A BROKEN COLLAR BONE (Scudder).
Usual attitude of patient with a fracture of this kind; note lowering and narrowed appearance of left shoulder.
Fracture of the collar bone is one of the commonest accidents. The bone is usually broken in the middle third. A swelling often appears at this point, and there is pain there, especially on lifting the arm up and away from the body. It will be noticed that the shoulder, on the side of the injury, seems narrower and also lower than its fellow. The head is often bent toward the injured side, and the arm of the same side is grasped below the elbow by the other hand of the patient and supported as in a sling. (See [Fig. 9].) In examining an apparently broken bone the utmost gentleness may be used or serious damage may result.
Treatment.—The best treatment consists in rest in bed on a hard mattress; the patient lying flat on the back with a small pillow between the shoulders and the forearm of the injured side across the chest. This is a wearisome process, as it takes from two to three weeks to secure repair of the break. On the other hand, if the forearm is carried in a sling, so as to raise and support the shoulder, while the patient walks about, a serviceable result is usually obtained; the only drawback being that an unsightly swelling remains at the seat of the break. To make a sling, a piece of strong cotton cloth a yard square should be cut diagonally from corner to corner, making two right-angled triangles. Each of these will make a properly shaped piece for a sling. (See Figs. [10] and [11].)
Fracture of the collar bone happens very often in little children, and is commonly only a partial break or splitting of the bone, not extending wholly through the shaft so as to divide it into two fragments, but causing little more than bending of the bone (the "green-stick fracture").
| Fig. 10. |
Fig. 11. The above illustration shows sling in position. It is made of cotton cloth a yard square cut diagonally from corner to corner. |
HOW TO MAKE A SLING (Scudder).
In Fig. 10 note three-cornered bandage; No. 2 end is carried over right shoulder, No. 1 over left, then both fastened behind neck; No. 3 brought over and pinned.
A fall from a chair or bed is sufficient to cause the accident. A child generally cries out on movement of the arm of the injured side, or on being lifted by placing the hands under the armpits of the patient. A tender swelling is seen at the point of the injury of the collar bone. A broad cotton band, with straps over the shoulders to keep it up, should encircle the body and upper arm of the injured side, and the hand of the same side should be supported by a narrow sling fastened above behind the neck.
LOWER-JAW FRACTURE.