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Treatment of Compound Fractures.
Treatment of Compound Fractures. - A compound
fracture - that is, one complicated with a wound of the flesh -
often presents certain difficulties in treatment, for the dressing must
always be so made as to permit free access to the wound, as well as
to allow the escape of matter which may be formed. In many
cases the wound is of such a nature that no attempt can be made
to prevent deformity in the healing of the limb, the object of treatment in such cases being simply to save the leg. In many instances
the treatment of a compound fracture of the leg consists for a week
or ten days merely in immersing the leg in warm water ; no rigid
dressing can be applied. It must be borne in mind that compound
fractures of the leg frequently give rise to the fatal disease known
as blood-poisoning (pyæ?nia), and that this condition is favored by
the application of stiff dressings, which retard the free escape of
matter. In every case the attempt to avoid deformity must be
subordinate to the effort to save the limb as well as the life of the
patient.
In cases in which the injury is not very extensive, we may
often apply, from the very first, a rigid dressing, which shall maintain the limb in fair position. The dressing which is most generally
useful for such fractures is the plaster of Paris splint ; it should be
applied according to the directions already given, but should be
modified by having an opening cut in it which shall expose the wound
itself and the flesh around it for a distance of at least one inch.
This opening or window may be cut within an hour after the bandage has been applied - that is, before the plaster has become
thoroughly hard. The wound should be treated according to
the principles already laid down for the treatment of such injuries ;
extreme care must be taken to prevent the accumulation of matter
in the wound, which can be done by thoroughly syringing with the
solution of Lambert?s listerine previously mentioned (one part of
listerine to five of water).
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