Full resolution (JPEG) - On this page / på denna sida - Cases Illustrating the Treatment - XXIV. Double Fracture of the Fibula at its Lower Third
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156 GASES ILLUSTRATING THE TREATMENT.
There has been no pain. The sleep had been undisturbed.
The patient can extend and bend the foot to a considerable
degree without much difficulty. Eversion and inversion slight.
When the same active movements are made under resistance
they go better.
Jan. SOth. The effusion is gone, but it still remains over the
fractures and inner side of ankle, although in a much smaller
amount. All the movements can be performed easier and with
more force.
Feb. 6th. Scarcely any effusion over the fracture. On the
inner side of the ankle it comes and goes, owing to the gouty
condition. The patient has during the week walked about the
room unassisted, simply steadying herself by the furniture. E"©
movement perceptible at the seat of the fractures. Active move-
ments performed with considerable force. Both they and the
passive are nearly normal in range.
Feb. 20 til. The patient can walk quickly up and down stairs.
The movements at ankle-joint normal in range and power. No
abnormal thickening at the’ seats of the fractures.
Treatment.—Ko splints were applied. The deviation of the
foot was corrected simply by muscular action. When the patient
was sitting or lying, the foot was steadied at a right angle to the
leg.
P(5trissage and effleurage were given from the very first, and
also vibrations over the situation of the fractures. The former
were administered for the effusion ; the latter more especially
for the pain. During the first days other passive movements,
such as rolling, bending, stretching, eversion and inversion of
the foot, were given in order to prevent exudation from organ-
ising and causing stiffness. Active movements as in previous
case.
The patient was not kept in bed a single day. She was
helped downstairs every morning, and had then to use the foot
as little as she could at first, but it was always held at a right
angle to the leg. From the third day, the patient was allowed
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