The essentials of bandaging /

by Berkeley Hill

Fracture of the Fibula.—Dupuytren’s Splint.—When the fibula only is broken, it may be treated in several ways; this, however, is the common plan:—

Apparatus.—1. Straight wooden splint.

2. Pad and wool.

3. A roller.

Step 1. The splint should be about 3 inches broad, and long enough to reach from the head of the tibia to 4 inches beyond the sole of the foot. A notch 1½ or 2 inches deep is generally cut at the lower end of the splint to catch the bandage in. The splint is then padded, care being taken that the padding is sufficiently thick to prevent galling at the upper end against the inner condyle of the tibia, and that it becomes thicker as it descends along the leg, for that to rest easily against the splint; lastly, the pad should end in a thick boss or projection opposite the internal malleolus, beyond which it should not reach, lest it interfere with the rotation and adduction of the foot inwards.

Step 2. The splint, when thus prepared, is applied along the inner side of the leg, taking care in doing this that the internal malleolus is against the middle of the splint, and not allowed by the assistant to slip towards the anterior or posterior border.

Step 3. A roller is then carried round the limb and splint, beginning below the knee and continuing in simple spirals for three or four turns, when it is fastened and cut off.

Step 4. A light layer of wool is wrapped round the outside of the ankle, heel, and dorsum of the foot. Then a roller, beginning at the splint, passes outwards in front of the ankle over the external malleolus, behind the heel and the splint; then over the dorsum to the outer margin of the foot, next under the sole through the notch of the splint to the front of the ankle joint again, where it repeats the same course three or four times. Each turn must be tightly applied and made to draw the foot well inwards to the splint, and in doing so to tilt outwards the broken part of the fibula (see fig. 40).

This splint is cumbersome, hence after two or three weeks, should be replaced by a light starch or gum casing for the foot and leg, leaving the knee free.