Wounds in war : the mechanism of their production and their treatment . d be looked uponas one of wound of the joint. Even in these doubtful cases,movements of the arm to elicit crepitus, or to ascertain howmuch of the normal motion of the joint remains, shouldbe made, if at all, with the greatest caution, lest furtherdamage be produced by them. The wounds and the skin 148 WOUNDS IN WAR surface. around them should be thoroughly washed andasepticised; iodoform should be dusted on the skin wounds,and a dry gauze and alembroth wool dressing applied. Anample supply of antiseptic wool should also b
Wounds in war : the mechanism of their production and their treatment . d be looked uponas one of wound of the joint. Even in these doubtful cases,movements of the arm to elicit crepitus, or to ascertain howmuch of the normal motion of the joint remains, shouldbe made, if at all, with the greatest caution, lest furtherdamage be produced by them. The wounds and the skin 148 WOUNDS IN WAR surface. around them should be thoroughly washed andasepticised; iodoform should be dusted on the skin wounds,and a dry gauze and alembroth wool dressing applied. Anample supply of antiseptic wool should also be placed inthe axilla, and between the arm and the side of the splints are required ; the hand should be placed acrossthe front of the chest, in the position employed in the treat-ment of a fractured clavicle, and the injured arm and fore-arm bandaged to the body by means of a wide the only danger in these cases is that of suppurationin the joint; when this is avoided they heal rapidly, andno interference with the movements of the limb Fig. of bullet on surgical neck of humerus.—Netley Museum. The treatment of those cases of wound of the shoulderin which fractures of the articular ends of the bones takeplace, as, indeed, the treatment of similar injuries of alljoints, has to be considered under the heads of (a) conser-vative treatment, (b) amputation, and (c) excision. All wounds of the upper extremity are peculiarly amen-able to conservative treatment, when compared with thoseof the lower limb, because in them immobilisation, and evenextension, can be carried out although the patients haveto be moved. Wounds of the shoulder form no exceptionto the truth of this statement ; on the contrary, they area class of joint injury in which this method has beenespecially successful. WOUNDS OF THE SHOULDER JOINT 149 It may almost be said that in wounds of the shoulder jointno amount of shattering of bone, provided that the greatvessels and nerv
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