Part 6
When the third day arrives, that is to say, the seventh from the first
dressing, if properly done, the swelling in the hand should be not
very great; and the part which has been bandaged should be found more
slender and less swelled at each time, and on the seventh day the
swelling should be quite gone, and the broken bones should be more
readily moved, and admit of being easily adjusted. And if these things
be so, you should,
[p. 177]after setting the fracture, apply the bandages
so as to suit the splints, and a little more tight than formerly,
unless there be more pain from the swelling in the hand. When you
have applied the bandages, you must adjust the splints all around
the limb, and secure them with strings so loose as just
to keep them in their place, without the application of the splints
contributing at all to the compression of the arm. After this the
pain and recovery should proceed as in the preceding periods of the
bandaging. But if, on the third day, the patient say that the bandaging
is loose, you must then fasten the splints, especially at the fracture,
but also elsewhere, wherever the bandaging is rather loose than tight.
The splint should be thickest where the fracture protrudes, but it
should not be much more so than elsewhere. Particular attention should
be paid to the line of the arm corresponding to the thumb, so that
no splint be laid on it, but upon each side of it, nor in the line
of the little finger where the bone is prominent at the wrist, but
on each side of it. And if it be found necessary that splints should
be applied in these directions at the seat of the fracture, they should
be made shorter than the others, so as that they may not reach the
bones which are prominent at the wrist, for otherwise there is danger
of ulceration, and of the tendons being laid bare. The splints should
be adjusted anew every third day, in a very gentle manner, always
keeping in mind that the object of the splints is to maintain the
lower bandages in their place, and that they are not needed in order
to contribute to the compression.
