Leg break

“ In such cases the bone gives way at its weakest point, and the line of fracture tends to be oblique. Thus both bones of the leg are frequently broken by a person jumping from a height and landing on the feet, the tibia breaking in its lower third, and the fibula at a higher level. Fracture of the clavicle in its middle third, or of the radius at its lower end, from a fall on the outstretched hand, are common accidents produced by indirect violence. The ribs also may be broken by indirect violence, as when the chest is crushed antero-posteriorly and the bones give way near their angles. ”

“ It became much inflamed and swollen, and at times painful.—Exercise aggravated all these bad symptoms, and though I obtained the advice of various physicians, eminent in their profession, their appliances proved useless, and some of them injurious. My limb grew worse until I was almost confined to my house, and my leg, in addition to the swelling and inflammation, assumed a dark purplish color from the knee to the ankle ”

“ As soon as he recovered his senses, he attempted to rise, but to his dismay, found that he could not stand. A sudden twinge of pain in his right ankle prostrated him, as quickly as if he had been shot.
He thought at first that his leg was broken, but after a careful examination, came to the conclusion that his ankle was sprained, but even a broken leg would not have been a greater misfortune then, for he was unable to walk, and was suffering the most excruciating pain.
I think no one can imagine what poor Guy suffered, for the rest of that long [Pg 68] night. ”

“ To know for certain whether the leg is fractured, let the patient lay on his back or on either side, with his leg and thigh bent, so that the muscles are entirely at ease, and out of action. Let an assistant hold up the leg by the knee; then take with one hand the ancle, with the other the middle of the leg, and move the ancle to and fro, holding the 112other hand steady, and if you feel a crackling, and the patient feels great pain in those parts, the leg is certainly fractured ”

“ Painful tension in the muscles of the thigh as if a long walk had been taken.
Wrenching pain on the outside of the right knee extend [Pg 258] ing down the right side of the leg to the malleolus, from thence into the heel, where it ceases.
Trembling of the legs from the knees to the toes so that there is difficulty in walking or raising the feet.
Tearing pains in the calves of the legs, with a feeling of heat, extending down to the toes; the palms of the hands and soles of the feet are very hot. ”

“ Pain in the middle of the leg, less severe when the limb was at rest, more so when it was suddenly moved; the patient absolutely unable to support herself on it so as either to stand or walk since the accident; inequalities sensible to the touch on the anterior surface of the tibia; a shortening or contraction of about half an inch; a preternatural mobility at the place of the fracture; evident crepitation, produced by the rubbing of the fragments against each other, when moved in contrary directions: a change in the direction of the lower fragment, which was bent somewhat outwards. ”

“ But this form of bandaging must not be used unless there be danger of vesications or blackening in the swelling, and nothing of the kind occurs unless the fracture be bound too tight, or unless the limb be allowed to hang, or it be rubbed with the hand, or some other thing of an irritant nature be applied to the skin.
22. More injury than good results from placing below the thigh a canal which does not pass farther down than the ham, for it neither prevents the body nor the leg from being moved without the thigh. ”

“ From one to two months are required to secure union in a broken leg in adults, and from three to five months elapse before the limb is completely serviceable. In children the time requisite for a cure is usually much shorter.
ANKLE-JOINT FRACTURE.
First Aid Rule.—One or both bones of leg may be broken just above ankle. Foot is generally pushed or bent outward. Prepare two pieces of thin wood, four inches wide and long enough to go from sole of foot to just below knee:—the splints. Pad them with folded towels or pieces of blanket. ”

“ You are always worse before storms. After sitting a little while you stiffen up, feeling much better after moving about. The tendons of your legs have a drawing sensation, and feel as if too short. There is more or less of numbness and paralysis, and a wooden sort of feeling of the leg when walking. You also have lightning-like shocks of pain through the limb, now and then. Your attacks come on every few weeks, and it is the left limb that is affected. You can be cured."
The doctor rattled these symptoms off with great volubility. The Count looked at him with open-eyed wonder. ”

