Splint

“ Cause.—A splint being one of the results of periostitis, and the latter one of the effects of external hurts, it naturally follows that the parts which are most exposed to blows and collisions will be those on which the splint will most commonly be found, and it may not be improper, therefore, to refer to hurts from without as among the common causes of the lesion. But other causes may also be productive of the evil, and among these may be mentioned the over-straining of an immature organism by the imposition of excessive labor upon a young animal at a too early period of his life. ”

“ It mostly results from fast driving or riding, or from the animal having been much worked while young, or made to unduly traverse hard or paved roads.1550 The splint is a frequent cause of lameness if it develops just under the knee, since it interferes with and circumscribes the free movement of the joint. It is very essential to have recourse to prompt measures directly this affection shows itself. ”

“ But a sling is still required some ten days after the splints are laid aside.
When the ulna alone is broken, an anterior splint reaching from the inner condyle to the tips of the fingers often suffices without a second one.
When the shaft of the radius is broken high up (a rare accident) the displacement is sometimes very difficult of reduction unless the wrist be well supinated. [Pg 45] To preserve this position it may be necessary to use a wooden angular splint, and to fix the vertical part to the arm behind the elbow, while the horizontal part is carried along the back of the forearm. ”

“ When [125] the patient is a big dog, it is advisable to have two splints, one on either side of the leg. They should extend from the foot to the stifle joint or just above.
The illustration shows a joint in the centre of the splint, but this is not absolutely necessary, though it has its advantages. One is, the joint does not become so stiff, as it allows just slight movement.
A splint with a joint for fractures of the back leg
Over the bandage a few strips of Mead’s plaister should always be used to prevent the bandage shifting. ”

“ Celsus says, it will be sufficient when a finger is broken to bind it to one piece of splint (surculum) after the inflammation has subsided.
Albucasis recommends one small splint to be applied upon the thumb when it is fractured. If one of the fingers be broken, it is to be bound up with the others, or one small piece of splint may be used. Avicenna, Rhases, and Haly Abbas treat distinctly of these accidents, but supply no additional information. ”

“ The splint extension may be immediate or deferred. Where the skin has held good there is no reason why the fingers should not be put in position at once and fixed in place by a splint of plaster of Paris or other material; but if it be evident that the integument at any point has been severely strained, it is desirable to wait for a few days before the parts are put on the stretch, and there is no reason to believe that the delay will be attended by any disadvantage. ”

“ Al-Zahrāwī also devised and depicted many kinds and shapes of splints for use in simple and compound fractures of the head, shoulders, arms, fingers, etc. (see fig. 20) . For example, in discussing the reduction of the humerus, he recommends a splint consisting of a smooth, thin stick bent in the shape of a bow with two strings, each attached to one end of the stick (fig. 21) . The injured bone is then placed in the middle of the bent splint for reduction while the patient is seated on a chair. Tying is applied only when there is no "hot" swelling (chapter 11) . ”

“ When the patient can be put immediately to bed after the injury, and does not have to be transported, it is only necessary to apply the outer, back, and front splints, omitting the inner splint. It is necessary for the proper and permanent setting of a fractured thigh that a surgeon give an anæsthetic and apply the splints while the muscles are completely relaxed. ”

“ For a Broken Thigh, Upper Leg.—The splint should extend from under the arm to the ankle, padded and bound to the body and to the leg by means of long towels or pieces of sheeting applied six inches apart. If the patient is in a wagon and no splint can be had, bags of dirt or sand applied around the thigh will hold some. ”

“ In minor casualties, as cases of sprained tendons, bruises, and the like, a cooling antiseptic wash is: four ounces of witch-hazel, two ounces of spirits of camphor, two ounces of tincture of opium mixed in an equal amount of water.
Splints.—Probably eighty per cent of horses have splints and not over five per cent remain lame from them. A splint is an enlargement or horny excrescence of a part of the shank bone. It is more common in young than old horses. Splints caused by striking in action, on the contrary, are ample cause for judging a horse unsound. ”

