On a new method of managing fractures : from the address in surgery, delivered at the Twentieth Anniversary Meeting of the Provincial Medical and Surgical Association, held at Oxford, on Wednesday and Thursday, July 21st and 22nd, 1852 / by James Torry Hester.

  • Hester, James Torrey.
Date:
1853
Catalogue details

Licence: Public Domain Mark

Credit: On a new method of managing fractures : from the address in surgery, delivered at the Twentieth Anniversary Meeting of the Provincial Medical and Surgical Association, held at Oxford, on Wednesday and Thursday, July 21st and 22nd, 1852 / by James Torry Hester. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

    7/32 (page 7)
    unsuccessful. Mr. Earless bed promised to afford the best means of support, and for a considerable time I was disposed to consider that it could hardly fail to ensure a good and straight limb; but on making experiments on it, I found that it was as defective as any other apparatus hitherto in use. It was whilst making my observations on his bed that I made the discovery on which I have based my mode of treatment. Let any one place himself in one of his beds, with the knee elevated to a proper height, and the back likewise elevated, then let the back be raised higher, or be more depressed, and he will find the knee thrust forwards in the one case, and dragged back in the other. A moment's consideration will render any explanation as to this pushing or dragging unnecessary, and it will be quite clear that unless the back be kept always at the same elevation, a good cure cannot be looked for. On still further making observations, I found that the same pushing and dragging of the limb took place under ordinary circumstances, in changing from a sitting to a recumbent position. Any one may convince himself on this point very easily. Let him sit with his legs straight and his feet touching the wall, and then fall back. He will find in doing so, that his feet are drawn about four inches from the wall. Let him reverse the experiment, and lie down with his feet against the wall, and on rising again into a sitting posture, he will find that his knees will become considerably bent. This effect is very easy of explanation. When sitting, as in the accompanying sketch of the skeleton, (Fig. II.) the acetabulum will be found to be above, or rather a little in front of a straight line over the tuber ischii, but on lying down the pelvis, as it were, rolls back, and the acetabulum is consequently carried several inches further backwards. Finding this to be the case, I considered that the best mode of treating fractures of the thigh would be to place the subjects of them on such a bed as would admit of the back being elevated or depressed, without at all interfering with the relative position of the trunk and thigh. Figure III. shows the bed as it is adapted to a fracture of the middle of the thigh. It will be seen that it has no connexion with the frame on which it rests, except by the hinges at the centre of the bed. Figures IV., V., and VI., show the extremes to which, when thus