Surgery.

Date:: [1913]

Credit: Surgery. Source: Wellcome Collection.

154/412 page 128

$occur inside the plaster. Mobility after reduction often makes traction methods necessary and union is often slow because of the poor blood supply. What are the Clinical Features ? All the signs of fracture are present and are easily elicited because of the proximity of the tibia to the surface. Care in handling is essential lest the fracture be made compound. What is the Treatment ? Fracture of the shaft of the tibia frequently occurs in children, the line of fracture being oblique and the displace- ment minimal. The leg is immobilised in plaster for six weeks. In cases with little displacement the patient is anaesthe- tised and the knee is flexed to a right angle and the leg hangs over the edge of the table. Plaster is applied after the lateral and rotational displacement is corrected manually. In cases with greater displacement and mobility after reduction a traction method is preferable, e.g. Bohler’s frame. A pin is passed through the os calcis or through the lower shaft of the tibia. After over-riding is corrected the fracture is moulded into position by hand and plaster is applied to incorporate the pin. The plaster is supported on a Braun- Bohler splint and traction on the pin is continued to prevent redisplacement in plaster. Compound fractures following complete excision of the wound are treated in the same way. THE ANKLE. Describe Sprain of the Ankle Joint. Sprain of the ankle joint follows twisting violence applied to the foot. Abduction and external rotation of the foot result in sprain of the tibial collateral ligament, but the most common injury is sprain of the anterior band of the fibular$

Surgery.

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