1. An original splint and traction apparatus for post-operative management of guillotine and pseudo-guillotine amputations of the thigh is here described.
2. The advantages of this apparatus are:
(a) It furnishes gentle, continuous traction on the soft parts of the thigh.
(b) The tractor is adjustable to suit the size of the stump as it shrinks.
(c) The four bars of the splint hold dressings in place and preserve proper alignment of the traction bands.
(d) It can be used for skin traction on any thigh amputation where there is a stump.
(e) When the patient takes to crutches it requires no support other than the traction stickers.
(f) It is comfortable to the patient.
(g) It is light.
3. In the presence of infection, the author prefers the pseudoguillotine amputation and the use of this apparatus to any sort of flap operation.
4. A case history illustrative of the use of the apparatus shows the following advantages of the method:
(a) As there is no dead space, which often exists with flap amputations, no pus is ever seen after operation.
(b) The bone is immediately covered by muscles so that it is seen only for a day or two.
(c) The patient is ambulatory within a few days, which favors shrinkage of the stump.
(d) The scar is smaller than that resulting from flap amputations and its ultimate position can be controlled by proper selection of the plane of amputation.
5. The illustrations accompanying this article were all taken on the seventeenth post-operative day.
(C) 1926 All Rights Reserved.The Journal of Bone and Joint Surgery, Inc.