COT A NEW APPARATUS 
FOR 
FRACTURES Oly THE LEG. 
By OSCAR J. COSKERY, 
PROFESSOR OF SURGERY, COLLEGE OF PHYSICIANS AND SURGEONS, BALTIMORE, MD. 
While fully satisfied of the fact that no apparatus other 
than the starch or plaster-of-Paris bandage is required in 
the great majority of fractures of the leg, still there are 
certain injuries in which these applications will not suffice. 
In a simple fracture of both hones pf the leg, with some com- 
minution, I have applied the starch-bandage, and had the pa- 
tient walking on crutches on the fifth day ; still, for badly com- 
minuted fractures near either joint, and more especially for 
compound comminuted fractures and for resections—in a word, 
wherever extension of some degree is required—the starch or 
plaster is useless. It is for the latter variety of fracture above 
spoken of, and preeminently for Pott’s fracture, that the pres- 
ent instrument wras devised. 
As will be seen by the accompanying woodcut, the splint 
consists in another adaptation of the wire, first used by Dr. 
N. K. Smith ; but the principle upon which it acts will not 
permit of its application to the thigh. 
The figure represents the splint as applied before the band- 
age, which encircles all, has been used, and may be called the 2 
■permanent apparatus. As shown, the wires, moderately strong 
(Nos. 7 to 10 are the best sizes), should extend from the upper 
portion ot the middle third of the thigh to nine inches below 
the sole of the foot. From about one inch above the malleoli 
to their upper extremity they should be parallel, three inches 
apart, and bent in an easy position opposite the knee. One 
inch above the malleoli they should commence to bulge, and a 
little above the sole of the foot, which should be the widest 
part of the splint, the separation must be from live to six 
inches. The wires then slope gradually to three inches in 
width, and are then securely fastened by a strong end-piece. 
Along the whole course of the splint the wires are fastened 
together by cross-pieces of wire. 
The application is as follows: the splint, measured upon 
the sound limb, is first bent opposite the knee, and the gaiter 
is applied to the foot of the injured side. The injured member 
is then held in an easy position by an assistant, the patient’s 
thigh being held at an angle of near 60° to the trunk, with 
the knee bent. The foot is then carried through the bulge be- 
tween the wires, and a piece of adhesive plaster, B, from six 
to eight inches wide, is made to encircle both thigh and 
splint. (The other two bands shown in the figure are merely 
suspensory.) The gaiter, A, is then attached to the end-piece 
by means of tapes, as shown in the cut. By making traction 
upon the tapes passed over the end-piece, and fastened when a 
sufficient amount of extension is gotten, the splint is then 
forced upward, and this movement is counteracted by the ad- 3 
hesive plaster on the thigh, the gaiter acting as the extension, 
the plaster as the counter-extension. The toes can he elevated 
or depressed by loosening or tightening the lacing of the 
gaiter at its lower portion. A common roller is then carried 
over all, from one end of the splint to the other. This hand- 
age can be removed at every dressing, but the apparatus, as 
shown in the drawing, remains until the cure is effected, the 
surgeon increasing or relaxing extension as may be required. 
I have never had an opportunity to use this apparatus in 
any of the conditions for which it is proposed except in two 
cases, the short notes of which are as follows : 
Joseph V., a Pole, aged thirty-nine years, was admitted 
into St. Joseph’s Hospital in this city, on May 18, 1872, hav- 
ing an hour before admission received a comminuted fracture 
of the right thigh, together with a simple fracture of both 
bones of both legs. The apparatus above spoken of was ap- 
plied upon the side of the fractured thigh, the latter being sup- 
ported by sand-bags. The leg was taken out of the splint in 
the sixth week, when it was found that the point of frac- 
ture could only be obscurely made out. 
J. S., aged 36 years, German, had a heavy steam-radiator 
fall upon the lower portion of the left leg. There was no 
opening down to the fracture, but tearing of the skin to such 
an extent as to necessitate frequent dressing. The diagnosis 
was comminuted fracture of lower end of leg-bones, probably 
extending into joint. In this case the apparatus was left on 
for seven weeks and the result was good. 
I claim nothing from these two cases, as, of course, they 
are too few to form even the vaguest opinion upon. Still, I 
would beg of my professional brethren a trial of this very in- 
expensive and easily applied apparatus in any such cases as, 
in their judgment, may require the patient to remain in bed, 
and when extension is necessary. I believe, however, that it 
will be most useful in Pott’s fracture, gun-shot fractures, and 
compound fractures near the joints.