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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    of these conditions are present as well as the absence of any marked senile structural change osseous union may take place in consequence of the pro^jer and permanent apposition of the broken ends of the bone. Our object, therefore, should be to bring about this condition as far as is practicable by artificial means, and this can best he done by rest fixation of the limb, and as much extension as will aid in promoting these two latter essential conditions, I have not as yet tested Professor Senn’s method, of lateral pressure, but in my experience the neces- sary conditions can best be fulfilled either by Mr. Bryant’s double splint, or, I hope I may say without vanity, by the screw extension combination splint which I have devised and employed, not merely in the treatment of various fractures of the lower ex- tremity, including those of the cendx femoris and its base, but also in certain forms of chronic arti- cular disease. Whatever apparatus is employed, it should be remembered that two things are essential, especially in dealing with very aged persons: First,. to have provision for enabling the patient to sit up occasionally, not allowing him to remain long in the recumbent position; and secondly, that the extension be not greater than will promote immobility; in other words, care should be taken not to have any violent and useless contest set up between mus- cular and mechanical forces—a condition necessarily antagonistic to, if not incompatible with, that rest, fixation, and freedom from pain which are so essen- tial to the satisfactory union of all wounds, whether of bones or soft structures. From the ])receding considerations, we are, I think iustiiied. iu forming flu' following conclusions :