A treatise on orthopedic surgery . circulation ofthe limb has become adapted to the new conditions. In theapplication of the bandage the bony prominences of the kneeand ankle are protected by cotton. A cotton flannel bandageis then applied smoothly, and directly upon this the light plas-ter bandage. At the second application, at the end of a week,the subsidence of the spasm will permit the straightening ofthe limb. In cases of longer standing several successive ap-plications of the bandage may be required, together withmanual extension during the application; or an anaesthetic maybe administer
A treatise on orthopedic surgery . circulation ofthe limb has become adapted to the new conditions. In theapplication of the bandage the bony prominences of the kneeand ankle are protected by cotton. A cotton flannel bandageis then applied smoothly, and directly upon this the light plas-ter bandage. At the second application, at the end of a week,the subsidence of the spasm will permit the straightening ofthe limb. In cases of longer standing several successive ap-plications of the bandage may be required, together withmanual extension during the application; or an anaesthetic maybe administered. Under anaesthesia the muscular spasm relaxesand deformity, even of some standing, may be reduced by trac-tion and by slight leverage, the head of the tibia being sup-ported and drawn forward by the hands as the deformity isgently reduced. Traction.—Deformity may be reduced also by traction withthe weight and pulley, the leg being supported so that no directleverage is exerted at the seat of the disease (Fig. 294). FiCx. Traction and countertraction in disease of tlie linee-joint. (Marsh.) Forcible Correction by Reverse Leverage—In the more resistantcases, especially if accompanied by subluxation, the followingmethod should be employed. The patient is anaesthetized and is placed face downward ona table, the feet projecting over its end. The body of the 430 OBTEOPEDIC SUEGEBY. patient is then elevated by means of pillows to conform to thedeformity—that is, the thigh is raised sufficiently to permit thetibia to lie evenly upon the anterior border on the table. Theoperator then holds the head of the tibia firmly against thetable while the assistant exerts intermittent and gradually in-creasing downward pressure on the thigh, but never to theextent to lift the tibia from the table; thus, further subluxationis impossible. As the contraction gives way the pillows areremoved. Usually the deformity may be reduced at one sitting,but if it is very resistant complete correc
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