The essentials of bandaging /

by Berkeley Hill

The McIntyre’s Splint may be used either bent or straight, whichever position of the knee most relaxes the tension of the muscles on the fragments. As a general rule the straight position is best if the fracture is high up, and the bent one, when near the ankle joint.

Step 1. A splint of suitable length is selected, by measuring the sound leg. The joint of the splint should be put opposite the patella, and space be left below the foot for the foot-piece to slide along the slot when extension is made.

The splint is next padded, the hollow where the lower part of the calf and small of the leg will come being well filled, that the leg may be thoroughly supported; but the space behind the heel and tendo Achillis must be left quite clear. A small pad is then fastened by a strip of strapping or by needle and thread to the foot-piece.

Step 2. The limb having been first cleaned and dried, the dorsum of the foot and ankle are wrapped in an even layer of cotton wool. A sock or boot made of flannel is next put on the foot. This may be readily extemporised by cutting off the foot of an angola stocking, slitting it up along the back to the toes, and sewing on to the sole, one inch in front of the heel, the middle of a piece of tape ¼ inch wide and 18 inches long. The foot is then wrapped in the sock, the edges drawn together by a needle and thread, care being taken that the sock fits closely round the ankle and dorsum of the foot. A little wool having been wrapped round the knee, the limb is next raised, while the splint is placed under it; the screw is turned until the inclined planes are at an angle suited for the maintenance of the fragments in position, and the foot-piece is pushed up to the foot with its screw-pin loose, that it may be adjusted to the amount of flexion or extension necessary for the foot; this being ascertained, the screw is tightened to keep it so while the foot is fastened to the foot-piece. For this the strings of the sock are brought over the top of the foot-piece, and drawn tight before tying them.

Fig. 41.—McIntyre’s Splint. The thigh fixed ready for extension of the leg.

The position of the heel is very important. It should not sink below the splint, or it will rest on the bandage; neither should it be drawn up too high, or the weight of the leg will hang on the sock, instead of resting on the pad; both frequent causes of pain at the heel. When the proper position is obtained, the strings are made fast to the pin behind the foot-piece, and the foot is steadied by two or three turns of a roller carried round it and the foot-piece (fig. 41).

Step 3. The thigh is next fastened to the thigh-piece by a roller carried from the top of the splint downwards along the thigh to the knee, or below that joint if the fracture is near the ankle.

In doing this the roller is passed inside the screw, should that be placed underneath the splint, as in fig. 43 page [65], and not at the side as in fig. 41, for the screw will be wanted free for further adjustment.