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.

    49/200 page 45
    In a surface wound this includes all stages up to the establishment of granulation tissue. Second : The second stage is that of immaturely formed repair elements, especially the laying down of fibrous tissue elements and bone elements to form cicatrix and callus. In this stage the seat of injury is still hyperaemic, but as the formed elements mature, the vascularity gradually diminishes, and the whole seat of repair passes gradually into the third stage. Third : The mature scar consists of fully formed fibrous tissue elements and hard callus. The fibrous tissue has become white owing to the disappearance of active hyperaemia, and in some cases, owing to contraction of fibrous tissue, repair of other parts of the wound is impeded for want of blood. About joints—say, the front of the wrist, the back of the knee, the flexure of the elbow—-there is a great tendency for the new scar to go on contracting till the limb is fixed in a useless, flexed position. Owing to the contraction of the scar, the blood-vessels cannot expand freely, and the whole area becomes dense, white, and anaemic. The first stage : during the first stage the region of the wound or injury must be left very much at rest. Fractures should be put up in the best position, torn tissues brought together as far as possible, and then left for the new repair blood-vessels to grow between fragments. These grow in the plastic exudate ; therefore any rough handling, injudicious massage or movement, will only tear them.
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