Ann asks:
I have a question about treatment of a leg fracture in the late 1860's. My character has broken his tibia (? --the bone at the front of the calf). It's not a compound break. Can you tell me if it would have been splinted or casted at that time, and how long before a determined person with such a break could walk using crutches? How long do such breaks take to heal?
Jordyn says:
Here is a great source that talks about the invention of plaster of paris. It looks like it would have been used for casting during your time frame. http://www.ehow.com/about_5134930_plaster-paris-history.html
This link says specifically:
With a cast in place-- he should be able to walk with crutches but NOT bear weight right away. That would be very painful. People are usually in casts, depending on the break, for four to six weeks. Today, we usually splint people for a week to allow for swelling before the cast is put in place to prevent compression syndrome but I can't say whether or not that would have been common practice at the time. He will have muscle atrophy of the leg during that time from non-use/limited use.
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Ann Shorey has
been a full-time writer for over twenty years. Her writing has appeared in Chicken Soup for the Grandma’s Soul, and
in the Adams Media Cup of Comfort
series. She made her fiction debut with The Edge of Light, Book One in the At
Home in Beldon Grove series. She’s tempted to thank Peet’s coffee and Dove
chocolates when she writes the acknowledgments for her books.
She may be contacted through her website, www.annshorey.com, which also contains her blog, http://annshorey.blogspot.com/ or find her on Facebook at http://www.facebook.com/AnnShorey.
Plaster Casts
- The invention of the plaster bandage can be attributed to an Arabic doctor and is noted in the Al-Tasrif, an Arabic medical encyclopedia dated from around 1000 C.E. This earlier adaptation of plaster for orthopedic cast making was unknown by European and American doctors. The use of plaster of Paris in the modern medical field began in earnest during the 1800s. By the 1850s bandages were rubbed with a plaster of Paris powder and then dampened and applied around the injury. During the 1970s this type of cast making began to wane. Most of today's orthopedic casts are made of synthetic materials.
With a cast in place-- he should be able to walk with crutches but NOT bear weight right away. That would be very painful. People are usually in casts, depending on the break, for four to six weeks. Today, we usually splint people for a week to allow for swelling before the cast is put in place to prevent compression syndrome but I can't say whether or not that would have been common practice at the time. He will have muscle atrophy of the leg during that time from non-use/limited use.
*************************************************************************
Ann Shorey has
been a full-time writer for over twenty years. Her writing has appeared in Chicken Soup for the Grandma’s Soul, and
in the Adams Media Cup of Comfort
series. She made her fiction debut with The Edge of Light, Book One in the At
Home in Beldon Grove series. She’s tempted to thank Peet’s coffee and Dove
chocolates when she writes the acknowledgments for her books.She may be contacted through her website, www.annshorey.com, which also contains her blog, http://annshorey.blogspot.com/ or find her on Facebook at http://www.facebook.com/AnnShorey.
I broke my tibia once, Not in the 1860s, but I can tell you what it's like.
ReplyDeleteIf they'd let me, I could probably have been walking with crutches within a few hours, but they wouldn't let me for nearly two days.
But for the first few days to maybe a week your character ought to be walking pretty gingerly, as it will be excruciating if he knocks his cast on anything.
My leg healed slower than was expected (they told me that's because I didn't break the fibula as well, and as it's longer then the tib it pushes the ends of the bone apart. Maybe something to think about, especially if you wanted him incapacitated a touch longer or frustrated at how long it was taking to heal).
*What they said: ~24 hrs before walking. 1-2 weeks before weight-bearing, 6 weeks in plaster total and 2 more with crutches.
*Actual: ~2 days before walking, 8 weeks in plaster, all of it non-weight bearing, 4 more weeks with crutches (weight-bearing). Then 2 weeks limping until I got a bit of muscle back.
I say plaster. It was actually fibreglass. Except the first bit, where they did a split cast - because of the swelling - which was actually plaster, and then covered it over with fibreglass after two days. That first cast was bl**dy heavy.
DeleteSorry. Getting confused (was a few years ago). They said it would be 8 weeks and 4, cast and crutches, it was actually 12 and 4.
DeleteBut that doesn't fit with what Jordyn said, though this time I *am* sure. If it turns out I only needed to be in a cast for half the time I was, I will be p*ssed off.
Will stop cluttering up this post with self-replies now.
Carrie,
ReplyDeleteI appreciate all the insight you offered. Thank you.