On the pathology and treatment of fracture of the neck of the thigh bone / [Bransby Blake Cooper].

  • Cooper, Bransby Blake, 1792-1853
Date:
1845]
Catalogue details

Licence: Public Domain Mark

Credit: On the pathology and treatment of fracture of the neck of the thigh bone / [Bransby Blake Cooper]. Source: Wellcome Collection.

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    to inquire into the respective merits of both the one and the other. Moreover, considering the frequency of the accident, it becomes the duty of the practical man to make himself acquainted with the discussions on the subject, in order that he may be able to judge more correctly what course to pur¬ sue when called upon to treat this peculiar accident. This he is the more bound to do, because even those who main¬ tain the possibility of union admit, that with all their me¬ chanical contrivances, it is rarely indeed, that they succeed in effecting the desired union. I shall not consider the diagnostic marks of the accident, because, as these are to be found fully detailed in the writings of our best surgical authors, I shall presume the reader to be fully acquainted with them. I shall therefore enter at once into the more immediate object of this essay, and, for perspicuity’s sake, adopt the following plan:— In the first instance I shall discuss the fact of the failure (in almost all cases) of inducing union of fractured neck of the thigh bone, even after the most assiduous application of the most complicated apparatus, and shall attempt to point out what are the true causes of such failures, as far as refers to the mechanical difficulties. Secondly, I shall examine into certain natural conditions of the neck of the thigh bone, in old people especially, which not only seem to preclude the possibility of bony union, but even to indicate certain provisions for the prevention of such union, as if to avoid the ill consequences which, at this part of the body, would necessarily arise from the usual mode of ossific reparation. Thirdly, I shall conclude by briefly describing that treat¬ ment which is attended with the most beneficial results in these cases. First, as to the alleged mechanical causes of failure. These are usually described as referrible to the extreme difficulty in producing perfect co-aptation of the fractured extremities of the bone, as well as in maintaining a sufficient degree of pressure upon them. The distention of the syn¬ ovial membrane by the inordinate secretion of synovia is also alleged as offering a difficulty in producing a conti¬ guity of the two portions. And, lastly, the isolated condition