The Gilchrist Association is a special bandage used to stabilize and immobilize the affected area for shoulder and upper arm injuries. The bandage is used after shoulder surgery, lateral fractures of the clavicle, shoulder fractures and minor injuries in the shoulder or AC joint. If complete immobilization is required, the dressing is not suitable.

What is a Gilchrist union?

The Gilchrist Association is a special bandage used to stabilize and immobilize the affected area for shoulder and upper arm injuries.

Injuries around the shoulder or upper arm often require immobilization of the affected arm. The immobilization serves the affected tissues for recovery and is also required, for example, in case of broken limbs, so that the fracture can heal properly and the fragments do not slip.

The American dermatologist Thomas C. Gilchrist developed a special shoulder and upper arm bandage in the 19th century. This classic bandage variation is known today as Gilchristverband. The associations exist in the 21st century as prefabricated constructions in different clothing sizes. This allows patients of any stature to be treated with a Glichrist dressing. Also the own production of a Gilchristverband lies in the range of the possible and requires neither much material, nor far-reaching medical knowledge.

The shoulder and the upper arm are firmly fixed by a Gilchristverband and can thus hardly leave the rest position. The fit of the association is a decisive criterion. A suboptimal fit can sometimes jeopardize the purpose of the created association.

Function, effect & goals

The Gilchrist Bandage is used for certain shoulder and upper arm injuries. The type of dressing is used for loose immobilization or moderate fixation of the shoulder joint. The indication for this type of immobilization arises, for example, in patients with a restored dislocation of the shoulder joint in the sense of already treated shoulder luxation.

Other indications for the bandage include minor injuries of the Schultereckgelenk, which is also known as AC joint. In addition, the bandage may be used for upper arm fractures, shoulder fractures, or lateral collarbone fractures. In certain cases, the bandage is also the aftercare step of a shoulder operation, typically the shoulder joint mirroring, and is also intended to cause immobilization of the operated area in this case. For the care of the patients prefabricated Gilchrist associations serve in different clothing sizes.

The bandages are distributed in the appropriate hospital facilities, are reusable and can be secured and removed with a Velcro fastener. In the case of the prefabricated Gilchrist dressings, the winding step is almost completely eliminated.

A finished bandage is constructed of a chest band of certain width and a top fixation and forearm fixation. The affected arm must be flexed by the patient in the elbow joint at a right angle. Meanwhile, the hand is directed towards the belly button and looks out of the bandage in that direction.

Complete immobilization of the affected arm is not the goal of the Gilchrist Association. Rather, the patient should use the hand of the affected side with some restrictions. The on-site portion of the dressing carries a noose around the patient's neck. The band around the chest holds the arm in a dorsal position and pulls it backwards. If you want to make a Gilchrist dressing yourself, use a long piece of tubular gauze, which is equipped with padding or cotton wadding and two to four safety pins fixed. However, the homemade Gilchrist dressing can also be realized using tight elastic bandages and is wound in this case.

Risks, side effects & dangers

The Gilchrist Association is not suitable for strong immobilization of the shoulder. If stronger to maximum rest positions are to be achieved, a so-called Desault Association application. This bandage is mainly used for unstable proximal humeral fractures and was developed by Pierre-Joseph Desault for absolute immobilization of the shoulder joint and upper arm.

The bandage corresponds to elastic bandages or in certain cases a body tube bandage. A Desault dressing may be used for a maximum of three weeks. If further restraint is required in the following weeks, the Gilchrist Association may replace the stronger type of dressing from that date. Also for fractures of the clavicle, the Gilchristverband is rather less. With such fractures, plasters of bandages are more likely to be used on children. Also, backpack packs for adults are more suitable for these fractures than a Gilchrist bandage.

Backpack bandages are based on a shoulder bandage that fixes the collarbone. The shoulder is pulled backwards in these bandages. Thus, a straight back posture is secured by the bandage and the collarbone does not grow together in a shortened position. When patients put on a Gilchrist instead of a backpack bandage in clavicle fractions, this can result in a shortening of the collarbone. Such shortening must in most cases be opened and surgically broken in order to return to the anatomical position.

If, in the case of a severe shoulder fracture, the Desault bandage is relinquished and thus the patient is completely immobilized, this may result in a permanent stiffening or functional impairment of the shoulder joint. Therefore, it is imperative to seek medical advice before putting on a Gilchrist bandage on your own. The bandage is not suitable for all injuries of the upper arm and shoulder, but can be used only for specific purposes meaningless and without complications.

Despite the bandage, a patient may still feel pain, as the Gilchrist bandage does not achieve absolute immobilization of the injured structures.

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