Commentaries on the Surgery of the War in Portugal, Spain, France, and the Netherlands from the battle of Roliça, in 1808, to that of Waterloo, in 1815; with additions relating to those in the Crimea in 1854-55, showing the improvements made during and since that period in the great art and science of surgery on all the subjects to which they relate.

Part 16

Chapter 16466 wordsPublic domain

157. The best apparatus for a compound fracture of the leg in either civil or military surgery, particularly in the latter, is that contrived by Mr. Luke, which may be seen in use at the London Hospital, and is supplied by Mr. M’Lellan, 3 Turner Street, Whitechapel Road. It is a simple iron cradle of small size, such as is used to guard a limb from the weight of the bedclothes, composed of three bars or large segments of a circle, united at their middles and ends or sides, as all cradles are, by a bar of iron of equal thickness. This is placed on a board a little wider than itself, with a ledge or bar at each side to prevent the cradle from moving, aided by two buttons or little pieces of wood on each side, which, being movable, turn over the iron bars, and thus render the board and cradle one firm piece. In this the leg is to be slung, to the center bar above, by ordinary tapes. A splint made of copper, to prevent rust or injury, hollowed to receive the leg, extending beyond the foot with a footboard, and beyond the condyles of the femur above, enables the tapes to be passed under the limb for slinging it; while from the extension of the splint beyond the condyles, it causes the leg and thigh to move together, in a manner which will often prevent the pain which follows a sudden motion of the patient. Solid wooden side splints are still wanting, and these should have holes cut in them to allow a vent for the discharge and for the application of dressings; or if a portion of the splint, say the middle, should require removal altogether for this purpose, the upper and lower parts may be united by a semicircular bar of iron, at the pleasure of the surgeon; within this the dressings may be applied, and by it the splint will be rendered firm.[3] When the leg is thus slung, the knee will be somewhat bent, the thigh raised, the muscles of the leg behind relaxed, and the patient can be moved with much greater facility than with any other apparatus; one great advantage of this apparatus is, that it can be used with effect even if the patient be obliged to lie on the ground. It admits of being slung as a whole in a spring-cart, by additional but strong, elastic straps fastened to or applied on the under part of the board, and thus a double slinging motion may be obtained when the sufferer is obliged to be moved.

[Footnote 3: This apparatus has, I think, been improved upon at the Bristol Hospital by the addition of a bar on each side of the center one.]