PLATE XV.

FIG. 1.-JAMES HUTCHINSON'S SPLINT FOR EXTENSION, ETC., IN FRACTURES OF THE LEG.

Composed of two wooden splints, long enough to extend from the knee to six or eight inches below the foot, furnished with a foot-piece for extension, and four holes above for counter-extension.-Elements of Surgery, by John Syng Dorsey, vol. i. p. 181. Philadelphia, 1813. (See my remarks on this splint in body of the Report.)

JOHN NEILL'S APPARATUS FOR FRACTURES OF THE LEG, REQUIRING EXTENSION AND COUNTER-EXTENSION.

FIG. 2.-APPARATUS FOR SIMPLE FRACTURES.

"For simple fractures of both bones of the leg, attended with shorten: ing and deformity not easily overcome, the limb should be placed in a long fracture-box, with sides extending as high as the middle of the thigh, and a pillow should be used for compresses.

"The counter-extension is made by strips of adhesive plaster, one and a half inches in breadth, secured on each side of the leg below the knee, and above the seat of fracture, by narrower strips of plaster applied circularly. The end of the counter-extending strips may then be secured to holes in the upper end of the sides of the fracture-box, by which the line of the counter-extension is rendered nearly parallel with the limb.

"The extension is also to be made by adhesive strips, in a mode which is now well known and understood. The ends of the extending bands may be fastened to the foot-board of the box."-Philadelphia Med. Exam., vol. xi. p. 580, 1855.

FIG. 3.-APPARATUS FOR COMPOUND FRACTURES.

"In compound fractures of the leg, shortening and deformity are often difficult to overcome, as is well known to experienced surgeons. In such cases we may wish to dress the wounded soft parts, and, at the same time, maintain a certain amount of extension and counter-extension.

"This can be readily accomplished by having the sides of the fracturebox sawed in two parts at the knee, so that the sides of the box above the knee, from the upper ends of which the counter-extension is made, need not be disturbed during the dressing, while that portion of the side of the box, corresponding to the leg, may be opened at pleasure, without diminishing the tension of the extending or counter-extending bands."-Phil. Med. Exam., vol. xi. p. 581. (See also, p. 582 of same volume for an ingenious mode of making extension and counter-extension at the same moment, in fractures of the thigh, invented by Dr. Neill.)

PLATE XVI.

R. O. CRANDALL'S APPARATUS FOR EXTENSION AND COUNTER-EXTENSION IN FRACTURES OF THE LEG.

Fig. 1. Section of the apparatus, applied to the limb; showing adhesive plaster counter-extending band, gaiter for extension, &c. Adhesive plasters are also used for extension.

Fig. 2. Posterior view of the lower portion of the apparatus..

Fig. 3. Apparatus complete. The counter-extending straps are passed over a block of wood supported above the knee, to prevent their pressure upon the sides of the knee.-Philada. Med. Journ., vol. iv. p. 193, Jan. 1856; also Transactions of the Med. Assoc. of Southern Central N. York, 1855, pp. 81-2.

Fig. 1.

Fig. 2.

Fig. 3.

PLATE XVII.

FIG. 1.-B. WELCH'S SPLINTS FOR FRACTURES NEAR THE ANKLE-JOINT.

FIG. 2.-B. WELCH'S JOINTED APPARATUS WITH FLEXIBLE SIDE SPLINTS FOR FRACTURES OF THE LEG.

"This may be flexed or extended, and fixed in the position required by the hinges. This is done by means of pinion-like teeth at the circumference of the hinges, which are held in contact by screws, forming the pivots of the joints. It is fitted to limbs differing in length by sliding joints at the sides of the limb, and in the splint which supports the under side of the limb. The depth is increased or diminished by turning a screw at the bottom of the foot-piece. Flexible side splints are confined by a bandage to the sides of the limb; another may be placed on the top of the thigh to support the thigh straps."

FIG. 3.-LOUIS BAUER'S WIRE SPLINTS FOR THE LEG.-Buffalo Medical Journal, April, 1857, vol. xii.