[p. 225] another person raised the arm extended along
the sides, the physician, applying the palm of the one hand to the
head of the bone, would push it away, and with the other would adjust
the broken bones, he would thus reduce the parts most readily to their
natural position. But, as formerly stated, the upper bone (sternal
fragment?) is rarely depressed downward. In most cases, after the
bandages have been applied, that position is beneficial in which the
elbow is fixed to the same side, and the shoulder is kept elevated;
but in certain cases, the shoulder is to be raised, as has been directed,
and the elbow is to be brought forward to the breast, and the hand
laid on the acromion of the sound side. If the patient has the resolution
to lie in bed, something should be placed so as to support the shoulder,
and keep it as much elevated as possible. But if he walk about, the
arm should be slung in a shawl, which embraces the point of the elbow,
and is passed round the neck.
Part 17
When the elbow-joint is displaced or dislocated to the side or outward,
while its sharp point (olecranon?) remains in the cavity of the humerus,
extension is to be made in a straight line, and the projecting part
is to be pushed backward and to the side.
Part 18
In complete dislocations toward either side, extension is to be made
as in bandaging fracture of the arm; for thus the rounded part of
the elbow will not form an obstacle to it. Dislocation, for the most
part, takes place toward the sides (inwardly?). Reduction is to be
effected by separating (the bones) as much as possible, so that the
end (of the humerus) may not come in contact with the olecranon, and
it is to be carried up, and turned round, and not forced in a straight
line, and, at the same time, the opposite sides are to be pushed together,
and propelled into their proper place. It will further assist if rotation
of the fore-arm be made at the elbow, sometimes turning it into a
supine position, and sometimes into a prone. The position for the
treatment consists in keeping the hand a little higher than the elbow,
and the arm at the sides; then it may either be suspended or laid
at rest, for either position will answer; and nature and the usage
of common means will accomplish the cure, if the callus does not form
improperly: it is formed quickly. The treatment
|