A practical treatise on fractures and dislocations . modes of reduction practiced and recommended by these differ-ent surgeons are as diversified and irreconcilable as their views of themechanism and pathological anatomy of the accident. Sir Astley Cooper recommends that extension shall be made bybending the thumb toward the palm of the hand, to relax the flexormuscles as much as possible, and then, by fastening a clove hitch uponthe first phalanx, previously covered with a piece of soft leather, theextension is to be continued, only inclining the thumb a little inwardstowrard the palm of the
A practical treatise on fractures and dislocations . modes of reduction practiced and recommended by these differ-ent surgeons are as diversified and irreconcilable as their views of themechanism and pathological anatomy of the accident. Sir Astley Cooper recommends that extension shall be made bybending the thumb toward the palm of the hand, to relax the flexormuscles as much as possible, and then, by fastening a clove hitch uponthe first phalanx, previously covered with a piece of soft leather, theextension is to be continued, only inclining the thumb a little inwardstowrard the palm of the hand. If these means fail after having beencontinued a considerable length of time, he advises that a weight shallbe suspended to the thumb, passing over a pulley. Finally, in theevent of the failure of this method also, Sir Astley thought that no fur-ther attempts should be made, and especially that no operation for thedivision of these parts is justifiable. Lizars and Pirrie adopt the views of Sir Astley with little or noqualification. Fig. Sir Astley Coopers method of reducing dislocations of the thumb, with pulleys. Charles Bell proposed flexing the joint, employing also at the sametime pressure; and in obstinate cases he advised subcutaneous sectionof the lateral ligaments with a small knife, a method which has sincebeen practiced successfully by Liston, Peinhardt, Gibson, of Philadel-phia, Parker, of New York, and others. Syme and Lizars justify thepractice in certain cases. In one case which has come under my notice,after failing to effect reduction by the usual methods, I succeededpromptly after cutting one lateral ligament; and in the second case Ionly succeeded after cutting both lateral ligaments. Poser, from his experiments upon the cadaver, concludes that thedislocated phalanx must first be bent forcibly backwards, or into theposition termed by some waiters dorsal flexion, so as to throw the headof the phalanx forwards upon the articulating surface of the met
Size: 2747px × 910px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1800, bookdecade1870, booksubjectfractur, bookyear1875