“ During the period in which dressing may be necessary I believe this form of splint is as good as can be got for use in Field hospitals, the only point needing care being to ensure that the bandaging is not too tight. It is much more reliable than are ordinary splints if transport is unavoidable, and is much lighter and less irksome to the patient. With such strips of cardboard, a few of the gauze splints (fig. 54) , and a few angular and wooden splints, I believe a Field hospital is fully equipped for the treatment of any fractures of the upper extremity. ”

“ Splints can be made of anything that is stiff and rigid. Something flat like a board is better than a pole or staff; limbs broken off a tree will do if nothing else can be found. Shingles make excellent splints. In applying splints remember that they should extend beyond the next joint above and the next joint below; otherwise, movements of the joint will cause movement at the broken point. With a fracture of the thigh, such as that described, the outer splint should be a very long one, extending below the feet from the arm pit. ”

“ What are the Signs which shew that the Splints remain in the Fracture after it hath been reduc'd?
They are the secret and continual Workings of the Fibres, or twitchings, that are felt by Intervals in the Part, with great Pains, which are the Indications of an Abcess arising therein; and when a Wound is join'd to the Fracture, the Lips of it are puff'd up, and become more soft and pale, the purulent Matter abounding also more than ordinary.
When the Splints appear, must they be drawn out by force? {191}
By no means; for great care ought to be taken to avoid all manner of violent Operations ”

“ The carpenters saw that his foot was swollen, and on drawing closer, saw the splinter in his foot. So making incisions all round the splinter with a sharp knife, they tied a cord to the splinter, removed the splinter with a pull, let out the pus, washed the wound with hot water, and by applying proper remedies, in no very long time made the wound comfortable. ”

“ I said to myself that, if my supposition was true, a splinter introduced into the body of a star-fish larva, devoid of blood-vessels or of a nervous system, should soon be surrounded by mobile cells as is to be observed in a man who runs a splinter into his finger. ”

“ The splints and rollers should be removed on the fourth or fifth day, that the positions of the fragments may be examined and the roller again applied to draw them closer together. After ten or twelve days, passive motion of the wrist and fingers, with pronation and supination of the radius, should be adopted, but great care is to be taken that the patient does not inadvertently bend the elbow joint while free of the splint. The splint must be worn, with the frequent removals directed above, for five weeks, by which time gentle flexion of the elbow may be practised. ”

“ The splints are to be smooth, even, and rounded at the extremities; somewhat less all along than the upper bandaging, and thickest at the part to which fracture inclines. Those parts where there are tuberosities, and which are devoid of flesh, such as the ankles or fingers, we must guard from the splints which are placed over them, either by position, or by their shortness. They are to be secured by the strings in such a manner as not to occasion pressure at first. A soft, consistent, and clean cerate should be rubbed into the folds of the bandage. ”

“ When swellings arise on any part of a limb from pressure, they are to be anointed with cerate or wine and oil, and wrapped in soft wool; and if the splints be hurting the limb they are to be removed for a time. (De Fract. 21.) When the bandages are taken off, he directs that hot water should be poured upon the limb. He recommends a spare diet unless there be a wound of the integuments. (De Fract. and Galen. Comment.) It may be proper to give some more account of the splenia and ferulæ (νάρθηκες) , used by Hippocrates in fractures of the extremities. ”

“ If temporary splints are put on do not make them too tight, and loosen them from time to time as needed. The extremities sometimes swell rapidly after a fracture, and the splints may so stop the circulation that, in a few hours, gangrene may be caused by them. ”

“ Lateral splints for the tibia, 66. Lavallée’s (Morel) splints, 33. Leather felt, Hides’, 89. —— splints, 90. —— —— for hip, 92. Leeches, 159. —— to make them bite, 159. —— to stop the bites, 160. —— in the mouth, 159. —— at the cervix uteri, 159. Leg, bandage for, 21. Ligature of arteries, 211. Linseed poultice, 171. Lister’s dressing, 172. —— tourniquet, 149. Liston’s long splint, 72. Lithotomy, 210. —— position, 140. Lithotrity, 210. Local anæsthesia, 186. Long splint, 72. Lower jaw, fracture of, 30. M. McIntyre’s splint, 63. Makeshift tourniquet, 151. ”

