SECT. CI.—ON THE HAND AND ITS FINGERS.
The bones of the carpus, metacarpus, and of the phalanges of the fingers, being of a spongy and porous nature, are often crushed but rarely fractured. The patient then being placed on a high seat, we are to direct him to lay his hand prone upon an even table, and the fractured pieces being stretched by an assistant, we arrange them with two fingers, that is to say, the thumb and the index-finger. A tight bandage is to be used at the time that inflammation prevails, for, owing to the porous nature of the bones, a redundance of callus is formed. If the phalanx or finger be simply broken, and it be the large one, called also the thumb, after suitable bandaging, it is to be bound to the palm that it may be kept at rest; but if any of the others, as for example, the index or little finger, it is to be bound along with the one next to it, or if one of the middle, it may be bound along with that on either side, or all may be bound altogether. For they are thus kept best at rest, as if the fractured bones had been supported with splints.
Commentary. Hippocrates recommends the general treatment applicable in all cases of fracture, with the exception of the splint, which, as Galen explains, is not admissible in these cases.
Celsus says, it will be sufficient when a finger is broken to bind it to one piece of splint (surculum) after the inflammation has subsided.
Albucasis recommends one small splint to be applied upon the thumb when it is fractured. If one of the fingers be broken, it is to be bound up with the others, or one small piece of splint may be used. Avicenna, Rhases, and Haly Abbas treat distinctly of these accidents, but supply no additional information.