On Fractures   

elapsed, or rather more, if there be no fever, and if the wound be
not inflamed, then there will be less to prevent an attempt at reduction,
if you hope to succeed; but otherwise you need not take and give trouble
in vain.


PART 32
When you have reduced the bones to their place, the modes of treatment,
whether you expect the bones to exfoliate or not, have been already
described. All those cases in which an exfoliation of bone is expected,
should be treated by the method of bandaging with cloths, beginning
for the most PART at the middle of the bandage, as is done with the
double-headed bandage; but particular attention should be paid to
the shape of the wound, so that its lips may gape or be distorted
as little as possible under the bandage. Sometimes the turns of the
bandage have to be made to the right, and sometimes to the left, and
sometimes a double-headed bandage is to be used.


PART 33
It should be known that bones, which it has been found impossible
to reduce, as well as those which are wholly denuded of flesh, will
become detached. In some cases the upper PART of the bone is laid
bare, and in others the flesh dies all around; and, from a sore of
long standing, certain of the bones become carious, and some not,
some more, and some less; and in some the small, and in others the
large bones. From what has been said it will be seen, that it is impossible
to tell in one word when the bones will separate. Some come away more
quickly, owing to their smallness, and some from being merely fixed
at the point; and some, from pieces not separating, but merely exfoliating,
become dried up and putrid; and besides, different modes of treatment
have different effects. For the most PART, the bones separate most
quickly in those cases in which suppuration takes place most quickly,
and when new flesh is most quickly formed, and is particularly sound,
for the flesh which grows up below in the wound generally elevates
the pieces of bone. It will be well if the whole circle of the bone
separate in forty days; for in some cases it is protracted to sixty
days, and in some to more; for the more porous pieces of bone separate
more quickly, but the more solid come away more slowly; but the other
smaller splinters in much less time, and others otherwise. A portion
of bone which protrudes should be sawn off for the following reasons:
if it cannot be reduced, and if it appears sons: that only a small
piece is required in order that it may get back into its place; and
if it be such that it can be taken out, and if it occasions inconvenience
and irritates any PART of the flesh, and prevents the limb from being
properly laid, and if, moreover, it be denuded of flesh, such a piece
of bone should be taken off. With regard to the others, it is not
of much consequence whether they be sawed off or not. For it should
be known for certain, that such bones as are completely deprived of
flesh, and have become dried, all separate completely. Those which
are about to exfollate should not be sawn off. Those that will separate
completely must be judged of from the symptoms that have been laid
down.


PART 34
Such cases are to be treated with compresses and vinous applications,
as formerly laid down regarding bones which will separate. We must
avoid wetting it at the beginning with anything cold; for there is
danger of febrile rigors, and also of convulsions; for convulsions
are induced by cold things, and also sometimes by wounds. It is proper
to know that the members are necessarily shortened in those cases
in which the bones have been broken, and have healed the one across
the other, and in those cases in which the whole circle of the bone