Fractures of the Leg or Thigh
Fractures of the Leg or Thigh
Fractures of the leg or thigh will entail an enforced stay of from four to six weeks in the woods, or the devising of some means to transport the patient to a place where he can have proper care, an arduous task in a country where there are no roads and the trails are difficult. If a personal experience may be allowed, I will tell how I once treated a man with fractured thigh and conveyed him with comparatively little discomfort over sixteen miles of rugged mountain trail and some forty miles of equally rugged mountain road.
I found the man in a mining camp in the very heart of the higher mountains, lying in his bunk with a badly fractured thigh. The bone was separated between the upper and middle third—that is, well up toward the body. The accident had occurred some twenty hours previous and there was much swelling, which it was necessary to reduce before anything else could be done. This was accomplished by the application of cold water by means of strips of blanket, changing the application as fast as the water became warmed by the body heat.
In the meantime I went out into the timber and felled a small cedar tree some six inches in diameter. From this I cut a section five feet in length and removed the bark. Splitting the bark in half, I rounded up the edges and made a splint for the outside of the limb extending from the armpit to six inches below the foot. The other half was made into a similar splint, only shorter, for the inside of the limb, extending from well up into the groin to a point opposite the outer splint below the foot.
It was necessary to cut holes in the splints where the bony prominences came. When all was in readiness and the limb reduced in size, I wrapped it well in soft cloth, having no absorbent cotton, and applied my splints. I had a man stand at the feet of the injured man, take hold of the injured leg, and pull steadily while I manipulated the fracture.
Right here I want to state that it is unnecessary to try to pull a broken bone out of the socket in order to set a fracture. A persistent pull of some fifty pounds will soon overcome the contraction of the muscles and the bone will be replaced. The acting surgeon must at the same time grasp the limb at the site of the break and knead the two ends into place. You will know when they are in place by the absence of inequality at the point of break.
After the bone had been replaced, I placed my splints in position and bound them on, using strips of sheet torn up for bandages. Any stout cloth will do as well. They may be placed in the ordinary manner, each wrap beside the other, or they may be run on in continuous form, permitting each ascending turn to half overlap the one below it. Care must be taken that the pressure is equal in all parts of the bandage and that it is placed tight enough to prevent any slipping of the splints.
The next problem was to get the man out. Again the cedar forest came to my relief. I felled another and somewhat larger tree, sufficiently large to permit placing the injured man in a boat-shaped section of the bark. This was made longer than his body and a semi-circular board fitted in each end. When the whole was completed it resembled a rude trough.
This trough was lined with blankets until it was quite soft. Two poles twelve feet in length were lashed to either side and the man securely lashed in the contrivance. When we were ready to start two steady pack animals were brought out and the litter with its burden swung in such manner that the animals could wind down the steep rocky trail with the burden between them. In this manner we jogged down the mountainside all day, our patient laughing and enjoying his pipe as though he were the guest of honor in some triumphal procession.
While cedar was mentioned as having been used in the above case, the reader will appreciate that any sort of timber with a tough bark will answer equally well.
There is one important fact that should always be borne in mind in the treatment of all fractures, and that is that at least the two adjoining joints should be fixed. If it is the thigh that is fractured, the hip, knee, and ankle should be included in the splint. If the leg, then the knee and ankle. The same rule holds good with fractures of the forearm or arm.
If timber with tough bark is not available, or in open countries where no timber grows, a broken bone may be nicely splinted by using small round sticks. Never use a clapboard unless it is extremely well padded; even then it is undesirable from the fact that it is liable to press upon some bony point and cause trouble. Also it is very liable to slip and permit your fractured bone to become displaced.
To fix a limb by using round sticks, wrap the limb well in soft cloth; then, having cut your sticks the right length, place them at regular intervals about the limb and bind as before. In the absence of anything better, two leather gun scabbards make quite effective splints.
What has been said with regard to fractures of the lower limb will apply with equal force to breaks of the upper except, of course, that the case is one of far less gravity. In cases of fracture of the arm, either above or below the elbow, the injured person can make himself quite comfortable by pinning the bottom of his coat to his shoulder and placing the injured arm in the V-shaped sling thus formed.
Moody, Charles Stuart. Backwoods Surgery & Medicine. New York: Outing Pub., 1916. Print.
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