File:Wounds in war - the mechanism of their production and their treatment (1910) (14577945880).jpg

Identifier: woundsinwarmecha00stev (find matches)
Title: Wounds in war : the mechanism of their production and their treatment
Year: 1910 (1910s)
Authors: Stevenson, William Flack, 1844-1922
Subjects: Wounds, Gunshot Gunshot wounds Military Medicine Medicine, Military
Publisher: New York : W. Wood
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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ction inbone, &c., it may be- left with less fear of dangerous con-sequences than may be looked for from the lodgment ofother foreign bodies—bits of clothing, for example. Fig. 70shows a lodged bullet which was extracted at Netley as itgreatly interfered with the movement of the joint. Wounds of the knee joint, when the apertures are small,are usually accompanied by considerable distention of thelarge synovial sac lining it. If this condition exist for anyconsiderable time and is causing pain, although there maybe no question of the removal of splinters, it may be desir-able to make a small incision on one side, and wash out thejoint with a weak antiseptic solution, using a drain for thefirst twenty-four hours, or some of the fluid may be re- 254 WOUNDS IN WAR moved by aspiration. The bandages securing the dress-ings should exert a firm and equable pressure over thejoint, and, in order to obtain this effect most thoroughly,the deeper dressings should be covered with rather large
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Fig. 70.—Detormed Mauser in head of tibia and projecting into knee-joint. quantities of sterile cotton-wool, the elastic pressure ofwhich is most useful in these cases. Immobilisation in cases of gunshots of the knee is lessdifficult to secure than it is in wounds of the hip joint.The movements of the body are so likely to react on thehip that the attachment of the limb to whatever apparatusis employed for immobilisation requires to be very firm IMMOBILISATION IN KNEE CASES 255 in order to prevent movement, and even then absoluterest is most difficult to obtain. This is not so in kneeinjuries, because any kind of strong splint, applied to theposterior aspect of the leg and thigh, is sufficient to ensureimmobility of the joint, and all the more efficiently if thelimb be slung, a most necessary practice in these cases.Wire splints, such as that of Roser (fig. 71), are verysuitable; a plaster fixation apparatus, interrupted at theknee, or Watsons splint (figs. 72, 73, and 74), as recom

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