FREE BOOKS

Author's List




PREV.   NEXT  
|<   171   172   173   174   175   176   177   178   179   180   181   182   183   184   185   186   187   188   189   190   191   192   193   194   195  
196   197   198   199   200   201   202   203   204   205   206   207   208   209   210   211   212   213   214   215   216   217   218   219   220   >>   >|  
of the fracture, this was always a matter of ease, needing only slight axis traction. The provision of efficient means of extension and immobilisation was a very different matter. These questions had to be considered under two sets of conditions: (1) when it was possible to keep the patient at rest in the hospital he was first deposited in; (2) when it was necessary for him to be transported for a considerable distance, probably not less than 500 miles. When transport is a necessity, the best method of immobilisation is the application of breeches of plaster of Paris, and a long outside splint. The latter we often had excellently made on emergency by the Ordnance Department or the Royal Engineers. A perineal band is the only form of extension possible under these circumstances. The Dutch ambulances were provided with a very excellent emergency splint for cases of fractured thigh, which is illustrated in fig. 56. I think something of this kind should be carried in one of the ambulances going on to every field of battle, as being far more suitable than a long outside splint for hasty and inaccurate application. This splint, fixed with some kind of firm bandage, is an excellent temporary one for use during transport. [Illustration: PLATE XVIII. Skiagram by H. CATLING. Engraved and Printed by Bale and Danielsson Ltd. (36) OBLIQUELY TRANSVERSE FRACTURE OF THE PATELLA Range 'short.' The entry and exit wounds were small, and a distinct grooving from loss of substance of the bone was palpable superficial to the actual cleft of the fracture.] [Illustration: FIG. 56.--Dutch Cane Field Emergency Splint for Thigh or Lower Extremity. (Dutch Ambulance, Winberg)] In cases which can be treated at a Stationary hospital near at hand, a long outside splint supplemented by plaster breeches, and a well-applied American extension, is a very good method of treatment, the only point to bear in mind being frequent examination of the position of the limb to ensure the extension being efficient. As already mentioned, the shortening in the primary stages is often slight and easily combated, but in many of these cases if examined in a few days the limbs are found to have shortened considerably, principally as a result of recovery of tone by the muscles, and the absence of any help from the resting of the two fragments end to end. The weight, therefore, has often to be progressively increased and the fracture readjusted if necess
PREV.   NEXT  
|<   171   172   173   174   175   176   177   178   179   180   181   182   183   184   185   186   187   188   189   190   191   192   193   194   195  
196   197   198   199   200   201   202   203   204   205   206   207   208   209   210   211   212   213   214   215   216   217   218   219   220   >>   >|  



Top keywords:

splint

 
extension
 

fracture

 

plaster

 

Illustration

 

breeches

 
method
 
transport
 

application

 

ambulances


emergency

 

excellent

 

matter

 

slight

 

hospital

 
efficient
 

immobilisation

 
Ambulance
 

Extremity

 

Winberg


American

 

treatment

 

applied

 
Stationary
 

supplemented

 

treated

 

wounds

 

distinct

 
PATELLA
 

grooving


Emergency

 

actual

 
substance
 

palpable

 

superficial

 

Splint

 
position
 
recovery
 

muscles

 

absence


result
 

principally

 

shortened

 

considerably

 

progressively

 

increased

 

readjusted

 
necess
 

resting

 
fragments