THE TREATMENT OF ALL FRACTURES OF THE FOREARM, EXCEPT OF THE OLECRANON PROCESS, BY EXTENSION, COUNTER-EXTENSION AND FORCED SUPINATION.Read at the Annual Meeting of the Mississippi Valley Medical Association, at Louisville, Ky., October, 1890

X. C. SCOTT
1890 Journal of the American Medical Association (JAMA)  
In calling your attention to this mode of treat¬ ment I hope to convince you that it is superior to any other method, that you will not condemn it untried as an old doctor friend of mine did, and who said to me, "Doctor, it may be all right, but I do not think it will do because I have not tried it myself." Give it a fair trial and you will be convinced that it can be carried out in a simple manner and that it is better and far superior to any other method, by being adapted to every form of
more » ... o every form of fracture of the forearm, except that of the olecranon process of the ulna. The splint is made of two pieces of board fas¬ tened together securely at right angles. The shorter piece extending up the back of the arm about two-thirds the distance from the elbow to the shoulder, and the longer piece extends along the back of the forearm to four inches beyond the tips of the fingers. These pieces should be one inch wider than the arm and forearm and also well padded. The dressing of the limb is carried out in the following manner: i. Two strips of strong adhesive plaster are applied longitudinally to the dorsal surface of the hand, commencing at the wrist or higher up, if the fracture is located higher, and extending beyond the tips of the fingers, are tied together at their free ends, forming a loop. 2. Two strips of adhesive plaster are applied in the same manner to the palmar surface of the hand and tied together. 3. The splint being well padded is applied to the dorsal surface of the arm and forearm. A broad piece of adhesive plaster is applied to the radial side of the forearm above the point of fract¬ ure and carried around behind the elbow and splint to the same point on the ulnar side, that it started from on the radial, and fastened. Crossed strips of plaster are also applied to keep the ends of the broad piece in place. 4. Another broad band of adhesive plaster fastens the arm to the upper part of the splint, and in addition I have been accustomed to throw a bandage around this part of arm and splint, 5. After the plaster is well set, the end of a piece of elastic rubber webbing, on the other end of which a buckle is fastened, is passed from the under surface through the opening in the end of the splint through the loops formed by the two strips of adhesive plaster on the dorsal surface of the hand, thence back through the opening in splint and carried forward over the end of splint, and back through the loops formed by the strips of plaster on the palmar surface of the hand, for¬ ward towards end of splint; and fastened by the buckle attached to the other end of this elastic band or strap. The advantage of this procedure is, that should either the dorsal or palmar strips of adhesive plaster become relaxed or loosened, one or the other can be tightened without disturbing or affecting the other. 6. Thus having made extension and counterextension, supination is easily accomplished by means of a strap of adhesive plaster one and a half inches wide applied to the carpal or bulbar portion of the hand, passing from the radial side
doi:10.1001/jama.1890.02410460011001c fatcat:wfititdhgbfgtns7mbkj2xtm2q