Atlas and epitome of traumatic fractures and dislocations . Fig. 14.—Paralysis and contractureof the muscles of the forearm due toischemia, in a young man seventeenyears of age, following fracture of thelower end of the humerus ten yearsbefore. The primary dressing con-sisted of a closely fitting plaster-of-Paris cast. [The cause of the muscu-lar contraction in this case was prob-ably due to an interstitial myositis(Tillman), in which the muscle isreplaced by scar tissue.—Ed.] bandage. Splints arevery much to be preferred. Failure to observe this ruleis responsible for many disastrous results.
Atlas and epitome of traumatic fractures and dislocations . Fig. 14.—Paralysis and contractureof the muscles of the forearm due toischemia, in a young man seventeenyears of age, following fracture of thelower end of the humerus ten yearsbefore. The primary dressing con-sisted of a closely fitting plaster-of-Paris cast. [The cause of the muscu-lar contraction in this case was prob-ably due to an interstitial myositis(Tillman), in which the muscle isreplaced by scar tissue.—Ed.] bandage. Splints arevery much to be preferred. Failure to observe this ruleis responsible for many disastrous results. A tight GENERA L CONSIDER A TIONS. 67 plaster-of-Paris bandage has in a number of cases led tocompression at the seat of fracture, producing ischemia,paralysis, and contracture or even gangrene of the entireextremity, and many a surgeon has been held responsiblefor such results and gotten himself into serious the cases of ischemic paralysis and contracture. Fig. 15.—Fixation bandage with two padded strips of lead, bent soas to conform accurately to the shape of the arm flexed at a right angleat the elbow. The illustration shows the upper extremity of theposterior splint being fixed by the bandage. (Volkmann) that I have seen were due to this practice ofdressing a recent fracture with plaster-of-Paris. The pro-longed interference with the blood-supply of the muscleleads to disintegration of its elements, the muscle loses itselasticity and becomes shortened and rigid (contracture).The irritability of the nerves remains intact, while that of 68 FRACTURES AND DISLOCATIONS. the muscle-fibers disappears more or less completely, de-pending on the severity of the case. The best splints for use in the treatment of fracturesare flexible metal splints, or plaster-of-Paris splints pre-pared for each case (Beelys combination splints of plaster-of-Paris and hemp). Of tlie former, I prefer either thewire splints proposed by Dr. Cramer, or narrow padd
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Keywords: ., bookcentury1900, bookdecade1900, booksubjectfractur, bookyear1902
