Observations on contraction of the fingers (Dupuytren's contraction) : and its successful treatment by subcutaneous divisions of the palmar fascia, and immediate extension also on the obliteration of depressed cicatrices after glandular abcesses, or exfoliation of bone by a subcutaneous operation / by William Adams.

  • Adams, William, 1810-1900.
Date:
1879
Catalogue details

Licence: Public Domain Mark

Credit: Observations on contraction of the fingers (Dupuytren's contraction) : and its successful treatment by subcutaneous divisions of the palmar fascia, and immediate extension also on the obliteration of depressed cicatrices after glandular abcesses, or exfoliation of bone by a subcutaneous operation / by William Adams. Source: Wellcome Collection.

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    may be readily divided by such incisions, and would lead to a loss of power of flexing the finger after the operation. As the fascia-knife is being withdrawn from each puncture, the surgeon should make pressure with the forefinger of his left hand on the spot at which the fascia has been divided, and the subcutaneous track through which the knife has passed. A pledget of lint should be immediately applied over each puncture and retained in position by a strip of plaster. By these means hgemorrhage under the skin is arrested, and the true subcutaneous character of the operation preserved. After the requisite number of punctures have been made and thus protected, an additional compress of lint should be applied, and the hand bandaged with the fingers in an extended position— quite straight, if they can be brought so—to a softly padded metal splint as shown in Fig. 6. At the same time I also adopted another important modification in the treatment of these cases, viz. :— The plan of immediate extension, bringing the finger, or fingers, as nearly as possible into the fully extended position, at the time of the operation; and afterwards applying, as a retentive apparatus, a well padded metal splint, bent to the shape of the wrist, hand, and fingers, and applied along the palmar surface. The finger, or fingers, as well as the hand and wrist, are then bandaged to the splint, as shown in Fig. 6. This was a great change from the prolonged after- treatment required by the method of gradual mechanical extension made with the complicated steel instrument regulated by rack-and-pinion move- ments.