A treatise on orthopedic surgery . d leverage. P, pulley; W, weight; F, fulcrum.—Marsh. ending in two loops, through which the two arms are passed,and through which is threaded another piece of stout webbingwhich runs transversely across the surface of the bed under thechilds shoulders, and is fastened at its two ends to the sides ofthe bedstead. When this is in action the patients shoulders are 350 OBTHOPEDIC SUSGEEY. kept flat on the bed, so that he can neither sit up nor turn on hisside. This chest band does not cause the slightest is not, of course, fixed tightly, and when th
A treatise on orthopedic surgery . d leverage. P, pulley; W, weight; F, fulcrum.—Marsh. ending in two loops, through which the two arms are passed,and through which is threaded another piece of stout webbingwhich runs transversely across the surface of the bed under thechilds shoulders, and is fastened at its two ends to the sides ofthe bedstead. When this is in action the patients shoulders are 350 OBTHOPEDIC SUSGEEY. kept flat on the bed, so that he can neither sit up nor turn on hisside. This chest band does not cause the slightest is not, of course, fixed tightly, and when the child finds that hecannot sit up he makes no further attempt to do so; and as helies flat the band is loose. It is often of advantage, particularly if the disease is active,to use some form of apj)aratus to -Qs. the patient more uses a long lateral splint of thin board reaching from theaxilla to a crossbar below the sole of the foot. To this the pa-tients body and sound limb are bandaged (Fig. 235). Fig. Traction in hip disease. Marslis method of fixing the patient in iDed withshoulder straps and a long T-splint on the sound side. (Howard Marsh.) For the same purpose-a plaster spica bandage or a Thomassplint may be applied on the sound side, but a more convenientappliance is the frame of gas-pipe covered with canvas that hasbeen described in the chapter on Potts disease. Upon thisframe the patient can be fixed, the limb being elevated by a sup-port attached to the frame or independent of it (Figs. 236 and237). It is perhaps needless to suggest that the bedclothes mustbe held from the elevated limb; in fact, that the patient mustfor a time be enclosed in a tent of bedclothes if the deformity isextreme. At first the traction weight must not be great, but asthe perineum becomes accustomed to pressure as much weightas can be tolerated is used, from ten to twenty pounds being theaverage. This may be reduced at night and increased during theday. Great care
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