Injuries of joints / by Robert Jones.

  • Robert Jones
Date:
1915
Catalogue details

Licence: In copyright

Credit: Injuries of joints / by Robert Jones. Source: Wellcome Collection.

    16/200 page 12
    of handling a large number of joint injuries, are to decide what is the most appropriate immediate treat¬ ment, and when and how to commence moving the injured joint, especially after the more serious injuries. The solution of the first is found in accurate dia¬ gnosis of the injury, and in forming a clear idea of the mechanical and physiological factors which enter into the processes of repair. As a simple illustration of this, we will assume that a man jumping from a wall or into a trench lands on the edge of a clod of earth, and violently twists his foot inwards. He feels a sharp stab of pain on the outer side of the ankle, his neighbours perhaps hear a sharp click which makes them think he has broken a bone. By the time the man has limped about and is seen by a surgeon, the whole ankle is swollen and painful. Having excluded a Pott’s fracture by running his finger down the fibula and finding it intact, the surgeon makes the diagnosis of ' sprained ankle ’. The time-honoured remedy of cold-water bandages or the application of some cooling lotion combined with rest ‘ till the swelling goes down * is in many cases too frequently adopted ; the patient subsequently being allowed up in a soft slipper, which is almost the worst thing he can do in the convalescent stage. Although the ankle is very painful, it will bear gentle but firm handling ; the history points to an injury about the external malleo¬ lus, and the inference is that there is a rupture of one of the three slips of the external lateral ligament of the ankle, or perhaps an avulsion of a scale of bone
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