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.

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    Free exit must be given to all discharges in septic cases, that the tissues may be as little as possible sodden in poisonous toxins and as much as possible nourished and fortified by the food elements and antibodies in the blood fluids. Therefore the surgeon should at once decide in what position the limb is to be treated, and en¬ deavour not to move it until repair is well estab¬ lished. In the second stage : passive movement is apt to tear newly formed tissues, causing bleeding and increased organization of scar tissue. On the other hand, it is possible now gently and gradually to change the position of the limb. It is during the end of this stage, when the imma¬ ture tissue elements are becoming matured, that the tendency to contract takes place ; therefore if the limb has not already been put in the position opposed to the deformity which is feared, it should be done now. For example : in a bullet-wound through the condyles of the humerus, with extensive loss of tissue and suppuration in front of the elbow, there will be a large scar formation. First, the fracture must be reduced, the arm put in the flexed position, and free drainage and dressing provided for. Next, as soon as the bone becomes fixed the elbow should be placed at a less acute angle, and as soon as possible in the extension splint shown on the diagram (Figs. 31 and 32). All this stage of treat-
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