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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    mention cases of a similar kind, in whick the plan of keeping the limb in a state of complete flexure, all through the period of healing, was followed by an opposite result”^. The best criterion of any plan of treatment is the efficiency ' with which it fulfils the required object. In the nine cases re¬ corded, it will be seen all were cured without the least eversion of the foot,—a distortion so frequently produced by the treat¬ ment with the double inclined plane ; in all, though oblique fractures, the limb was restored to its full length, and in a short time the motions and functions of the neighbouring joints per¬ fect. I have seen in the hands of others this method equally successful: then great was my surprise to read in a volume, not long since issued from the press, the following observa¬ tions:—“ During the attendance of Mr. Abernethy on St. Bar¬ tholomew’s Hospital, his custom was to place all patients with fractured thigh upon the side, according to the practice of Mr. Pott, bending the thigh on the pelvis, and the leg on the thigh; and I cannot find the practice of the present day more success¬ ful than his”^. There is not a book on modern surgery but discards Pott’s views and mode of treating fractures of the thigh; because they are incapable of fulfilling the indications of cure, and if persisted in, are almost in every instance followed by pitiful deformity: the method is renounced by every modern surgeon for a better line of practice eminently successful; and why Mr. Skey has not advanced with his contemporaries! cannot pretend to answer. In Case viii., where the femur was split very obliquely above the knee-joint, the double inclined plane, as favourably recommended by Sir A. Cooper, was quite useless,—extension, and that with considerable force, was imperatively required to counteract the fragments passing each other, and this was grate¬ fully afforded by the long splint. The mechanism adopted by Desault and Boyer, for keeping up permanent extension, were appliances most successfully em¬ ployed by these celebrated surgeons ; and although complicated and cumbersome, yet they were useful on a like principle, though not to the same extent as the apparatus now in most general use, as simplified and improved by the late Mr. Liston. Many, indeed, have been the additions made to Desault’s splint. Van Houte’s alteration of it is for. the purpose of keeping up extension in the long axis of the limb, by means of a cross ^ Houston, in Dublin Journal of Medical Science, First Series, vol. viii., Art. xix.