On the diagnosis and treatment of fractures of the neck of the femur : being the introduction to a discussion in the Section of Surgery at the Annual Meeting of the British Medical Association held in London, July-August, 1895 / by Sir William Stokes.

  • Stokes, Sir William, 1839-1900.
Date:
1896
Catalogue details

Licence: Public Domain Mark

Credit: On the diagnosis and treatment of fractures of the neck of the femur : being the introduction to a discussion in the Section of Surgery at the Annual Meeting of the British Medical Association held in London, July-August, 1895 / by Sir William Stokes. 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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    ]\V Hxing, namely, the fragments with ivory, bone, or metallic nails. In ten of such experiments bony union was obtained in most of them. The ivory and bone nails were usually found absorbed, the metallic ones encysted. The importance of these experiments consists in demonstrating that the more perfect the fixation and immobilisation are, the greater is the chance of bony union, and the conclusion is irresistible that the surgeon should be cautious not to break down or disturb any penetration or impaction that may be present. Consequently, with the view of securing permanency of the impaction. Professor 8enn has introduced the principle of making lateral pressure in the direction of the axis of the cervix by a pad which rests on the external siu’face of the great trochanter, and the necessary pressure made by a screw action, which can be regulated from day to day. In non- impacted fractures the fractured surfaces should be brought into perfect mutual apposition, and in this position the affected limb, pelvis, and thigh on the opposite side should be encased in a plaster-of-paris dressing, all of the bony prominences being well protected by salicylic wool. In this dressing Professor 8enn combines the application of his splint, in which provision is made for the lateral pressm-e. Some surgical authorities, Sir John Erichsen among the number, consider that in an extracapsular impacted fracture a limb cannot be restored by traction to its normal length, and that nothing can be done to diminish the deformity, the patient remaining throughout life more or less crippled. Eecently there seems to be evidence of a tendency for the pendulum of surgical opinion to sw'ing to the opposite side, for with the view of preventing or diminishing the per-