Treatment of fractures of long bones by simple extension / by John Swinburne.

  • Swinburne, John, 1820-1889.
Date:
1861
Catalogue details

Licence: Public Domain Mark

Credit: Treatment of fractures of long bones by simple extension / by John Swinburne. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    the weight of the patient, the muscles are ready to do their part in the locomotion. One objection, and by the way the only one which possesses a show of validity, has been made, that the foot is liable to evert or invert; but a single moment's reflection will satisfy any one that no great ingenuity is required to avoid this—a bag of sand or bran on either side of the foot, or a strip of plaster, or of cloth, any of these simple means can be so employed as to main- tain the foot in a proper position. The fact to be dwelt upon is, that but little extension is neces- sary during the first stage of treatment. In order to prevent perineal excoriations, and accustom the patient to the necessary pressure when union is taking place, little more is essential, at first, than what is required to overcome spasmodic muscular con- traction, and displacement of the fractured ends. When the process of reparation has been thoroughly begun, even after the provisional callus has been thrown out, or at all events has begun to form, say a period of fifteen days, there is time enough to use extension for the purpose of acquiring the necessary length of the limb. In this way the patient has an opportunity of becom- ing accustomed to the confinement, and the parts where the pres- sure falls become inured and hardened, and thus better prepared for the necessary extending force. The efficacy of this treatment, like that of many and all others, is to be tested by its practical results. So far as an experience of about thirteen years, which, it is granted, is only a limited time, can be depended upon, there is no method more reliable than this. There is none under which more favorable results have proceeded, none in which there have been fewer failures (in this there have been no unfavorable results), considering the dif- ferent varieties of fractures to which it is applicable, and in which it has been used; and also considering the circumstances which have often attended, and of course complicated this as all other methods, it has been eminently successful, and has been exclusively used in private practice with uniform satisfaction. No written histories have been kept of the majority of these cases, except facts obtained from note-books, but the results have been such as to warrant its indiscriminate use. By this method there have been treated forty cases, twelve of which were hospital, and twenty-eight private patients. Of the latter twelve were intra-capsular.