A practical treatise on fractures and dislocations . r warrant a resort to permanent exten-sion and counter-extension, a double inclined plane furnishes a conve-nient mode for its accomplishment; but it is only occasionally that, infractures of the leg, permanent extension and counter-extension can beemployed ; an assertion which, however much it may surprise the inex-perienced, observation will prove to be true. If the fracture is near 31 482 FRACTURES OF THE TIBIA AND FIBULA. the middle of the leg, quite remote from the points upon which theappliances for extension, etc., are to be made fast
A practical treatise on fractures and dislocations . r warrant a resort to permanent exten-sion and counter-extension, a double inclined plane furnishes a conve-nient mode for its accomplishment; but it is only occasionally that, infractures of the leg, permanent extension and counter-extension can beemployed ; an assertion which, however much it may surprise the inex-perienced, observation will prove to be true. If the fracture is near 31 482 FRACTURES OF THE TIBIA AND FIBULA. the middle of the leg, quite remote from the points upon which theappliances for extension, etc., are to be made fast, and the inflammationis moderate, something may be done in this way; but when the point offracture approaches the ankle-joint, as it actually does in a great majorityof cases, a gaiter, made of any material whatever, if it has sufficientfirmness to overcome completely the action of the muscles, will inevitablycause congestion and swelling, accompanied sooner or later with greatpain and with ulcerations, and simply because the extension is made Fig. James Hutchinsons splint, for extension, etc., in fractures of the leg. (From Gibson ) directly upon parts already tender and inflamed from the accident itself;and when we add to this complete and violent ligation of the limb nearthe seat of fracture, a similar ligation of the limb just below the knee,for the purpose of making counter-extension, we are prepared to under-stand how the worst consequences may ensue. Neill, of Philadelphia, and others have sought to overcome some of the diffi-culties in the way of making extension in fractures of the legs, by substitutingadhesive plaster for the usual extending or counter-extending bands. Says : For simple fractures of both bones of the leg, attended with shorten-ing and deformity not easily overcome, the limb should be placed in a longfracture-box with sides extending as high as the middle of the thigh, and a Fig. 315.
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Keywords: ., bookcentury1800, bookdecade1890, booksubjec, booksubjectfractures
