A Manual for the College of Surgeons in London, Dublin, and Edinburgh, by J. Steggall, and M.W. Hilles

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.1839 Excerpt: ... nearly in the sitting posture, the hip-joint flexed, and the knee extended so as to relax the psoas and iliacus internus muscles; assist the position by means of compresses and splints judiciously applied. Fracture of the middle third of the femur has been already treated of at page 161. Fractures of the lower third of the femur are treated on the double inclined plane, with the knee-joint flexed to prevent the action of the heads of the gastrocnemius on the lower fractured portion. Fractures of either condyle of the femur extending to the knee-joint are treated in the straight position in order that the upper surface of the tibia may act as a support to the fracture. A pasteboard splint, moulded on the joint, supported by common splints and bandages, should be made use of. Passive motion should be commenced at the end of the fifth week. Fractures of the patella. The transverse fracture of the patella is the most frequent. It is generally produced by the spasmodic action of the rectus muscle, when the knee is in the semiflexed position, the patella being then broken across the lower end of the femur. The patella may be also fractured transversely by direct violence, as in falling on the knee. Symptoms: Pain and swelling about the joint, separation of the broken bones, the superior being drawn upwards by the rectus muscle, and inability of extending the limb. Treatment: Place the limb in the extended position, flexing the hip-joint so as to relax the rectus femoris, and allow of the upper portion being drawn down and placed in apposition with the lower. This being accomplished, a leather belt is buckled round the thigh above the upper portion of bone, from each side of which a leather strap provided with buckles passes to a broad belt beneath the foot, and i...