Treatment of fractures of long bones by simple extension / by John Swinburne.

  • Swinburne, John, 1820-1889.
Date:
1861
Catalogue details

Licence: Public Domain Mark

Credit: Treatment of fractures of long bones by simple extension / by 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 obliged to keep his bed, and hence there is less demand for comely appliances than in cases of fracture of the arm or forearm. In fracture of the femur, I use simply extension and counter-ex- tension without splints, and in the leg I sometimes do the same, making use of the following plan by which the extension and counter-extension is effected. The patient is placed in bed, and a broad, well-padded perineal belt, made from 1| to 2h inches in diameter where it comes in contact with the perineum, (in order more fully to equalize the pressure) is adjusted as indicated in the plate, so that the line of extension shall be through the long- axis of the femur. It may be stated that one important object of extension, not mentioned before, is to overcome the otherwise distorting influ- ence of the adductor muscles. This perineal belt (No. 1 and 2, fig. 2) is secured to the head of the bedstead, and no splint at all is made use of, as the powerful muscles and fascia that envelope the femur are amply competent to support and fix the bone. The pelvis being thus fixed by the perineal belt, extension is obtained by means of adhesive strips secured to the leg. The plasters are cut proportionally to the size of the limb, from one-half to one inch in breadth, and of sufficient length to be applied along the outside of the leg, de- scending spirally, protruding so as to form a strong loop under the sole of the foot, and then extending up on the inside of the leg. These strips are not applied one directly over the other, but at small distances apart, so as to embrace a larger surface of the leg, thus equalizing the tension upon the integument. Then a number of shorter strips are applied in a manner similar to the many tailed bandage, surrounding and securing the long plasters against possible detachment, The shorter strips are not indis- pensable, as the same end may be attained by a simple roller. Fig. 1 and 2. All that is now necessary is to pass a strong cord through the loop of plasters, and secure it to the foot of the bedstead. The simplicity of this method is a strong recommend- ation. There are many occasions when a Liston splint, or any other, can be obtained only with difficulty; for the treatment by this method nothing is required but ordinary adhesive plaster, which can be obtained very readily; and an old sheet or rope will furnish the remaining complement of apparatus. The patient can move about in the bed as much as is necessary with greater freedom than when embarrassed by a long splint,