Joint diseases : treatment by rest and fixation / by De F. Willard.

  • Willard, De Forest, 1846-1910.
Date:
[1885]
Catalogue details

Licence: Public Domain Mark

Credit: Joint diseases : treatment by rest and fixation / by De F. Willard. 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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    of complete fixation, while every available constitutional health promoter is brought actively into service. In hip disease, after all pain has ceased for months, and earlier if the general health demands, some form of appara- tus should be applied to prevent joint motiou and yet per- mit the patient to move about on crutches, and with a high shoe on the sound foot. In this department every surgeon has his particular modification, and believes that it alone is capable of giving good results. While pleading partially guilty of the same weakness. I am yet able to see merits in all fixation splints. As for the so-called extension appliances, although I have seen nearly all of them in service, 1 can not imagine that they exert any separation of articular surfaces. By adhesive- plaster and bandage-pressure their beneficial action is, how- ever, probably exerted in controlling muscular action, and thus giving a certain amount of rot, fixation, and protec- tion, particularly in those appliance* in which hip-joint mo- tion is transferred above the pelvis. I employ horizontal extension, not with any idea of pulling the bone from its socket, hut simply to relieve muscular spasm, give quietude, and reduce deformity. 1 arn compelled also to differ with many .skilled sur- geons, who believe that the perineal straps and ischiatie rests are capable of acting as pelvic crutches, and thus doing away with axillary one*. The tissues covering the pubic rami are thin and the skin is sensitive, and, as I have always encountered these appliances, the patients either could not endure the pressure, or, as more frequently happened, the straps, except for an hour after the physician’s visit, were so loose that the weight was borne upon the articulation, and relapse has been the result. Even when most perfectly adapted, the jar upon the hip is far greater at each step than is received during axillary locomotion, and the liberation of