Cases of difficult fractures occurring in private practice / by Fredk. H. Alderson.

  • Alderson, Frederick Henry.
Date:
[1895]
Catalogue details

Licence: Public Domain Mark

Credit: Cases of difficult fractures occurring in private practice / by Fredk. H. Alderson. 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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    and perfect immobility of the bone. I applied Liston’s long splint, extending from the axilla to three inches below the foot. A well-padded perineal band and counter extension was well kept up by occasionally tightening the tape of the band simultaneously at the axilla and ankle, also by small bags of shot suspended from the foot. The long splint was kept on for six weeks, and on May 14th, when it was removed, the fragments were firmly united, and with no bulging nor any superfluous callus. Unfortunately, this satisfactory result of the fracture was spoilt by the discovery of a huge bed-sore over the left buttock, and this complication was a surprise, for the patient had never complained nor appeared uncomfortable, and although this bed-sore was in a suppurating condition, her temperature, until the last day or two, had not risen, and then only to ioo'b On May 21st, the bed-sore not improving, but extensively sloughing, I called in Mr. Keetley, who happily suggested a fracture bedstead—i.e., a bedstead with a space to receive the buttocks (which was to be kept uncovered) and thus all pressure removed, and irrigation to be applied twice daily, or even oftener, with Condy’s fluid or zinc or carbolic lotion, by means of a syphon spray, and this was kept very frequently playing on the bedsore from beneath the bedstead, and at first sometimes for two or three hours at a time. This treatment was followed by the best results, the large sore rapidly contracting and granulating. Recovery was, unfortunately, greatly retarded by an acute attack of arthritis in both knees. Whether this could have been due to degenerate neurotic changes, from the pressure of the bandage (for the left knee-joint was very much worse than the right), or from cold resulting from the spray, in a rheu- matic subject, it would be interesting to have your opinion. Miss P never used crutches,2 and I much regret I could not persuade her to be here this evening, for the union of the fractured femur was most perfect, and she walks without 2 I very much doubt if this patient would ever have been able to use crutches, as there was a great want of nerve power. She could never grasp my hand firmly. There was even a suspicion that the accident was caused by a slight fit, which caused the patient to trip, and this would account for a morbid insensibility to pain that was so noticeable throughout her illness, and for her more than usual reticence.