A Practical Treatise on Fractures and Dislocations

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H. C. Lea, 1875 - Dislocations - 831 pages
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Page 133 - A roller five yards long, and two inches wide ; suitable compresses. Application : Place the initial extremity of the roller upon the occiput, just below its protuberance, and conduct the cylinder obliquely over the centre of the left parietal bone, to the top of the head ; thence descend across the right temple and the zygomatic arch, and pass beneath the chin...
Page 257 - ... I am correct in my views, we shall be able sometimes to consummate union of a fractured humerus where it is delayed, by straightening the forearm upon the arm, and confining them to this position. A straight splint, extending from the top of the shoulder to the hand, made of some firm but moulding material, and made fast with rollers, will secure the requisite immobility to the fracture. The weight of the forearm and hand will only tend to keep the fragments in place, and if the splint and bandages...
Page 254 - ... femur, between which, above all others, the circumstances of form, situation, &c., are most nearly parallel, and in both of which nonunion is said to be relatively frequent. I find that of forty-nine fractures of the humerus, four occurred through the surgical neck, twelve through the oondyles, and twenty-nine through the shaft.
Page 412 - The circumstances which would justify such an expression of scepticism, where the witnesses, as in this case, are presumed to be intelligent and honest men, must be extraordinary. Such, however, I conceive to be the circumstances in this instance. It is certainly very extraordinary that a few gentlemen of acknowledged skill, but whose means and appliances are concealed from no one, are able to do what nearly the whole world besides with the same means, acknowledges itself unable to accomplish. Such...
Page 258 - I had succeeded in making the arm nearly straight I now punctured the upper end of the lower fragment with a small steel instrument, and as well as I was able, thrust it between the fragments. Assisted by Dr. Boardman, I then applied a gutta percha splint from the top of the shoulder to the fingers, moulding it carefully to the whole of the back and sides of the limb, and securing it firmly with a paste roller. March 4th. (Not quite four weeks after the application of the splint,) I opened the dressings...
Page 257 - ... since it is not peculiar. The same occurs much oftener, and to a much greater extent, in fractures of the femur, and equally as often in fractures of the clavicle; yet in neither case are these results so frequent. Nor can it be due to the action of the deltoid or...
Page 417 - The peculiarity of which doctrine consisted in its assumption, that the resistance of those muscles which tend to produce shortening can generally be sufficiently overcome by posture, without the aid of extension, and that for this purpose, for example, in the case of a broken femur, it was only necessary to flex the leg upon the thigh, and the thigh upon the body; laying the limb afterwards quietly on its outside upon the bed.
Page 598 - ... places the heel of his other foot in the axilla, receiving the head of the os humeri upon it, whilst he is himself in the sitting posture by the patient's side. He then draws the arm by means of the handkerchief, steadily for three or four minutes, when, under common circumstances, the head of the bone is easily replaced ; but if more force be required, the handkerchief may be changed for a long towel, by which several persons may pull, the surgeon's heel still remaining in the axilla.
Page 255 - A temporary false anchylosis has occurred, and, instead of motion at the elbow-joint, when the forearm is attempted to be straightened upon the arm, there is only motion at the seat of fracture. It will thus happen that every upward and downward movement of the forearm will inflict motion upon the fracture; and, inasmuch as the elbow has become the pivot, the motion at the upper end of the lower fragment will be the greater in proportion to the distance of the fracture from the elbow-joint.
Page 538 - ... then by revolving the stick as an axis or double lever, the power is produced precisely as it should be in such cases, viz: — slowly, steadily, and continuously.

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