On Fractures (16-20)

When the parts are adjusted, you should apply the bandages while the limb is in a stretched position, making the first turns to the right or to the left, as may be most suitable; and the end of the bandage should be placed over the fracture, and the first turns made at that place; and then the bandage should be

But if the other bone (fibula?) of the leg be broken, less powerful extension is required, and yet it must not be neglected, nor be performed slovenly, more especially at the first bandaging. For in all cases of fracture this object should be attained then as quickly as possible. For when the bandage is applied tight while the bones are not properly arranged, the properly arranged, the part becomes more painful. The treatment otherwise is the same.

Of the bones of the leg, the inner one, called the tibia, is the more troublesome to manage, and requires the greater extension; and if the broken bones are not properly arranged, it is impossible to conceal the distortion, for the bone is exposed and wholly uncovered with flesh; and it is much longer before patients can walk on the leg when this bone is broken. But if the outer bone be broken, it causes much less trouble, and the deformity, when the bones are not properly set, is much more easily concealed, the bone being well covered with flesh; and the patients speedily get on foot, for it is the inner bone of the leg which supports the most of the weight of the body. For along with the thigh, as being in a line with weight thrown upon the thigh, the inner bone has more work to sustain; inasmuch as it is the head of the thigh-bone which sustains the upper part of the body, and it is on the inner and not on the outer side of

When the thigh-bone is broken, particular pains should be taken with regard to the extension that it may not be insufficient, for when excessive, no great harm results from it. For, if one should bandage a limb while the extremities of the bone are separated to a distance from one another by the force of the extension, the bandaging will not keep them separate, and so the bones will come together again as soon as the persons stretching it let go their hold; for the fleshy parts (muscles?) being thick and strong, are more powerful than the bandaging, instead of being less so. In the case then which we are now treating of, nothing should be omitted in order that the parts may be properly distended and put in a straight line; for it is a great disgrace and an injury to exhibit a shortened thigh. For the arm, when shortened, might be concealed, and the mistake would not be great; but a shortened thigh-bone would exhibit the man maimed. For when the sound limb is placed beside it, being longer than the other, it exposes the mistake, and therefore it would be to the advantage of a person who would be improperly treated that both his legs should be broken, rather than either of them; for in this case the one would be of the same length as the other. When, then, proper extension has been made, you must adjust the parts with the palms of the hands, and bandage the limb in the manner formerly described, placing the hands of the bandages as was directed, and making the turns upward. And the patient should return the same answers to the same questions as formerly, should be pained and recover in like manner, and should have the bandaging

But this also should be known, that the thigh-bone is curved rather to the outside than to the inside, and rather forward than backward; when not properly treated, then, the distortions are in these directions; and the bone is least covered with flesh at the same parts, so that the distortion cannot be concealed. If, therefore, you suspect anything of this kind, you should have recourse to the mechanical contrivances recommended in distortion of the arm. And a few turns of the bandage should be brought round by the hip and the loins, so that the groin and the articulation near the perineum may be included in the bandage; and moreover, it is expedient that the extremities of the splints should not do mischief by being placed on parts not covered with the bandages. The splints, in fact, should be carefully kept off the naked parts at both ends; and the arrangement of them should be so managed, as that they may not be placed on the natural protuberances of the bone at the knee-joint, nor on the tendon which is situated there.