Notes on the modern treatment of fractures . ntly, Mr. Butcheradopted this method very successfully in a case of fracturedfemur of five months duration where there were nearly fiveinches shortening and great angular deformity.* Thesemethods are especially adapted to cases where the fragmentshave united at an angle. When the deformity depends uponlateral application of the two bony cylinders, rapture must beattempted by flexion across the bond of union, combined withrotation in the axis of the limb and strong extension and coun-ter-extension. As has been stated, these cases are less ap-propriat
Notes on the modern treatment of fractures . ntly, Mr. Butcheradopted this method very successfully in a case of fracturedfemur of five months duration where there were nearly fiveinches shortening and great angular deformity.* Thesemethods are especially adapted to cases where the fragmentshave united at an angle. When the deformity depends uponlateral application of the two bony cylinders, rapture must beattempted by flexion across the bond of union, combined withrotation in the axis of the limb and strong extension and coun-ter-extension. As has been stated, these cases are less ap-propriate for treatment by refracture than the former , in some cases of this kind, as well as in others wherethe shortening is great, it may be well to keep the patientetherized and continue the excessive extension for an hour orso after rupture, in order to gain as much length as possiblebefore dressing the fracture. In order to obtain a firm hold upon the limb when making-extension by the compound pulleys, and yet to distribute the. pressure so as not to bruise the tissues, Dr. Levis devised aserrated plate for the thigh to give attachment to the pulleyrope. It consists of a strong iron hook, the upper part ofwhich expands into a flat plate about seven inches long andtwo wide. This plate is slightly curved transversely to applyitself to the limb, and is roughened. On the upper surface* Dublin Journal of Medical Science, vol. lviii., 1874. 54 THE MODERN TREATMENT OF FRACTURES. of this plate, at each side, there extends a longitudinal ridgeserrated by deep notches cut into it. The appliance is ad-justed in the following manner: After a bandage has been ap-plied to the limb at the point selected, the plate and hook arelaid upon it, then a strong cord is carried around the limbcircularly and over the plate, catching in the sawlike teethon the ridges above. This binds the hook and plate firmlyto the limb just as sailors splice two spars together by a , the compo
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Keywords: ., bookcentury1800, bookdecade1890, bookidnote, booksubjectfractures
