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Image from page 764 of “A manual of operative surgery” (1910)

Image from page 764 of “A manual of operative surgery” (1910)
Hand Wrist Pain
Identifier: manualofoperativ0002trev
Title: A manual of operative surgery
Year: 1910 (1910s)
Authors: Treves, Frederick, Sir, 1853-1923 Hutchinson, Jonathan, 1859-1933
Subjects: Surgical Procedures, Operative Surgery
Publisher: Philadelphia : Lea & Febiger
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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Text Appearing Before Image:
the metacarpal of the thumb should not be opened. To this last conservative measure we attach importance. If the extensors of the carpus must be divided they should be sutured down with kangaroo tendon as nearly as is possible to their former points of attachment. After-Treatment.—The wound must be well drained, and be dressed with the most careful aseptic precautions. The limb must be maintained hip on a splint which will support the palm of the hand, will keep the wrist a little extended and the fingers a little flexed, while at the same time it will not prevent movements of the fingers from being carried out (Fig. 460). A straight anteriorsplint, well padded,answers the purpose aswell as the more compli-cated ones. There is a constanttendency for the handto assume the position of adduction, and this is apt to become more marked some time after the splint has been removed. The limb will need to be maintained upon a splint for a consider-able period, varying from two to six months.

Text Appearing After Image:
FIG. 461.—LEATHER SPLINT FOR THE WRIST. 736 OPERATIONS ON BONES AND JOINTS [part vii I (J. H.) have obtained excellent results in several cases by theuse of a single dorsal incision, the hand and forearm being fixed afterthe operation in a light plaster-of-Paris case, which leaves the fingersfree, the plaster bandage being applied over a gauze and wool dressing.At the end of six weeks the plaster and stitches are removed, a secondcase being applied. It is essential during the whole of this time that passive move-ments of the fingersbe kept up. The fin-gers should be moved asearly as the third day.The wrist should be keptat rest until the partshave become consolida-ted, when passive move-ments may be com-menced. Active move-ments of the fingersshould be undertaken assoon as the patient canmove without pain. For some time afterthe splint is left off, thepatient should wear aleather support, andshould be persistent inhis attempts to exercisethe wrist and fingers andto increase the rang

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