. Röntgen ray diagnosis and therapy . emises of ischgemia are known to be wanting assoon as the pressure of displaced fragments is removed, such fearis uncalled for. So, while in former years the author appliedsplints first and resorted to the plaster-of-Paris dressing four toseven days afterward, he now applies the plaster dressing imme-diately after reduction, resorting to the splint treatment a weekor two later, as the case may require. If the protruding fragmentis not reduced, gangrene of the overlying soft tissues may be pro-duced by any kind of dressing. In the Journal of the AmericanMed
. Röntgen ray diagnosis and therapy . emises of ischgemia are known to be wanting assoon as the pressure of displaced fragments is removed, such fearis uncalled for. So, while in former years the author appliedsplints first and resorted to the plaster-of-Paris dressing four toseven days afterward, he now applies the plaster dressing imme-diately after reduction, resorting to the splint treatment a weekor two later, as the case may require. If the protruding fragmentis not reduced, gangrene of the overlying soft tissues may be pro-duced by any kind of dressing. In the Journal of the AmericanMedical Association, November, 1902, two illustrations showingextensive gangrene at the dorsum as well as on the palm, which 224 THE ROtfTGEST RAYS was caused by well-padded splints, were presented. TSTo effort atreduction had been made. Such results are of grave consequencefor the patient as well as for the surgeon. If the direction of the displacement is slightly upward, orupward and outward (Fig. 158), a plaster-of-Paris dressing em-. Pig. 158.—Outward Displacement in Fracture of the Lower End of theRadius, in a Woman of Sixty Years—Four Days after the Injury. bracing the thumb (the direction of the thumb influences that ofthe fragment to a great extent) is applied (Fig. 159). The handis moderately flexed at the same time. If gentle pressure with theindex-finger does not suffice to keep the fragment down, it must bepressed down by a signet around which the bandages are the splint is fastened with a bandage, the fluoroscope showswhether the fragment is in a desirable position. A dorsopalmaras well as a lateral examination must be made, because an antero-posterior view only shows whether there is a^r upward displace-ment left. If the fluoroscope shows imperfect adaptation, the bandagemust be removed and reposition done over again. Under such cir-cumstances the fragment may better be retained if the thumb ispulled in an outward direction while the hand is shifted
Size: 2079px × 1202px
Photo credit: © Reading Room 2020 / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1900, bookpublishernewyo, bookyear1904
