England and Wales
BMJ (Clinical Research Edition)
The Chairman then introduced Major M. Sinclair, C.M.G., R.A.M.C., who gave a demonstration of the most recent. methods for the treatment of fractures by Thomas and other splints. Major Sinclair first demonstrated how a Thomas splint should; be applied to fractures of the lower limb, before the patient was remioved from the spot where the accident occurred; extension could be obtained at once by passing a heavy skewer horizontally tlhroughi the sole of tlle boot. and fastening thlis to the
... thlis to the cross-bar at the lower end of the splint. He then enumerated the various methods of applying extension in liospital, and expressed his preference for painting the unshaved leg -with the special glue be lhad devised, and then applying a long strip of gauze bandage on each side of the leg and fastening these to the lower end of tl e splint; otller methods were to drive special screws into the upper end of the tibia or to fix calipers to thle condyles of the femur, or to the external and internal malleoli. By these mnetlhods no slhortening resulted in the fractured limb; indeed, if care were not taken, lengtlhening might be produced. Major Sinclair slhowed devices for obtaining external and internal rotation of the foot, where niecessary, and also metlhods of bandaging wlhich would restore the antero-posterior curvature of the femur. In compound fractures the limb was always bandaged by the "sectional" method; packets containing sterilized gauze dressings, short strips of bandage *and clips being used. The wound was treated solely by hydrogen peroxide and sterile saline, and the gauze dressing applied; the leg was bandaged in sections with the short strips fastened along the anterior surface by the clips; thus any area of the limb could be inspected or dressed without removing the whold bandage and splint. Major Sinclair then showed a large abduction splint or frame used for the treatment of fractured femurs and also for wounds of the lumbar and gluteal regions, or for pelvic cases; the patient was slung up to the frame by a series of hammock-like nettings, and with the help of pulleys could raise himself and thlus facilitate nursing. With the ordinary Tlhomxias splint a system of pulleys was useful, so that thie patient could, by very little effort, suspend hiimself in mid-air while the bed was being moved and an armchair put in its place; thus accidents through slipping or fainting were avoided, as the patient gradually got accustomed to being up after his long period in bed. Splints for the arms were also shown; one, for the wrist and hand, caused much interest and amusement; by adjusting a series of springs-and side-pieces the interphalangeal, metacarpo-phalangeal, and carpal joints were given freedom of movement in succession.