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.

    36/200 page 32
    injury is often very confusing to the practitioner. Very often after an injury due to violence, repair is only accomplished by the formation of a con¬ siderable mass of cicatricial tissue. If there has been a suppurative wound associated with much bruising and tearing of the soft parts, as in a shrapnel or bullet wound which has driven shattered bone through the soft parts, there must be for a long time a mass of cicatricial tissue in the deeper parts of the wound, often out of proportion to the size of the surface wound of entry. After the sepsis has been overcome and the wound has healed, these cicatrized areas remain tender; shooting pains are felt, and are sometimes called neuritis, though there is no real inflammation of nerves; often the pain passes off when the patient uses the limb, but reappears at night ; such cicatricial areas are also sensitive to changes of atmospheric pressure. Pain of this type is generally due to irregularities of blood-pressure. If such an area were superficial it would be a dusky scar, obviously the seat of venous congestion, and the treatment would be to promote vascular activity. To test this in deeply situated cicatrices about joints, all that is necessary is to promote a rapid flow of blood to the surface by lightly slapping and massaging the skin ; as soon as a rosy flush appears on the skin, ask the patient to move the joint, and if he can do so with less pain and stiffness than before it will be obvious that the slight alteration in blood-pressure has made all the difference.
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