SPRAIN. A sprain or strain is a term employed in surgery to designate p violent stretching of tendinous or ligansentous..pui:rts with or without rupture of Sqlne 'Of .their fibers. Srnins are very frequent in all‘thei joints of especially in the wrist and the articulations of the thutlib.* In glecauxver extfitmity-thc ankle is the ,jo'l L tei, fcAtiArINKA Li -.
by far the most frequently affected;' and thi.:is accounted for tild. . 2 small size of the articular surfaces; the grea0.weight the astrarlIns-(ifie bone pre senting the lower articular surface) has to supgiiIrt, and the, Adding nature of the lateral ligaments. In slight joint the ligame only stretched or te' slightly lacerated, but in more severe .eftses they may be completely torn through. Sprains of the ankle are sometimes mistaken forfractures, and rice versa; and the two ' -..
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injuries may co-exist. The pain and/,§welling sometimes make an accurate diagnosis difficult, especially if the patient is not seen for some tame after the accident; end if any doubt exists, the case should be treated as for the more severe injury, since it is better that the treatment should be prolonged than that the pa'lent should be maimed; and, fortunately, that whiclr is the proper treatment of a fraela.e is the best that can be employed for a sprain. Sprains of the knee are not uncommoa, ;tett nee characterized by great swelling from effusion of fluid within the joint. Spraius of the back are not unfrequent accidents, and are the most serious of any, but in most cases it may be anticipated that after confinement in bed or on a sofa for two or three weeks, and with proper treatment, the patient will be able to walk, although he may feel stiffness and pain for several weeks longer. The treatment of sprains generally must be regulated by
their severity. In a severe sprain, ,attended with much pain and inflammation, leeches should be applied, followed by hot-water fomentatious, or the application of a hot linseed-meal poultice. In slighter cases, rest and cold lotions constitute sufficient treat ment. In all cases of sprain of the extremities, thin pasteboard splints placed on the outer and inner surfaces of the joint, over a wet bandage previously laid round it, afford support to the part and comfort to the patient. In sprains of the back, more decided antiphlogistic or lowering measures are required. "After an active mercurial purge, a dose or two of Dover's powder may be given, with salines at intervals. The diet ought to be spare. In those of vigorous constitution the abstraction of blood may be required. Afterward, nothing will conduce more to the comfort of the patient then well-managed fomentation of the back. Amendment will he denoted. by the patient's turning in bed more freely, and seeking to sit up. At that period stimulating liniments, or the application of the compound tincture of iodine, will be called for. When able to walk, he will be benefited by a warm plaster to his loins."—Shaw on "Injuries of the 'Back," in Holmes's System of Surgery, vol. ii. p. 202.