This information on fractures comes from Mackenzie's Ten Thousand Receipts ©1867 What I like about this is the concise nature of the information given because it is not a medical book but simply a book of useful information and the kind of information my historical characters would be aware of. It's a fairly long excerpt but well worth the research read, imho.
The signs by which fractures may be known having been already pointed out with sufficient minuteness, it will be unnecessary to dwell thereon; it will be well, however, to recollect this general rule: In cases where, from the accompanying circumstances and symptoms, a strong suspicion exists that the bone is fractured, it is proper to act as though it were positively ascertained to be so.
Fracture of the Bone of the Nose.
The bones of the nose from their exposed situation are frequently forced in. Any smooth article that will pass into the nostril should be immediately introduced with one hand, to raise the depressed portions to the proper level, while the other is employed in moulding them into the required shape. If violent inflammation follow, bleed, purge, and live on a low diet.
Fracture of the Lower Jaw.
This accident is easily discovered by looking
into the mouth, and is to be remedied by keeping the lower jaw firmly pressed against the upper one by means of a bandage passed under the chin and over the head. If it is broken near the angle, or that part nearest the ear, place a cushion or roll of linen in the hollow behind it, over which the bandage must pass, so as to make it push that part of the bone forward. The parts are to be confined in this way for twenty days, during which time all the nourishment that is taken should be sucked between the teeth. If, in consequence of the blow, a tooth is loosened, do not meddle with it, for if let alone, it will grow fast again.
Fracture of the Collar-Bone.
This accident is a very common occurrence, and is known at once by passing the finger along it, and by the swelling, etc. To reduce it, seat the patient in a chair, without any shirt, and place a pretty stout compress of linen, made in the shape of a wedge, under his arm, the thick end of which should press against the arm-pit. His arm, bent to a right angle at the elbow, is now to be brought down to his side, and secured in that position by a long bandage, which passes over the arm of the affected side and round the body. The forearm is to be supported across the breast by a sling. It takes from four to five weeks to re-unite.
Fracture of the Arm.
Seat the patient on a chair, or the side of a bed. Let one assistant hold the sound arm, while another grasps the wrist of the broken one and steadily extends it in an opposite direction, bending the forearm a little, to serve as a lever. Yon can now place the bones in their proper situation. Two splints of shingle or stout pasteboard, long enough to reach from below the shoulder to near the elbow, must be then well covered with tow or cotton, and laid along each side of the arm, and kept in that position by a bandage. The forearm is to be supported in a sling. Two small splints may, for better security, be laid between the first ones, that is, one on top and the other underneath the arm, to be secured by the bandage in the same way as the others.
Fracture of the Bone of the Forearm.
These are to be reduced precisely in the same way, excepting the mode of keeping the upper portion of it steady, which is done by grasping the arm above the elbow. Apply two splints, one extending to the palm and one to the back of the hand, and over them a bandage. When the splints and bandage are applied, support it in a sling.
Fracture of the Wrist.
This accident is of rare occurrence. When it does happen the injury is often so great as to require amputation. If you think the hand can be saved, lay it on a splint well covered with tow; this extends beyond the fingers. Plaoc another splint opposite to it, lined with the same soft material, and secure them by a bandage. The hand is to be carried in a sling.
The bones of the hand are sometimes broken. When this is the case fill the palm with soft compresses or tow, and then lay a splint on it long enough to extend from the elbow to beyond the ends of the fingers, to be secured by a bandage, as usual.
When a finger is broken, extend the end of it until it becomes straight, place the fractured portion in its place, and then apply two small pasteboard splints, one below and the other above, to be secured by a narrow bandage or adhesive straps. The top splint should extend from the end of the finger over the back or the hand. It may sometimes be proper to have two additional splint for the sides of the finger.
Fracture of the Rib.
When, after a fall or blow, the patient complains of a pricking in his hide, we may suspect a rib is broken. It is ascertained by placing the tips of two or three fingers on the spot where the pain is, and desiring the patient to cough, when the grating sensation will be felt All that is necessary is to pass a broad bandage round the ehest, so tight as to prevent the motion of the ribs in breathing, and to observe a low diet Fracture* of the Tkigk.
