Health and Beauty

1889

Fractures

Fracture is said to be simple when there is no external wound; compound, when complicated with lesion of the surrounding soft parts; and comminuted when the bone is broken into many fragments. The symptoms of fracture are pain and inability to move the limb. When there is great swelling, it is often difficult to ascertain the nature or even the existence of a fracture. The course of a simple fracture is a painful and inflamed swelling a few days after the accident, with more or less febrile reaction; these gradually subside, and with proper treatment the bone unites in from one to two months, with or without deformity according to circumstances not always under the control of the surgeon. Complicated fractures often terminate in the death of portions of bone and of the soft parts, in unhealthy abscesses and tetanus, leading perhaps to fatal results unless the limb be removed. The indications of treatment are to reduce or set the fragments and keep them at rest and in close contact so as to prevent deformity; all disturbing muscles must be relaxed, the ends of the bones extended and the parts properly supported and kept in place, the limb bandaged, and some kind of splint applied to keep it immovable of its natural length. The variety of bandage, splints, and apparatus for the different kinds of fracture is very great, and in nothing does American surgery stand more pre-eminent than in its ingenious and effectual instruments fort the treatment of broken bones. When a surgeon cannot be procured immediately the broken limb should be kept as nearly as possible in its natural position. The two portions of the bone must be pulled in opposite directions, until the limb is the same length as its fellow, then apply a splint and bind it to the part with a bandage. Of course when there is no deformity the pulling of the bones is unnecessary. Should there be much swelling a cold lotion should be used. If the patient is faint, give brandy and water, or sal-volatile and water.