup of any material, properly secured from slipping by a girth round the ankle, is all that is necessary. It is only requisite to see that the weight hangs at such a distance from the floor that the child cannot bring it to the ground by slipping down the bed; and if the limb is much out of the straight line, a couple of sandbags may be wanted to form a groove for it and insure the proper line of action of the force. I have seen too many instances of the application of this plan to doubt its efficiency and its superiority to the long splint. Among others, I may again refer to the case of a little boy with the cicatrix of a burn in the bend of each elbow, quoted above, p. 281. Extending There are also instruments for making extension ; such as splmts. £ne American splint, devised by Dr. Sayre of New York (at least which bears his name), and which we have tried at the Hospital for Sick Children. Its principle is to draw the thigh away from the pelvis by means of the action of a rack and pinion. It is light and easily applied, and by its means it is hoped that the child may be safely allowed to walk about, as the splint is trusted to draw the limb out of the pelvic articu- lation, and so to fix it that the action of walking will not be painful. Mr. Barwell speaks favourably of it, I believe ; but I cannot say that in our practice it has been successful. Nor have I found any benefit from the apparatus recom- mended by Mr. Barwell himself, which seems to be on the same principle, except that he does by means of india-rubber what Sayre effects by a rack and pinion, and that he confines his patients to bed. But while the child is in bed, I prefer the weight to any apparatus. Puncture Puncture of the joint is a measure which I think is occa- ofthejomt. sjona]]y usef\jj anc[ which I have found at any rate innocuous to a degree which has surprised me in the case of the knee- joint, in which 1 have often employed it. Still I cannot recommend it as having much curative power, for I have constantly found the fluid re-accumulate as fast as it has been withdrawn. It is doubtless useful, however, in another point of view, viz. as affording valuable information when suppuration is suspected. It should be performed with a fine](https://iiif.wellcomecollection.org/image/b20416325_0476.jp2/full/800%2C/0/default.jpg)
