Part 16
When the parts are adjusted, you should apply the bandages while the
limb is in a stretched position, making the first turns to the right
or to the left, as may be most suitable; and the end of the bandage
should be placed over the fracture, and the first turns made at that
place; and then the bandage should be
[p. 187]carried up the leg, as described
with regard to the other fractures. But the bandages should be broader
and longer, and more numerous, in the case of the leg than in that
of the arm. And when it is bandaged it should be laid upon some smooth
and soft object, so that it may not be distorted to the one side or
the other, and that there may be no protrusion of the bones either
forward or backward; for this purpose nothing is more convenient than
a cushion, or something similar, either of linen or wool, and not
hard; it is to be made hollow along its middle, and placed below the
limb. With regard to the canals (
gutters?) usually placed below fractured
legs, I am at a loss whether to advise that they should be used or
not. For they certainly are beneficial, but not to the extent which
those who use them suppose. For the canals do not preserve the leg
at rest as they suppose; nor, when the rest of the body is turned
to the one side or the other, does the canal prevent the leg from
following, unless the patient himself pay attention; neither does
the canal prevent the limb from being moved without the body to the
one side or the other. And a board is an uncomfortable thing to have
the limb laid upon, unless something soft be placed above it. But
it is a very useful thing in making any subsequent arrangements of
the bed and in going to stool. A limb then may be well or ill arranged
with or without the canal. But the common people have more confidence,
and the surgeon is more likely to escape blame, when the canal is
placed under the limb, although it is not
secundum artem. For the
limb should by all means lie straight upon some level and soft object,
since the bandaging must necessarily be overcome by any distortion
in the placing of the leg, whenever or to whatever extent it may be
inclined. The patient, when bandaged, should return the same answers
as formerly stated, for the bandaging should be the same, and the
same swellings should arise in the extremities, and the slackening
of the bandages in like manner, and the new bandaging on the third
day; and the bandaged part should be found reduced in swelling; and
the new bandagings should be more tightly put on, and more pieces
of cloth should be used; and the bandages should be carried loosely
about the foot, unless the wound be near the
[p. 188]knee. Extension should
be made and the bones adjusted at every new bandaging; for, if properly
treated, and if the swelling progress in a suitable manner, the bandaged
limb will have become more slender and attenuated, and the bones will
be more mobile, and yield more readily to extension. On the seventh,
the ninth, or the eleventh day, the splints should be applied as described
in treating of the other fractures. Attention should be paid to the
position of the splints about the ankles and along the tendon of the
foot which runs up the leg. The bones of the leg get consolidated
in forty days, if properly treated. But if you suspect that anything
is wanting to the proper arrangement of the limb, or dread any ulceration,
you should loose the bandages in the interval, and having put everything
right, apply them again.