“ Most of the cases which we have seen prove the impossibility of either standing or walking (6) . But, admitting that they were ruptures, are we authorized to pursue the mode of treatment there adopted? Certainly we are not. None of the indications formerly mentioned (16) is there fulfilled. What is there, under such circumstances, to prevent an involuntary motion from destroying the contact of the divided ends, by forcibly flexing the foot and extending the leg? The limb is not subject to any compression. Should such an accident happen, the cure must necessarily be tedious. ”

“ Back Failures.—Often a severe pain in the toe, foot, ankle, or lower leg has its cause, not in anything wrong with the part which is painful, but in some failure of nerve in the patient's back. Blistering or other treatment of the painful part will often injure, and cannot do much, in any case, to cure. Pains even in the knee and groin sometimes have the same cause—in back failure. In other cases the symptoms are, weariness, stiffness, inability to stoop, or stand long without support, and pains in the stomach and thighs. ”

“ Beach speaks of an individual who suffered fracture of both thighs, and compound comminuted fracture of the tibia, fibula, and tarsal bones into the ankle-joint, necessitating amputation of the leg. The patient not only survived the operation, but recovered with good union in both thighs. As illustrative of the numerous fractures a person may sustain at one time, the London Medical Gazette mentions an injury to a girl of fourteen, which resulted in 31 fractures. ”

“ I sometimes wonder if the donor of this piece of nerve still "feels it" in his own leg, for, months after a man has lost his leg, he still feels it there. There was one man in the hospital who had lost both legs and screamed with pain every night because his toes were twisted, and it was only when they had dug up his feet and straightened out his toes that he got rest. ”

“ A man was brought to the Hotel-Dieu, with a luxation of the foot, complicated with a fracture of the lower part of the leg, and a laceration of the ligaments and capsule, through which the astragulus had escaped by a luxation forward and upward, so as to have half of its anterior surface exposed. ”

“ It is sometimes conjectured that they have spiritual fingers, but it is not so. There are instances of persons experiencing pain seemingly in the toes, after the leg has been amputated. This is in consequence of the exposure and irritation of the nerves which go to the foot. ”

“ Apparatus.—When a person receives a severe contusion of the leg or foot, or breaks his leg, or has painful ulcers over the leg, or is unable from some cause to bear the pressure of the bed-clothes, it is advisable to know how to keep them from hurting the leg. ”

“ Mental pain is worse than physical, so it was really a relief to reach the ground, even though one foot did go over, and a pain like a red-hot poker shot up the leg. I thought I had broken the foot to pieces, but it was only the ankle that was sprained, and I could limp along, in a fashion, though so slowly that it took ages to get round to the front of the house. ”

“ For instance, in the case of a fractured leg below the knee, if a couple of flat boards three inches wide be tied about the leg with two pocket handkerchiefs, the ends of the fractured bone will not rub against each other and the pain will be355 much less in carrying. ”

“ Pain in the legs as from weariness. Contusive pain at left leg. Tingling and twisting pain in the right leg. Itching and smarting at the tibia, in front, at night. 355. Beating above the right knee. Slight itching at the knee, changing to an acute pain when rubbed. Contusive pain at right knee. Spraining sensation in left knee, with cracking when walking. Pain at the left knee as if sprained. 360. Pain as from a sprain in left knee, with dartings below the pan. Violent pain in the feet. Beating pain near the right inner ankle. The left foot burns, the right foot is cold. ”

“ Finally, pass a wide band of cloth about the body, from armpit to hips, inclosing the upper part of the well-padded splint, and fasten it snugly. The hollow between splint and waist must be filled with padding before this wide cloth is applied.
In fracture of the thigh bone (between the hip and knee) , there is often great swelling about the break. The limb is helpless and useless. ”

