St. Louis courier of medicine (Volume 23)

This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated.1900 Excerpt: ... reaching results of injuries to ligaments and tendons are not to be overlooked.. A very large literature has accumulated on the subject of the treatment of acute sprains, on which widely divergent views are still held, but comparatively little has been written about a fairly common condition which is clearly enough described by the term chronic sprain, when weeks and, perhaps, months after an injury the joint continues painful, irritable and, possibly, disabled. The normal joint reacts in a fairly definite and uniform way when injured or wrenched. The synovial membrane becomes hyperemic and swells, increase of the amount of synovial fluid takes place, periarticular swelling and atrophy of the muscles are accompaniments, and pain and stiffness are present. This is Nature's method of responding to traumatism in this particular structure. Under favorable circumstances the process shortly begins to subside and changes the reverse of those described above and in inverse order occur. This should continue under normal conditions until complete resolution is accomplished and the joint is as strong and movable as before and shows no effect of the injury. There are, however, first, certain conditions in healthy persons which prevent this favorable progress; and, second, certain constitutional morbid conditions in the patient may make ordinary sprains of considerable importance, in the matter of prognosis, especially. In healthy persons there are, in general, two reasons why sprains become chronic. In one, the acute synovitis has not been recovered from on account of misuse or too early use of the joint; and in the second, which is comparatively uncommon, the muscular weakness' (which is always the accompaniment of sprains) may persist, and later be of itself a cause ...