A new method of direct fixation of the fragments in compound and ununited fractures / by Nicholas Senn.

  • Senn, Nicholas, 1844-1908.
Date:
[1893]
Catalogue details

Licence: Public Domain Mark

Credit: A new method of direct fixation of the fragments in compound and ununited fractures / by Nicholas Senn. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    ciples as a wound of the soft parts, viz., to bring into apposition and hold in contact by direct temporary mechanical measures the different anatomical constituents of the wound until the process of repair is completed. As soon as this method of treatment is perfected and more generally adopted, we shall hear less fre- quently of the many unsatisfactory remote results of these inju- ries, such as delayed and non-union paralysis, impairment of general health from long confinement to bed, shortening, angular deformity, displacement by rotation, exuberant callus, and per- manent injury to adjacent joints from long-continued permanent extension. In veiy oblique fractures, compound as well as sim- ple, interposition of soft tissues takes place more frequently than is generally supposed, and this condition not infrequently is the sole cause of non-union. In oblique fractures of the femur it is generally conceded that continued extension and exteinal fixa- tion do not succeed in preventing more or less shortening and angular deformity. It is a well-known fact that long-continued extension is usually followed by temporary and often by peima- nent injury to the adjacent joints. Over-riding of fragments is often productive of harmful pressure upon important vessels and nerves. Displacement of fragments and imperfect immobilization are the most potent factors in the production of exuberant callus which so often impairs the functional result and so frequently causes remote painful affections. Displacement of detached fiag- ments in comminuted compound fractures is often not recognized, and much less frequently corrected without direct intervention. Thorough disinfection is frequently out of question without enlarging the external wound and free exposure of the seat ot fracture. Long-continued confinement in bed incident to treatment ot fractures of the lower extremities is detrimental to the general health of the patient, and is often the indirect cause of many fatal intercurrent affections. These evils attending the treatment ot compound fractures heretofore in vogue can be avoided in a meas- ure by resorting to direct fixation of the fragments. Diiect tieat- ment of the fracture does not add to but diminishes the dangei of traumatic infection, provided the operation is done under stiict