Full resolution (JPEG) - On this page / på denna sida - Cases Illustrating the Treatment - XXIII. Double Fracture of Fibula at its Lower Third, with Fracture of the Internal Malleolus
<< prev. page << föreg. sida << >> nästa sida >> next page >>
Below is the raw OCR text
from the above scanned image.
Do you see an error? Proofread the page now!
Här nedan syns maskintolkade texten från faksimilbilden ovan.
Ser du något fel? Korrekturläs sidan nu!
This page has never been proofread. / Denna sida har aldrig korrekturlästs.
152 CASUS ILLUSTRATING TEE TREATMENT.
ending 4 cm. high anteriorly and 3 cm. posteriorly. It was
thus easily to be seen that the injury had been cau.sed by a
crush. The bullre were not completely healed. The foot was stiff.
Treatment and Progress.—It consisted as usual of p(itrissage
and effleurage; intermingled with and following on the former being
other passive movements, such as rolling, extension, and flexion,
etc. ; then active movements, partly free, partly under resistance ;
and lastly, frictions over the internal and external popliteal nerves.
Feb. 19^A. The swelling has gone down on the leg, but remains
round the ankle and upper part of the dorsum of the foot, although
considerably diminished. The movements at the ankle go pretty
well, and do not cause nearly so much pain as at first. The frac-
tured pieces adhere well to each other. The bullae have healed.
They had delayed the treatment on the inner side of the ankle.
Feb. 26th. The swelling round the ankle much diminished, and
on the dorsum of the foot it is gone. The passive and active move-
ments are scarcely felt at the fractures. The patient can move
his feet freely. I decided to let him try to walk, which he did,
steadied on both sides. He kept the foot stiff, both because he
was somewhat nervous and because he felt pain in the joint when
he rested his weight upon it. It was, he said, a sort of burning
sensation. As I supposed that the pain was caused by exudation
in the joint itself, I gave rolling of the foot, and passive extension
and flexion, rather longer than usual. At the fractures he felt
no movement on walking. The muscles of the calf are smaller
on the injured leg, and do not act so well.
3farch 6th. Walked up and down the room for over five
minutes. The foot turned very red, but there was no pain in the
joint. He walks pretty quickly and steadily without assistance.
He feels the foot somewhat stiff, from a dragging behind at the
heel and internal malleolus. From to-day, the foot and leg lie
free.
March 12th. He has walked more and more every day, and each
time with greater ease. In order to diminish the stiffness and to
stimulate the muscles of the calf, he had to make the movement
<< prev. page << föreg. sida << >> nästa sida >> next page >>
