to certain
objections--for example, if applied immediately after the accident
they are apt to become too tight if swelling occurs; and if applied
while swelling is still present, they become slack when this subsides,
so that displacement is liable to occur.
When it is desired to enclose the limb in a plaster case, coarse
muslin bandages, 3 yards long, and charged with the finest quality of
thoroughly dried plaster of Paris, are employed. The "acetic plaster
bandages" sold in the shops set most quickly and firmly. Boracic lint
or a loose stocking is applied next the skin, and the bony prominences
are specially padded. The plaster bandage is then placed in cold water
till air-bubbles cease to escape, by which time it is thoroughly
saturated, and, after the excess of water is squeezed out, is applied
in the usual way from below upward. From two to four plies of the
bandage are required. In the course of half an hour the plaster should
be thoroughly set. To facilitate the removal of a plaster case the
limb should be immersed for a short time in tepid water.
A convenient and efficient splint is made by moulding two pieces of
poroplastic felt to the sides of the limb, and fixing them in position
with an elastic webbing bandage; this apparatus can be easily removed
for the daily massage.
_Padding_ is an essential adjunct to all forms of splints. The whole
part enclosed in the splint must be covered with a thick layer of soft
and elastic material, such as wool from which the fat has not been
removed. All hollows should be filled up, and all bony projections
specially protected by rings of wadding so arranged as to take the
pressure off the prominent point and distribute it on the surrounding
parts. Opposing skin surfaces must always be separated by a layer of
wool or boracic lint. A bandage should never be applied to the limb
underneath the splints and pads, as congestion or even gangrene may be
induced thereby.
#Operative Treatment of Simple Fractures.#--Operation in simple
fracture is specially called for (1) in fracture into or near a joint
where a permanently displaced fragment will cause locking of the
joint; (2) when fragments are drawn apart, as in fractures of the
patella or olecranon; (3) when displacement, especially shortening,
cannot be remedied by other means; (4) when complications are present,
such as a torn nerve-trunk or a main artery; (5) when non-union is to
be feared, as in certain cases of fracture
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