Medical and Surgical Therapy Volume 4 (Paperback)

This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1918 Excerpt: ...extension on the arm and wrist in a su3; pension appliance, for shattering of the humerus and radio-carpal fracture. Esquillectomy was performed in the case of the humerus; the wrist was resected. For some days continuous extension was made on the hand, the bands being fixed to the stirrup of the humeral extension. Weight of extension, 1,500 grammes; counterpoise weight, 4 kilogrammes. (The frame is not illustrated.) combined with continuous extension. In short, a better result is obtained at less inconvenience. Two types of suspension apparatus may be used: the type in which extension is applied to a horizontally suspended limb (fig. 102), or another in which the arm is extended horizontally and the forearm vertically (fig. 65, p. 428). Experience leads me to recommend the latter from all points of view. The arm is placed in a hammock with continuous horizontal extension applied above the elbow; the forearm is flexed and suspended at right angles; traction is exerted on the palm of the hand or on the fingers, if the wound is very low down, but on the proximal part of the wrist if possible. Patients readily become accustomed to this: I have two in course of treatment at the present time for double lesion, and both fractures are progressing as uneventfully as could be desired. I have frequently treated fracture of the humerus, radius, ulna, and metacarpus in the same patient. These cases gave more trouble than the two of which I have just spoken, and the superiority of suspension fixation seems to me to be beyond discussion. CHAPTER XV FRACTURES OF THE FEMUR Three main varieties are found in practice: 1. Sub-trochanteric fracture. 2. Fracture of the shaft proper. 3. Supra-condylar fracture. I. Sub-trochanteric Fracture 1. Anatomical Features.--There is almos...