A practical and systematic treatise on fractures and dislocations . Treatment of Fractures of the Tibia.—In most in-stances a fracture of the tibia alone can be managed withease and success. The coaptation of the fragments whenthere is displacement, is generally not a difficult the projection ®f the upper fragment forw^ard be consider-able, it may require some tact to get it back into place. Theinfluence of an anaesthetic may be employed to overcome mus-cular rigidity. The tendo-Achillis has been divided to over-come the spasm and contraction of the gastrocnemius andsoleus, but such
A practical and systematic treatise on fractures and dislocations . Treatment of Fractures of the Tibia.—In most in-stances a fracture of the tibia alone can be managed withease and success. The coaptation of the fragments whenthere is displacement, is generally not a difficult the projection ®f the upper fragment forw^ard be consider-able, it may require some tact to get it back into place. Theinfluence of an anaesthetic may be employed to overcome mus-cular rigidity. The tendo-Achillis has been divided to over-come the spasm and contraction of the gastrocnemius andsoleus, but such a course is rarely if ever necessary. I havenever seen a case that demanded a section of the tendon toassist in reduction. 238 Fractures. FiG. The twist or rotation which follows a fracture near the ankleis worse to overcome than the angular deformity followingfractures of the tibia higher up. In an ordinary case the limb from the toes to the knee maybe enveloped, not tightly, in a common muslin roller to mod-ify swelling, congestion, and muscular action ;two lath splints long enough to reach fromthe knee to the ankle may be laid on thesides of the leg, and bound there by anotherroller. If there be much tendency to the for-ward projection of either fragment a thirdsplint may be laid upon the posterior aspectof the leg, and a compress upon the anteriorsurface of the limb near the fracture, and soplaced as to bear upon the projecting piece ofbone, though not at its vSry point. Sidesplints have been prepared with concavities tofit the form of the leg, and Avith holes neartheir lower ends to avoid pressure upon themalleoli. These carved and nicely construct-ed splints are applied Avith ease, and they an-swer an excellent purpose
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Keywords: ., bookcentury1800, bookdecade1870, booksubjectfractur, bookyear1870
