Fractures of the femur in children, treated by Bryant's method of vertical extension / by J.M. Barton.

  • Barton, J. M.
Date:
1886
    FRACTURES OF THE FEMUR IN CHILDREN, TREATED BY BRYANT'S METHOD OF VERTICAL EXTENSION. BY J. M. BARTON, A.M., M.D., SURGEON TO THE JEFFERSON COLLEGE HOSPITAL, PHILADELPHIA. Read in the Surgical Section, at the Thirty-Seventh Annual Meeting of the American Medical Association. Reprinted from the Journal of the American Medical Association, December 4, rSS6. CHICAGO; Printed at the Office of the Association. 1886.
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    Treated by Bryant’s Method of Vertical Extension. The treatment of fractures of the femur in children has always been attended with great difficulty. The fragments are so short they are not readily grasped by the dressings, and usually the thigh is so compar- atively large and soft that the extremities of the frag- ments are with difficulty maintained in apposition. Only the most firm and secure dressings will be re- tained, as all the efforts of the sufferer are directed towards their removal. The dressings are soon soiled by the discharges from the bladder and bowels; and frequent renewals interfere with the process of re- pair. The displacement of the dressings by the pa- tient, causing injurious pressure, and the uncertainty which the surgeon feels concerning the condition of the limb, necessitate frequent examinations, espe- cially when the child shows evidences of discomfort. The disappointment following the usual methods of treatment is perhaps best shown by the fact that in St. Bartholomew’s Hospital Reports for 1867, Messrs. Paget and Callender reported that they treated many cases of fracture of the thigh in chil- dren negatively, without splints, all apparatus being dispensed with, “ the child being laid on a firm bed with the broken limb, after setting it, bent at the hip and knee and laid on its outer side.” The plaster dressing is a valuable one in these frac- tures, and as usually applied—with short splints around the femur and a long splint reaching from the axilla to below the foot, thoroughly covered in with plaster bandages, and either varnished or covered with oiled silk to protect it from the discharges—has often given admirable results.