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Fractures of the Tibia.Treatment. - For the first few days it is usually necessary to apply hot fomentations, such as cloths saturated with hot water. These may be continued until the swelling has subsided. Meanwhile the limb may be placed in a fracture-box. ^This box consists of four pieces; one piece, which should be about an inch broader than the thickest part of the calf, lies under the leg. To the lower extremity of this there is fastened an upright piece long enough to project above the toes of the injured foot; on either side of the first piece there is fastened by means of hinges a side piece which extends above the top of the leg. This box may be thoroughly cushioned with cotton batting, or filled with bran, while the side pieces which are fastened with hinges are laid fiat upon the bed. The limb is then placed upon the cotton or upon the bran, and bound to the upright foot piece by means of a bandage. The box and the foot attached to it are then drawn toward the foot of the bed with sufficient force to straighten the limb and to reduce any deformity which may be present. The side pieces are then raised so as to enclose the limb, the bran or cotton being thickly packed above the bony prominences of the ankle so as to prevent the leg from shortening. Two or three bandages are then tied around the entire box so as to exert pressure upon the cotton padding surrounding the limb. The box containing the injured limb is then placed upon a pillow in a position most comfortable to the patient. If the fracture be oblique and there bd consequently a decided tendency to shortening of the broken leg, it will be advisable to attach a weight to the box so as to keep the limb constantly extended. This weight should be fastened to the foot piece by means of a rope running over a pulley. In this case the foot should be fastened to the upright piece at the foot of the box by means of strips of adhesive plaster. In every case in which a fracture-box is employed, extreme care must be taken to see that the broken ends are kept accurately in position. The movements of the patient's body frequently result in displacement of the broken ends, so that unless the limb is carefully watched, the bone may heal with some deformity. In fact the fracture-box is not the most satisfactory dressing for inexperienced hands to use. It will be better for such to employ a starch or plaster of Paris bandage in the way which has been already described, for if this bandage is once properly applied, it remains in position and prevents subsequent displacements of the fragments such as usually occur under the use of a fracture-box. If there be merely a transverse fracture of the tibia without displacement of the broken ends or shortening of the leg, the dressing which has already been described in connection with simple fractures of the fibula will be sufficient. A blanket folded from either end so as to make two rolls between which the limb rests is placed under the leg ; two bandages are then tied around the blanket near either end so as to hold the limb firmly between the rolls. But first, if you want to come back to this web site again, just add it to your bookmarks or favorites now! Then you'll find it easy! Also, please consider sharing our helpful website with your online friends.
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