The operating room and the patient; a manual of pre- and post-operative treatment . ecompletely relaxed. A plaster cast is then applied. In elderlypatients the head of the bed is raised one or two feet; this lessensthe danger of hypostatic pulmonary congestion and serves toincrease the blood supply at the seat of injury. Repair is slowand weight must not be borne upon the limb for many course of bone healing should be observed by a series ofX-ray plates. After six or eight weeks the cast may be removedand a modified hip splint substituted. In the course of theafter-treatment massage
The operating room and the patient; a manual of pre- and post-operative treatment . ecompletely relaxed. A plaster cast is then applied. In elderlypatients the head of the bed is raised one or two feet; this lessensthe danger of hypostatic pulmonary congestion and serves toincrease the blood supply at the seat of injury. Repair is slowand weight must not be borne upon the limb for many course of bone healing should be observed by a series ofX-ray plates. After six or eight weeks the cast may be removedand a modified hip splint substituted. In the course of theafter-treatment massage and passive and active exercises shouldbe given. Whitman considers by far the most important exer-cise the frequent complete abduction of the limb. Fracture of the Patella. Open —The splint () is to be abandoned at the end of ten days, and, as soon 342 OPERATING ROOM AND THE PATIENT thereafter as the skin wound is strongly healed, the patellashould be moved from side to side once or twice daily to preventthe formation of adhesions (McBurney). The patient may. Fig. 175.—Dressings for fracture of the patella. (Fowlers Surgery.) walk about in three weeks at the most, the knee being supportedon a posterior splint while he is up. This should be removedwhen he lies down. Some passive movements ma5 be cautiously attempted from time to time afterthe first three weeks; these may beincreased as time passes. To preventrefracture from an accidental fall,the patient may wear a check ap-paratus (Fig. 176). Amputations and Disarticulations.—The after-treabment of these casesdepends somewhat upon whether thewound is left open or is sutured, uponthe lesion necessitating the operation,and upon the technic employed. General Rules. Stay in Bed.—It is desirable to get these patients out of bed and in the sunlight as quickly as their general condition will permit. Usually four or five days rest in bed will be sufficient. The patient may then be lifted into a wheel chair if
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