A practical treatise on fractures and dislocations . of cotton-waddingover the whole surface of the limb. Any excess of the bands at theupper end is disposed of by turning the ends down, and inclosing themin a few additional turns of the roller. As soon as the application ofthe adhesive strip and roller is completed, the weight may be adjusted,and extension applied. The amount of extension required for adultswill vary from eighteen to twenty-three pounds. In a large proportionof cases, twenty or twenty-one pounds will be borne without complaint;and the ability of the patient to tolerate the ex
A practical treatise on fractures and dislocations . of cotton-waddingover the whole surface of the limb. Any excess of the bands at theupper end is disposed of by turning the ends down, and inclosing themin a few additional turns of the roller. As soon as the application ofthe adhesive strip and roller is completed, the weight may be adjusted,and extension applied. The amount of extension required for adultswill vary from eighteen to twenty-three pounds. In a large proportionof cases, twenty or twenty-one pounds will be borne without complaint;and the ability of the patient to tolerate the extension, alone limits the 1 Therapeutic Gazette, Nov. 15,1888. FRACTURES OF THE SHAFT OF THE FEMUR. 413 amount. Occasionally, even a few pounds, when first applied, cause painin the ligaments about the knee-joint; but in a few hours the amountmay be increased. It is better to apply eighteen or twenty pounds atonce, if it can be borne. Lifting the knee slightly by a pad placedunderneath will often relieve the pain caused by the extension. Fig. Mode of applying adhesive plaster.(When the dressings are completed, the limb is to rest on the bed.) [It is better to have the plaster strips extend above the knee, and nearly tothe point of fracture. If they are applied altogether below the knee, the jointwill be subjected to an unnecessary strain, which may cause a certain degree ofweakness of the fibrous structures.] Sometimes, in the case of very muscular patients, and where the primaryshortening is considerable, I believe we make a positive and permanent gain ifwe place the patient under the influence of chloroform for a few minutes whenthe weight is first applied. In these cases, as in dislocations, I generally preferchloroform to ether, for the reason that the patient is less liable to muscular con-tractions when he is passing under the influence of the anaesthetic. Extension being effected, and the patient already resting upon theposterior coaptation splint, the three other
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Keywords: ., bookcentury1800, bookdecade1890, booksubjec, booksubjectfractures
