FREE BOOKS

Author's List




PREV.   NEXT  
|<   45   46   47   48   49   50   51   52   53   54   55   56   57   58   59   60   61   62   63   64   65   66   67   68   69  
70   71   72   73   74   75   76   77   78   79   80   81   82   83   84   85   86   87   88   89   90   91   92   93   94   >>   >|  
he maximum tenderness is over the injury to the bone. The effusion of blood and synovia into the joint and into the tissues around gives rise to swelling and discoloration, and the fluid effused into tendon sheaths often produces a peculiar creaking sensation, which may be mistaken for the crepitus of fracture. In sprains, the bony points about the joint retain their normal relations to one another, and this usually enables these injuries to be diagnosed from dislocations. When the swelling is great, it is often necessary to have recourse to the Roentgen rays to make certain that there is no fracture or dislocation. The special features and complications of sprains of the knee are discussed with other injuries of that joint. _Repair of Sprains._--Blood and synovia are absorbed and torn structures become reunited, but in this process adhesions may form inside the joint and in the surrounding tendon sheaths and interfere with the movement of the joint. _Prognosis._--Stiffness, lasting for a longer or shorter time, follows most sprains, but may be largely prevented by proper treatment. In old and rheumatic persons, changes of the nature of arthritis deformans are liable to supervene, interfering greatly with movement. While suppuration is rare, tuberculous disease is alleged to have resulted from a sprain. _Treatment._--If seen immediately after the accident, firm pressure should be applied by means of an elastic bandage over a thick layer of cotton wool, to prevent bleeding and effusion of synovia. Later the best treatment is by massage and movement. In the ankle, for example, massage should be commenced at once, the part being gently stroked upwards. If the massage is light enough there is no pain, it is actually soothing. The rubbing is continued for from fifteen to twenty minutes, and the patient is encouraged to move the toes and ankle; a moderately firm elastic bandage is then applied. The massage is repeated once or twice a day, the sittings lasting for about fifteen minutes. The patient should be encouraged to move the joint from the first, beginning with the movements that put least strain upon the damaged ligaments, and gradually increasing the range. In the course of a few days he is encouraged to walk or cycle, or otherwise to use the joint without subjecting it to strain, or to a repetition of the movement that caused the accident. Alternate hot and cold douching, or hot-air baths, followed by massage
PREV.   NEXT  
|<   45   46   47   48   49   50   51   52   53   54   55   56   57   58   59   60   61   62   63   64   65   66   67   68   69  
70   71   72   73   74   75   76   77   78   79   80   81   82   83   84   85   86   87   88   89   90   91   92   93   94   >>   >|  



Top keywords:

massage

 

movement

 

encouraged

 

synovia

 

sprains

 

injuries

 

bandage

 

fifteen

 
strain
 
lasting

minutes

 
elastic
 

tendon

 

accident

 

swelling

 
sheaths
 

effusion

 
fracture
 

patient

 

applied


treatment

 
stroked
 

upwards

 
gently
 

alleged

 

resulted

 
bleeding
 

pressure

 

immediately

 

cotton


sprain
 

commenced

 
Treatment
 

prevent

 

gradually

 

increasing

 

douching

 

Alternate

 

subjecting

 

repetition


caused

 

ligaments

 
damaged
 
twenty
 

moderately

 

disease

 

continued

 

rubbing

 

soothing

 

repeated