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Tuesday, September 24, 2013

Splints

From: comestepbackintime.wordpress.com


Apart from amputation skills, the Civil War Surgeon developed relatively sophisticated techniques in the use of plaster splints. I came across an article, ‘Plaster Splints in the American Civil War’ published 1943 in the December issue of The British Medical Journal by an author just referred to as ‘S.W.’ S.W. had discovered a series of essays, titled ‘A-T’, that had been published between 1862-4 by The United States Sanitary Commissioner and intended for distribution amongst Army Surgeons. The essays covered a wide ranges of topics on battlefield medicine, including techniques for creating plaster splints which can be found in Volume ‘T’. The Army Surgeons were recommended to use the Maisonneuve technique and A.W.’s article details this procedure:

‘Shave or oil the skin. Make a paper pattern of the area to be covered and cut to it two thicknesses of Canton flannel or old muslin, devising windows if wounds are present; the sides of the flannel should remain about one inch apart when in position. Sprinkle plaster into equal quantity of water to a creamy consistence. Immerse cloth till thoroughly saturated, lay it on a flat surface and smooth with hand. Apply flannel to limb and put snugly over it a roller bandage. The limb is then held for a few minutes, extension being made if necessary until the plaster sets, when the roller bandage is removed. If it is necessary to delay the “setting” of the plaster this maybe achieved by adding a small quantity of carpenters’ glue.’

S.W. goes on to discuss the importance role that the use of plaster splints played in improving survival rates of Civil War soldiers:

‘..a patient with a much swollen elbow-joint wounded at the Battle of Cross-Keys. The joint had been entered by a round bullet, which was removed two weeks later, when free incisions around the joint were found to be necessary. At this stage a plaster splint was applied to the anterior surface of the arm and retained by a transverse band above the wrist and another at the middle of the humerus, the arm being flexed. This split was worn for a month and then renewed. The head of the radius came away and the patient recovered with some degree of motion in the joint. Dr Swan employed the plaster splints in several cases of fracture after the seven days’ fighting before Richmond, during M’Clellan’s campaign, and the patients were comfortable transported to Washington.’

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