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Commentary: A few comments have been posted about On Fractures.
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Table of Contents
Part 7
If, then, you see that the bones are properly adjusted by the first dressings, and that there is no troublesome pruritus in the part, nor any reason to suspect ulceration, you may allow the arm to remain bandaged in the splints until after the lapse of more than twenty days. The bones of the fore-arm generally get consolidated in thirty days altogether; but there is nothing precise in this matter, for one constitution differs from another, and one period of life from another. When you remove the bandages, you must pour hot water on the arm and bind it up again, but somewhat slacker, and with fewer bandages than formerly: and again on the third day you undo the bandages, and bind it still more loosely, and with still fewer bandages. And if, while the arm is bound up in the splints, you should at any time suspect that the bones do not lie properly, or if anything about the bandages annoys the patient, you should loose them at the middle of the time, or a little earlier, and apply them again. A diet slightly restricted will be sufficient in those cases in which there was no external wound at first, or when the bone does not protrude; but one should live rather sparingly until the tenth day, as being now deprived of exercise; and tender articles of food should be used, such as moderately loosen the bowels; but one should abstain altogether from flesh and wine, and then by degrees resume a more nourishing diet. This diet. may be laid down as a just rule in the treatment of fractures, both as to how they should be treated, and what will be the results of a proper plan of treatment; so that one may know, that if things do not turn out thus, there has been some defect or excess in the treatment. And in this simple plan of treatment it is necessary to attend also to the following directions, which some physicians pay little attention to, although, when improperly executed, they are capable of marring the whole process of bandaging: for if both the bones be broken, or the lower one only, and the patient who has got his arm bandaged keep it slung in a shawl, and that the shawl is particularly loose at the fracture, so that the arm is not properly suspended at this end or that, in this case the bone must necessarily be found distorted upwards; whereas, when both bones are thus broken, if the arm recline in the shawl at the wrist and elbow, but the rest of it be not kept up, the bone in this case will be distorted to the lower side. The greater part of the arm and the wrist of the hand should therefore be equally suspended in a broad soft shawl.