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.
SECT. CII.—ON THE THIGH.
The case of a broken thigh is analogous to that of the arm, but in particular, a fractured thigh is mostly deranged forwards and outwards, for the bone is naturally flattened on those sides. It is to be set by the hands, with ligatures, and even cords applied, the one above and the other below the fracture. When the fracture takes place at one end, if at the head of the thigh, the middle part of a thong wrapped round with wool, so that it may not cut the parts there, is to be applied to the perinæum, and the ends of it brought up to the head and given to an assistant to hold, and applying a ligature below the fracture, we give the ends of it to another assistant to make extension. If it is fractured near the knee, we apply the ligature immediately above the fracture, and give the ends to an assistant, with which to make extension upwards; and while we put a ligature round the knee to secure it, and while the patient lies thus, with his leg extended, we arrange the fracture. Pieces of bone which irritate the parts, as has been often said, are to be taken out from above; and the rest of the treatment we have already described in the section on the arm. The thigh gets consolidated within fifty days. The manner of arranging it afterwards will be described after delivering the treatment of the whole leg.
Commentary. Hippocrates has correctly stated the difficulty attending the management of a fractured thigh-bone, and the disgrace which an ill-managed case entails upon the surgeon. He directs him to make extension and counter-extension, and to apply the bandages and splints in the manner formerly described. He recommends a few turns of the bandage to be brought about the loins, in order to prevent the skin at the top of the thigh from being injured by the splints. He points out the extreme importance of attending to the position of the heel, as if improperly laid, it is capable of deranging the fracture entirely. It gets consolidated, he says, in about fifty days. (De Fracturis.)
Celsus pronounces it impossible to heal a fractured thigh-bone without deformity. The patient, he says, must ever afterwards tread upon his toes; and yet, he adds, the case will be worse if neglected.
Albucasis holds forth greater encouragement. He describes the process of treatment very minutely, directing the surgeon to stuff up all the hollow places in the limb with soft pads before applying the splints. He also recommends him to surround the whole limb with a bandage from the heel to the nates. We are inclined to think, although the language of his barbarous translator is not sufficiently precise, that his splints extended the whole length of the limb.
Rhases, and we believe, he alone of all the ancient authorities, directs the thigh to be laid in a somewhat bent position, and for this purpose he recommends something suitable to be put below it.
Haly Abbas and Avicenna, as usual, borrow everything from our author.