TREATING A BROKEN HIP (Scudder).
Note the manner of straightening leg and getting broken bone into line; also assistant carefully steadying the thigh.
A fracture of the hip is really a break of that portion of the thigh bone which enters into the socket of the pelvic bone and forms the hip joint. It occurs most commonly in aged people as a result of so slight an accident as tripping on a rug, or in falling on the floor from the standing position, making a misstep, or while attempting to avoid a fall. When the accident has occurred the patient is unable to rise or walk, and suffers pain in the hip joint. When he has been helped to bed it will be seen that the foot of the injured side is turned out, and the leg is perhaps apparently shorter than its fellow. There is pain on movement of the limb, and the patient cannot raise his heel, on the injured side, from the bed. Shortening is an important sign.
With the patient lying flat on the back and both legs together in a straight line with the body, measurements from each hip-bone are made with a tape to the bony prominence on the inside of each ankle, in turn. One end of the tape is held at the navel and the other is swung from one ankle to the other, comparing the length of the two limbs. Shortening of less than half an inch is of no importance as a sign of fracture. The fragments of broken bone are often jammed together (impacted) so that it is impossible to get any sound of grating between them, and it is very unwise to manipulate the leg or hip joint, except in the gentlest manner, in an attempt to get this grating. If the ends of the fragments become disengaged from each other it often happens that union of the break never occurs.
Fig. 25.
TREATMENT FOR FRACTURED HIP (Scudder).
Note method of holding splints in place with muslin strips; one above ankle, one below and one above knee, one in middle and one around upper part of thigh.
The treatment simply consists in keeping the patient quiet on a hard mattress, with a small pillow under the knee of the injured side and the limb steadied on either side by pillows or cushions until a surgeon can be obtained. (See Thigh-bone Fracture.)