. Modern surgery, general and operative. atientcan be moved in bed. I consider this apparatus one of the most comfortableappliances which can be worn and excellent results are obtained by its splint is even more comfortable and useful (Fig. 323). In fracture ofthe middle third or upper part of the lower third of the shaft if the line offracture is transverse and there is little deformity, as is seen often after afracture by direct force, and often in children, immobilization in an immov-able dressing may be all that is required; but if shortening exists, extensionmust be used. If ex
. Modern surgery, general and operative. atientcan be moved in bed. I consider this apparatus one of the most comfortableappliances which can be worn and excellent results are obtained by its splint is even more comfortable and useful (Fig. 323). In fracture ofthe middle third or upper part of the lower third of the shaft if the line offracture is transverse and there is little deformity, as is seen often after afracture by direct force, and often in children, immobilization in an immov-able dressing may be all that is required; but if shortening exists, extensionmust be used. If extension is used, continue it for four weeks and then sub-stitute a plaster-of-Paris dressing for four weeks. The amount of weightrequired is pointed out by Dawbarn—i pound for each year up to twenty.^In fracture near the knee-joint {lower part of the lower third of the femur) it maybe impossible to effect reduction by horizontal traction. In such a case maketraction, and while it is being made gradually bring the leg to a right Fig. 413.—Mclntyres splint. Place the limb in a double inclined plane (PI. 7, Fig. 2). A McInt>Te splint(Fig. 413) is a useful form of double inclined plane. After four weeks of theuse of a double inclined plane apply a plaster-of-Paris dressing, which is to beworn for four weeks. Useful appliances for fracture of the femur are shownin Figs. 398, 399, 400 and 403. Fractures of the Shaft of the Femur in Children.—In children under threeyears of age the extension apparatus will not satisfactorily immobilize thefragments. Fractures of the thigh in children are reduced by extension andcounterextension; a well-padded splint reaching from the axilla to below thesole of the foot may be applied to the outer side of the limb and body. Thissplint is held in place by bandages which are overlaid by plaster of Paris. It isworn for four weeks, when it is removed and a plaster bandage, applied so as toinclude the entire limb, is worn for four weeks. Th
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