. A practical treatise on fractures and dislocations . ablycause congestion and swelling, accompanied sooner or later with greatpain and with ulcerations, and simply because the extension is madedirectly upon parts already tender and inflamed from the accidentitself; and when we add to this complete and violent ligation of thelimb near the seat of fracture, a similar ligation of the limb just belowthe knee, for the purpose of making counter-extension, as is done inwhat is known among American surgeons as Hutchinsons splint1{tig. 194), we are prepared to understand how the worst consequencesmay
. A practical treatise on fractures and dislocations . ablycause congestion and swelling, accompanied sooner or later with greatpain and with ulcerations, and simply because the extension is madedirectly upon parts already tender and inflamed from the accidentitself; and when we add to this complete and violent ligation of thelimb near the seat of fracture, a similar ligation of the limb just belowthe knee, for the purpose of making counter-extension, as is done inwhat is known among American surgeons as Hutchinsons splint1{tig. 194), we are prepared to understand how the worst consequencesmay ensue. I have once seen, when this abominable apparatus hadbeen used, a complete ring of ulceration below the knee, and anotheras complete around the foot and ankle. The limb was twice girdled, • Elements of Surgery, by John Syng Dorsey, vol. i. p. 181. Philadelphia, 1813. FRACTURES OF THE TIBIA AND FIBULA. 467 and yet the surgeon thought he was performing a duty for the omissionof which he would scarcely have been regarded as excusable. Fig. James Hutchinsons splint for extension, etc., in fractures of the leg. (From Gibson.) Jarviss adjuster, a still more mischievous, inasmuch as it is a morepowerful, instrument, operating in a similar manner, has been pro-ductive of like consequences; but Jarviss adjuster is liable to theadditional objection that by its great weight it drags off the limb,turning the toes outwards, an objection which no care, or diligence cangenerally overcome. I could wish that neither of these appliances would ever again beimpressed into the service of broken legs. Neill, of Philadelphia, Crandall, of New York, and Daniels, ofBroome Co., N. Y., have each sought to overcome some of the diffi-culties in the way of making extension in fractures of the legs, bysubstituting adhesive plaster for the usual extending or counter-extending bands. Says Dr. Neill: For simple fractures of both bones of the leg, at-tended with shortening and deformity not easily
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