Modification of Fixed Apparatus for Fractures

1865 American Journal of the Medical Sciences  
1865.] Surgery. 247 change in the state of the limb, through increase of swelling or its diminution, by simply letting out the lace, or taking it in, without even removing the band¬ age. It is, moreover, very light, and yet strong enough for any purpose to which a splint can be applicable." 35. Modification of Fixed Apparatus for Fractures.-Prof. Joixiffk Tcfnell describes (Dublin Quarterly Journ. of Med. Sci., Peb. 1865) a modification of the fixed apparatus which he has used both in hospital
more » ... d both in hospital and private practice with great satisfaction. " The material required," he says, " for forming these splints is very generally available, consisting only of lint or old linen for the inner lining; strips of the same, torn three inches in width, and long enough to reach from the head of the tibia to the sole of the foot. To make the splint itself; The white of eight eggs and half a pound of flour for the fixing substance. These are all that are required ; each and every one of which is to be procured in almost the poorest home-and as such, this splint is readily available to the surgeon in country practice. " The main feature of difference between this mode of setting fractures and every other kind of fixed apparatus, is the construction of the splint in two halves, and the applying of the bandage, which is to form the same lengthwise, instead of circularly, thus avoiding all possible sources of constriction of the limb. " Supposing, then, that the fracture has occurred in a city, or wherever else the most desirable materials are to be procured, the surgeon sends for the following, and places them beside him before interfering with the patient, further than to strip him of his clothes and lay him upon a properly prepared bed, upon the side opposite to the fractured limb-the leg itself being supported easily on a pillow-and the fracture, as far as possible, reduced. The articles required are -a table for spreading the bandages upon, a wash-hand and small sharp-edged basin, eight eggs, and half a pouud of flour, as before stated; a large iron or silver spoon, a large knife, three calico roller bandages, half a yard of Taylor's lint, and some hot water. The lint is first thrown upon the limb, from the knee to the sole of the foot, and cut' roughly into the outline of the limb, of a size sufficient to tuck under the sole at the bottom, and from side to side of the leg. " This lint is placed in the large basin, and hot water poured upon it, so as to saturate it completely, and whilst dripping, and without beimg wrung, it is lifted out and put upon the outer side of the limb of the patient who is lying with the leg bent, and exactly in the same position recommended by Pott, with this difference that the limb is on the inner instead of its outer side, by this measure insuring subsequent inversion instead of eversion of the foot. Extension and counter-extension are now made by the hands of two assistants, and the fracture set by the surgeon, who models the wet lint on to the limb with his hands, so that it is as closely applied as a stocking would be; any starting or spasm of the muscles is prevented by the assistants just laying their hands steadily upon the limb. The surgeon now breaks the eggs upon the sharp edge of the small basin, drops the yelks into it, and the albumen into the other, having first thrown out the hot water which was previously in it for wetting the lint; he then takes sufficient flour, according to the size of the eggs, and with the spoon beats it and the albumen into a homogeneous mass of the consistence of pancake. He next measures with the end of a roller the length of the limb, from the knee to the centre of the sole, and placing the forefinger of his left hand, pointing upwards, and the forefinger of an assistant opposite to him at the required dis¬ tance, he winds the whole of the three roller bandages, one after the other, around the fingers, and then with a scissors divides them at either end; thus in a few moments obtaining the strips necessary for the splint, all of exactly the same aud the proper length. Each of these tails is now spread thickly with the egg and flour upon one side, and as spread, folded double, with the plastered surfaces opposed and laid aside. The object of this is to keep them moist, and in hot weather from drying; as soon as they are all done the surgeon commences, and having them handed to him one by one, he lays them on the limb, moulding them to it, layer after layer, from the innermost portion of the tibia within to
doi:10.1097/00000441-186507000-00080 fatcat:c5j3oupxv5g2ljus2ywh4brzue