“ When, therefore, they walk about before they are whole, the joints which have been luxated are cured incompletely; and, on that account, while walking about, they have pains in the leg from time to time. ”

“ Etiological Factors.—Even a slight sore on one foot will give rise to considerable achy fatigue of the knee of the opposite leg, because, consciously or unconsciously, we stand much more on that leg, use it more in walking, and spare the other because of the pain induced by use of the foot. Above all, throwing more weight on the other leg causes us to use muscles a little abnormally with consequent soreness. ”

“ Black himself, chiefly with the 3x and θ.
This proving is quite long. From it we note the following symptoms: Severe pain in right shoulder joint. Muscular twitching in right leg. Dull pain under left false ribs. Neuralgic pain in sciatic nerve. Back, lumbar region, stiff and weak. Pain in right knee joint, painful to move and tender to the touch. Weight and oppression of the heart, with gripping feeling as if a hand were squeezing it; the load seemed to lift, with great relief, but came back again. A curious sensation of tickling about the heart. Twinges of pain in the great toes. ”

“ When examined, the right leg and thigh were cold as ice, but no fracture or dislocation could be discovered. He was confined several weeks to his bed; and then could only hobble about on crutches with great pain. At length he was able to dispense with the crutches, but every motion of the limb caused great agony. He tried the waters and baths of Wisbaden; but experienced no benefit. Thirteen months after the accident, and when the excruciating pains had rather gained than lost force, he came to Wildbad. ”

“ The gluteal, posterior femoral, gastrocnemial, and outer pedal surfaces are affected together with the muscles moving the foot, while the thigh and inner side of the leg and foot become anæsthetic, with lesion of the upper part of the lumbar enlargement accompanying paralysis of the quadriceps and deep muscles. ”

“ Since proper action in the lower part of the leg is thus prevented excessive work is thrown on the muscles of the thigh, &c., and exercise becomes painful and exhausting. Moreover, ill-formed shoes and boots are the cause of many painful affections of the feet, such as corns on the joints or between the toes, of the hard or soft variety, bunions or inflammations of the joints, ingrowing toe-nails, the extraction of which is one of the most painful operations known to surgery ”

“ There are certain physicians who, in all fractures of the leg, whether bandages be applied or not, fasten the sole of the foot to the couch, or to some other piece of wood which they have fixed in the ground near the couch. ”

“ Where the leg, for instance, has been lost, they feel as if the foot was present, but as though the leg were shortened. If the thigh has been taken off, there seems to them to be a foot at the knee; if the arm, a hand seems to be at the elbow, or attached to the stump itself.
As I have said, I was next sent to [Pg 7] the United States Army Hospital for Injuries and Diseases of the Nervous System. Before leaving Nashville, I had begun to suffer the most acute pain in my left hand, especially the little finger ”

“ If general treatment is necessary, then packing-sheets. Tepid bath and tepid sitting baths must be resorted to.
Sprained Ankle.—Put the foot immediately into cold water, and rub foot, ankle, and leg up to the knee for an hour, particularly the wounded part. The water of the bath, after the first time, only up to the instep, but repeated three or four times a day. Bandage the foot, ankle, and leg up to the knee; first, with quite wet bandages, and when inflammation has somewhat subsided, then with heating bandage. The foot should not be allowed to remain quiet. ”

“ His back ain't hurt serious, but his left leg and his right arm are both broken and he's an awful lot cut and bruised, especially about the back and the head. I can set a leg myself, as good as most, and many a one have I done, but those that I've set 'em for don't always seem to have as good use of their limbs after as before. ”

“ In injuries resulting from indirect violence, however, pain localised to a spot at some distance from the point of impact is strongly suggestive of fracture—as, for example, when a patient complains of pain over the clavicle after a fall on the hand, or over the upper end of the fibula after a twist of the ankle. Pain elicited by attempts to move the damaged part, or by applying pressure over the seat of injury, is more significant of fracture. ”