American practice of surgery : a complete system of the science and art of surgery . rule, the upper end of the lower fragment underlies FRACTURES. 199 the upper fragment and points toward the tibia, or leans inward and slightlybackward, especially in the instances of decided deformity. Stimson mentionsthree points where pain or at least tenderness on pressure is quite a character-istic feature, viz., on the fibula at the seat of fracture, in front of the tibio-fibular ligament, and at the anterior border of the internal malleolus. Treatment.—In a simple fracture at the lower end of the fibula
American practice of surgery : a complete system of the science and art of surgery . rule, the upper end of the lower fragment underlies FRACTURES. 199 the upper fragment and points toward the tibia, or leans inward and slightlybackward, especially in the instances of decided deformity. Stimson mentionsthree points where pain or at least tenderness on pressure is quite a character-istic feature, viz., on the fibula at the seat of fracture, in front of the tibio-fibular ligament, and at the anterior border of the internal malleolus. Treatment.—In a simple fracture at the lower end of the fibula, a perma-nent dressing of plaster of Paris generally suffices. In some of the cases of com-pound or comminuted fracture, or in cases attended with marked inflammatoryfeatures characterized by great swelling of the tissues, or with effusion into thejoint, it may be necessary to apply a temporary dressing, such as Dupuytrenssplint (Fig. 90) or another of similar utility. This splint is made of a straightpiece of thin board reaching from the middle of the thigh to just below the. Fig. 91.—Crofts Splint; Method of Cutting out the Lateral Portions. (From Cheyne and Burg-hard.) The pieces of white paper in the lower figure are equal to half the circumference of the limbin the upper at the corresponding marks, with the exception of the right-hand one, which is equal to thedistance from the point of the heel to the mark at the root of the toes. foot, and is padded with a long wedge-shaped pad, with the thick end placedalong the inner surface of the leg, beginning just below the internal malleolus,while the thin end reaches nearly up to the upper end of the splint. The splint itselfmay be secured by three strips of adhesive plaster, or by webbing with buckles,or by turns of a plain roller bandage, one of which, according to Da Costa, shouldbe passed just above the ankle, another just below the head of the fibula, and athird at the upper end of the splint; or it may be secured by a
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Keywords: ., bookauthorbuckalbe, bookcentury1900, bookdecade1900, bookyear1906
