On the treatment of fractures of the femur by a simple modification of Liston's splint : with observations on re-fracture of the bone in cases of deformity / by Richard G. H. Butcher.

  • Butcher, Richard G. H., 1819-1891.
Date:
1853
Catalogue details

Licence: Public Domain Mark

Credit: On the treatment of fractures of the femur by a simple modification of Liston's splint : with observations on re-fracture of the bone in cases of deformity / by Richard G. H. Butcher. Source: Wellcome Collection.

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    had placed it at first, and applied Liston’s splint to retain it so. The patient immediately experienced great comfort. 28th. The patient slept steadily through the night, and free from all spasms. 30th. Going on most favourably; free from all pain. As the patient ])ossesses ample means, he requested permission to be removed home, and solicited my attendance. He was removed from the hospital in a cart, and conveyed several miles without the slightest disturbance of the fracture, or displacement of the splint which I had applied three days before. 31st. Visited the patient after his journey; he has not suf¬ fered the least irritation from his removal. I did not think it necessary to re-adjust the splint. November 3rd. Replaced the pelvic band. 24th. This case has gone on from the commencement with¬ out any complication. Re-adjusted the splint for the first time since it was put on twenty-nine days ago. 30th. Removed the splint now five weeks after the occur¬ rence of the fracture; and it is remarkable, how far the conso¬ lidation of the union between the broken I'ragments is accom¬ plished; the limb fully preserves the length it was before the accident; and the foot, leg, and lower fragment hold their proper direction without the slightest deformity of any kind. Re-applied the splint as before. I have no doubt that the limb will be as useful to the pa¬ tient as it was before he met with the accident. I have stated that the union is already nearly completed, and the man pro¬ mises to be cured in the ordinary time required for the repara¬ tion of a broken thigh. The most prominent points of interest in Case No. I. are, first, the site of fracture and the nature of the deformity; se¬ condly, the re-fracture of the united bone. In fracture of the fe¬ mur occurring below the lesser trochanter, it was first strenu¬ ously laid down by Sir A.Cooper, that a great prominence in front characterized the accident, occasioned by the upper fragment being lifted forwards and upwards by the action of the psoas and iliacus muscles. He says, “ the thigh-bone is sometimes broken just below the trochanter major and minor; it is a dif¬ ficult accident to manage, and miserable distortion is the conse¬ quence if it be ill-treated. The end of the broken bone is drawn forwards and upwards so as to form nearly a right angle with the body, and the cause of this position is evidently the contraction of the iliacus internus and psoas muscles.” Ever since this paragraph was written, its substance has been