Compound and comminuted gun-shot fractures of the thigh and means for their transportations, etc / John Swinburne.

  • Swinburne, John, 1820-1889.
Date:
1864
Catalogue details

Licence: Public Domain Mark

Credit: Compound and comminuted gun-shot fractures of the thigh and means for their transportations, etc / John Swinburne. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    IS «*> injury. He can roll from side to side, or even sit up, and thereby relieve the tedium of confinement. One other, and not the least advantage claimed, is, that in this form of treatment there is no agglutination of the muscles to the bone, or each other, and consequently no stiffening of the limb from that source; and as soon as the bone is strong enough to bear the weight of the patient, the muscles are ready to do their part in the locomotion. One objection, and by the way the only one which possesses a show of validity, has been made, that the foot is liable to evert or invert; but a single moment's reflection will satisfy any one that no great ingenuity is required to avoid this—a bag of sand or bran on either side of the foot, or a strip of plaster, or of cloth, any of these simple means can be so employed as to maintain the foot in a proper position. The fact to be dwelt upon is, that but little extension is neces- sary during the first stage of treatment. In order to prevent perineal excoriations, and accustom the patient to the necessary pressure when union is taking place, cleanliness must be observed. It is essential, at first, to overcome spasmodic muscular contrac- tion, and keep the limb from lateral distortion. When there is much loss of bony substance, less extension is required. In fact, some longitudinal distortion is necessary for a bony union. Still, the muscles must be kept sufficiently upon the stretch in order to keep the limb from lateral distortion, else the sharp ends of the bone will gore the muscles, nerves, &c, and thereby pro- duce great pain, and other irreparable mischief. The efficacy of this treatment, like that of many and all others, is to be tested by its practical results. So far as an experience of about thirteen years in private practice, (with data of about fifty cases of simple, compound and comminuted fractures of where the bed took the place of the stretcher,) which, it is granted, is only a limited time and data, can be depended upon, there is no method more reliable than this. There is none in private prac- tice, under which more favorable results have proceeded, none in which there have been fewer failures (in this there have been no unfavorable results), considering the variety of fractures to which it is applicable, and in which it has been used; it has been eminently successful, and the result has been such as to warrant its indiscriminate use.