Traumatic separation of the epiphyses
(This historic book may have numerous typos and missing te...)
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. 1898 Excerpt: ...whether the elbow be kept in the extended or flexed position TREATMENT.--All cases should be put up at once in the completely extended position, and maintained in that position by a long anterior straight splint, or other suitable apparatus, extending from the shoulder to the end of the metacarpal bones. The olecranon must be secured in its natural position. We must not wait until swelling has subsided, as recommended by some surgeons, for it will be found very much more difficult to straighten the forearm subsequently than it would have been at IG. 135.--STRAIGHT ANTERIOR SPLINT (GOOCIl's SPLINTING) FROM SHOULDER TO WRIST FOR SEPARA-TION OF THE OLECRANON A bandage is applied in oblique turns to the elbow-joint above and below the olecranon to prevent displacement of its epiphysis. (Alter Spence) first, and there will be the risk of the olecranon becoming displaced, if this had not occurred already. Should displacement of the olecranon have taken place, it will be still further drawn up and fixed in that position. The synovial fluid, being in contact with the fractured ends of the bone, will not only tend to prevent the accurate apposition of the fragments, but, by lining the surfaces with synovial lymph, may entirely stop the formation of osseous union between the fragments. This position has been almost universally adopted for fractured olecranon in England since the time of Sir A. Cooper, and in France also--following the authority of Roux, Malgaigne, and Dupuytren. Where displacement has occurred, the exact apposition of the fragments--the most important factor in the treatment, which should be aimed at in all cases--can only be brought about by extension of the arm. In this position only can the triceps be relaxed, and the descent of the epiphysis perm...
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