Image from page 122 of "The treatment of fractures" (1900)
Title: The treatment of fractures
Authors: Estes, William Lawrence, 1855-
Contributing Library: Yale University, Cushing/Whitney Medical Library
Digitizing Sponsor: Open Knowledge Commons and Yale University, Cushing/Whitney Medical Library
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pre-vent pressure on the insertion of the tendon. Thispadded splint is bandaged to the foot and leg. whileextension is maintained on the extremity, then therailroad placed properly and the track made to fit inthe grooves on the transverse runners. Sufficientweight should then be applied to hold the trochantermajor to its proper level. The pulley must be ad-justed at such a height that the weight shall not Fractures of the Femur. 119 drag the foot downwards, but raise it a very littlefrom the general level of the bed. I have found thatstrong adults require from ten to fifteen poundsweight to make sufficient extension. A very import-ant complement to the dressing is the counter-ex-tension band. I have found best a pretty broad softperineal pad attached to either elastic cords or non-elastic bands, which in this last case must be care-fully watched and frequently re-adjusted, always kepttaut, and always fastened so as to make a constautpull outwards as well as upwards from the perineum.
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Fig. S3. Shows the extension splint applied to the leg, in use. (The accompanying illustration shows the wholedressing applied in actual service.) This apparatusis adapted to both forms of fracture of the neck, andhas given me the best satisfaction in the majority ofcases. It is simple, easily applied, and maintains itsextension more constantly and more efficiently thanany other dressing I have ever tried, and it givesmost comfort to the patients. If a rigid dressing is required by the exigencies ofthe case, and this will sometimes happen in very young,restless subjects, I think plaster-of-Paris dressing ap-plied, while the patient is under anaesthesia, fromthe toes to the sternum, is the best, Manual or pulley 120 The Teeatmext of Fkactubes. extension must be maintained until the plaster is set.While the majority of eases will have eversion of thefoot after the fracture, a number will show inversionThese cases with inversion I have found more diffi-cult to replace and retain than the
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