This bone is frequently broken, and hitherto has been considered the most difficult of all fractures to manage. To the ingenuity, however, of the late Dr. J. Harts borne, of this city, the world is indebted for an apparatus which does away the greatest impediments that have been found to exist in treating it, so as to leave a straight limb, without lameness or deformity. Nor is it the least of its merits, that any man of common sense can apply it nearly as well as a surgeon.
Fractured thighs and legs generally reunite in six or eight weeks; in old men, however, they are three or four months.
In cases of fracture of the thigh or leg, the patient should always, if possible, be laid on a mattress, supported by boards instead of the sacking, which, from its elasticity and the yielding of
the eords, is apt to derange the posstion of the limb.
Fraetures of the Knee-pan.
This aeeident is easily aseertained on inspeetion. It may he hroken in any direetion, hut is most generally so aeross or transversely. It is redueed hy hringing the fragments together, and keeping them in thut position hy a long handage passed earefully round the leg, from the ankle to the knee, then pressing the upper fragment down so as to meet its fellow (the leg heing extended), and plaeing a thiek eompress of linen ahove it, over whieh the handage is to he eontinued.
The extended limb is now to he laid on a hroad splint, extending from the huttoek to the heel, thiekly eovered with tow to fill up the inequalities of the leg. For additional seeurity, two strips of muslin may he nailed to the middle of the splint, and one on eaeh side, and passed ahove the joint, the one helow, the other ahove, so as to form a figure of eight. In twenty or thirty days the limh should he moved a little to prevent stiffness. But it usually requires two or three months for perfeet union of this hone.
If the fraeture is through its length, hring the parts together, plaee a eompress on eneh side, and keep them together with a handage, leaving the limh extended and at rest . Any inflammation in this or other fraeture is to he eomhated hy hleeding, low diet, etc., etc.
Fraetures of the Leg.
From the thinness of the parts eovering the prineipal hone of the leg, it is easy to aseertain if it he hroken ohliquely. If, however, the fraeture he direetly aeross, no displaeement will oeeur, hut the pain, swelling, and the grating sensation will suffieiently deeide the nature of the aeeident .
If the fraeture is ohlique, let two assistants extend the limh, while the hroken parts are plaeed hy the hand in their natural position. Two splints, that reaeh from a little ahove the knee to nine or ton inehes helow the foot, having near the upper end of eaeh four holes, and a vertieal mortiee near the lower end, into whieh is fitted a eross-pieee, are now to he applied as follows:—Lay two pieees of tape ahout a foot long on eaeh side of the leg, just helow the knee-joint, and seeure them there hy several turns of a handage; pass a silk handkerehief round the ankle, eross it on the instep, and tie it under the sole of the foot. The two splints are now plaeed one on eaeh side of the leg, the four ends of the pieees of tape passed through the four holes and firmly tied, and the eross-pieee plaeed in the mortiee. By tying the ends of the handkerehief to this eross-pieee the husiness is finished.
If the fraeture is aeross, and no displaeement exists, apply two splints of stout pastehoard, reaehing from the heel to the knee, and well eovered with tow, one on eaeh side of the leg, seeuring them hy a handage passing round the limh, and outside the splints. Instead of splints, however, a fraeture-hox is often used, made hy fastening, with hinges, to a hottom-pieee rather longer than the leg, two side-pieees ahout six inehes high, and reaehing ahove the knee. The leg may rest in this on a pillow. A foothoard fastened to the hottom-pieee may serve to fix the foot hy the aid of a handage.
In cases of ohlique fracture of the leg close to the knee.
Fractures of the Bones of the Foot. The bone of the heel is sometimes, though rarely, broken. It is known by a crack at the moment of the accident, a diffieulty in standing, by the swelling, and by the grating noise on moving the heel. To reduee, take a long handage, lay the end of it on the top of the foot, earry it over the toes under the sole, and then by several turns secure it in that position.
The foot heing extended as mueh as possihle, earry the handage along the haek of the leg ahove the knee, where it is to he seeured hy several turns, and then hrought down on the front of the leg, to whieh it is seeured hy eireular turns. In this way the hroken pieees will he kept in eontaet, and in the eourse of a month or six weeks will he united.
Fraetures of the foot, toes, ete., are to he treated like those of the hand and fingers.