On a new method of managing fractures : from the address in surgery, delivered at the Twentieth Anniversary Meeting of the Provincial Medical and Surgical Association, held at Oxford, on Wednesday and Thursday, July 21st and 22nd, 1852 / by James Torry Hester, fellow of the Royal College of Surgeons, surgeon to the Radcliffe Infirmary, Oxford.

  • Hester, James Torry
Date:
1853
Catalogue details

Licence: Public Domain Mark

Credit: On a new method of managing fractures : from the address in surgery, delivered at the Twentieth Anniversary Meeting of the Provincial Medical and Surgical Association, held at Oxford, on Wednesday and Thursday, July 21st and 22nd, 1852 / by James Torry Hester, fellow of the Royal College of Surgeons, surgeon to the Radcliffe Infirmary, Oxford. Source: Wellcome Collection.

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    one, and left the limb in the best possible position, he discovers on his next visit, one end of the bone riding over the other; and when union has taken place, the patient is mortified and the surgeon disgraced, by a shortened and deformed limb. This can only result from defective apparatus. Mr. Pott, in treating of fractures, says :—“ The general doctrine relative to them is contained under the following heads:— Extension. Delegation or Bandage. Counter Extension. Position. Coaptation, or Setting. Prevention or Relief of Accidents.” Application of Medicaments. Now, it appears to me that we have to attend first to position, without which, we shall in vain hope to be successful in our treat¬ ment of fractures. Extension and counter extension are the next points of importance, and that, in my opinion, is but an imperfect apparatus, by which they are not effected. What is done by the splints in ordinary use? They merely give side support, and afford us no means of keeping up the extension of the limb to which they are applied. And what is a common result ? A riding of the bone, and a shortening of the limb. For the first few days after a fracture, there is generally considerable spasm of the muscles, and after that has ceased, a tonic contraction of them. Should the fracture be transverse, the bone will be bent; if oblique, the ends will ride over one another; and in either case deformity will ensue. I shall briefly notice the means which are ordinarily in use, and first, as to the treatment of fractures of the thigh, which are unquestionably those which result so frequently in deformity, and as the straight position with the long splint is now most commonly in use, I shall begin with it. As I before said, it will certainly ensure a proper length of limb, blit the objections to its use are, first, that the position is an unnatural and an uncomfortable one, and I do not know that I can do better than quote Mr. PotPs words relative to it. After speaking of fractures of the humerus, and expatiating on the small amount of trouble and pain, and the slight extension which is requisite in the treatment of them, he says :—“ Is it not because both patient and surgeon concur in putting the arm in a state of flexion, that is in such a state as