“ The pieces which compose it are, 1st, A common junk-cloth25 (FFF plate II.) , accommodated to the size of the limb and the splints: 2dly, a bandage for the body (BB) and one passing under the thigh (H) to secure the first on the side opposite to the fracture: 3dly, three stiff splints, an inch and a half wide, the external one of which (AA) being very strong, must be long enough to extend from the spine of the ileum, to the distance of four inches below the sole of the foot. This splint is hollowed out or notched at its lower end, and has a mortise in it a little higher up. ”

“ To Extract a Splinter from a child’s hand, fill a wide-mouthed bottle half full of very hot water and place its mouth under the injured spot. If a little pressure is used the steam in a few moments will extract the splinter. ”

“ If the contusion has been so great, as to splinter the bones, such splints as are loose, and seem to prick through the flesh, should by all means be removed. Violence must however be avoided; for by a little patience, nature will of her own accord separate and discharge them. ”

“ On removing the splinters by the aid of an incision, I found that the lung was adherent to the inside of the chest, and was enabled to withdraw from within the lung some splinters of bone and a part of his coat. He left Toulouse apparently doing well; but natives of warm climates rarely suffer from such severe attacks of inflammation as those of northern habits and constitutions. ”

“ The splints and bandaging have served their purpose only too well, because callous is forming already. Unless you wish to have one leg half an inch shorter than the other during the rest of your life, Mr. ”

“ Every distemper of the body now, is complicated with the spleen, and when we were young men we scarce ever heard of the spleen. In our declinations now, every accident is accompanied with heavy clouds of melancholy; and in our youth we never admitted any. It is the spleen of the minde, and we are affected with vapors from thence; yet truly, even this sadnesse that overtakes us, and this yeelding to the sadnesse, is not so vehement a poison (though it be no Physick neither) as those false waies, in which we sought our comforts in our looser daies. ”

“ A horse often becomes lame when throwing out a splent; but that state of the bone which causes the lameness seldom continues long; nor does it ever produce permanent lameness. If any remedy is applied, a blister is always sufficiently strong. A new method of treating splents has been lately introduced; that is, passing a seton under the skin and immediately over the splent. It is said to be an improvement. I once tried it in a case of old bone spavin, but it did no good; nor did firing, which was tried soon after, though the hot iron was passed through the skin, and into the bony excrescence. ”

“ HYPERÆMIA—CONGESTION OF THE SPLEEN. Four hours after full meal in splenic diastole. In well fed, high conditioned. From obstruction of splenic or portal vein or vena cava, heart, liver, or pulmonary disease, inhibition from encephalon acting through splanchnics or vagi, microbes, ptomaines, toxins, paresis, albuminoid diet. Spleen may be seven times its normal weight. Lesions: simple blood engorgement: proliferation of pulp cells: increased friability; rupture; dark color; hyperplasia of trabeculæ—hypertrophy. Symptoms: none; or colic; palpation in ruminants ”

“ SPLEEN, is a spongy viscus, situated in the left side near the lower part of the stomach, under the ribs. This organ is supposed to be designed by Nature to prepare the blood for the secretion of bile in the liver. Its purpose, though inaccurately known, must be important to the animal economy; as indigestion, and a variety of other complaints, have resulted ffom splenetic affedions.—It deserves to be remarked, that the term Spleen is frequently used to denote a disorder, which is more strictly, by physicians, called hypochondriasis. ”

“ The old method of rubbing or bruising a splent, puncturing it, and rubbing in some blistering preparation, will often produce a considerable swelling of the whole limb, and do a great deal of mischief. Lameness from a splent may sometimes be removed by placing a pledget of old linen, wet with goulard or saturnine lotion on it, and confining it with a bandage kept constantly wet. ”