A treatise on fractures

Front matter

TREATISE ON FRACTURES.

/ BY

LEWIS A. STIMSON, B.A., M.D.,

Chapter II

1. Incomplete fractures :

Fissures .....

True, incomplete, or green-stick Depressions ....

Separation of a splinter or apophysis a. Subdivided according to the direction of the line of fracture

b. According to the seat of fracture c. Intra- articular fractures

Comminuted, impacted, with crushing .

Chapter III

Transverse or lateral ; angular ; rotatory ; overriding ; by penetration or crushing ; direct longitudinal separation. Active causes

PAGE

33 36

Chapter IV

. Predisposing causes . . . . . . .76

Normal or physiological

Pathological .....

Inherited or acquired liability .

Osteoporosis ....

Disease of the nerve centres . .

Rachitis .....

Syphilis, mercurialism, ' ' rheumatism' ' .

CONTENTS.

Cancer . . .

Cysts ; caries and necrosis

Immediate or determining causes

a. External violence

b. Muscular action Intra-uterine fractures, and fractures during delivery

CHAPTER V. Deformity

Abnormal mobility

Crepitation Subjective or rational signs

Loss of function ; pain ; history

CHAPTER VI Clinical description

Anatomo-pathological processes

History ; nature of the process ; details

failure of union Details in compound fracture Details in the short and flat bones Details in articular fractures Details in fracture of parallel bones Details in separation of an epiphysis simple fracture ; splinters

Chapter VII. Complications And Remote Consequences Of Fracture

Stiffness of the joints .

Atrophy of the limb

Obliteration of the large veins ; embolism

Fat embolism .

Extravasation of blood .

Injury of an artery ; traumatic

Emphysema

Gangrenous septicaemia

Gangrene

Suppuration ; pysemia ; necrosis

Muscular twitchings and tetanus

Delirium tremens and nervous delirium

Exuberant and painful callus

Paralysis due to injury of a nerve

Paralysis by inclusion of a nerve in the callus

Secondary fracture

CONTENTS.

Chapter VIII. Page

Reduction .......

. 154

Retention ....

. 159

Scultetus bandage

. 160

Bivalve cushion .

.-

. 161

Wooden splints .

Fracture boxes .

. 163

Gutters ....

Posterior and suspended splints .

Malgaigne's point and hooks

Moulded splints .

Plaster of Paris . .

Inclined plane .

Continuous extension

Movements, local and general treatment

Compound fractures ....

Suture of the fragments

Antiseptic (Lister) method

Modifications

Treatment of inflammatory processes

Treatment of articular fractures .

Treatment of gunshot fractures .

Amputation

Aphorisms

Chapter XII Page

Pathological anatomy ......

. 232

Fractures of the vault .

. 232

Fractures of the base

. 234

Symptoms and diagnosis — vault

. 239

Symptoms and diagnosis — base

. 241

Prognosis

. 246

Treatment — vault

. 247

Treatment — base

. 252

CHAPTER XIII. Pathology

. 255

Etiology ....

. 260

. 261

Atlas and axis .

. 263

Lower cervical and upper dorsal

. 264

Lower dorsal and upper lumbar

. 267

Lower lumbar .

. 269

Course and terminations

. 270

Treatment ....

. 274

CHAPTER XIX. Pathology . . - . ■

.

. 324

Middle third

. 325

Outer third

. 327

Inner third

. 328

. 329

Complications

.

. 330

Etiology ....

. 332

Simultaneous fracture of both clavicles

. 333

Symptoms and course .

. 334

. 337

CHAPTER XX. Of the body of the scapula

Of the inferior angle .

Of the upper angle

Of the spine of the scapula

Of the acromion

Of the coronoid process

Of the surgical neck

Of the glenoid cavity .

Chapter XXI

1. Fractures of the upper end ......

Pathology and course ......

a. Fractures of the head .....

b. Fractures of the anatomical neck, and through the tuberosities

c. Fracture of the tuberosities ....

d. Separation of the epiphysis ....

e. Fracture of the surgical neck ....

/. Intra- and extra-capsular fractures, -with dislocation of the upp fragment ......

Diagnosis .......

Treatment . . .

372 377 379

Vlll

2. Fractures of the shaft of the humerus

Symptoms, treatment

3. Fractures of the lower end of the humerus .

1. Fractures above the condyles

2. Fractures of the epitrochlea

3. Fractures of the external epicondyle

4. Fractures of the internal condyle

5. Fractures of the external condyle

6. Intercondyloid fractures

8 Fracture of the articular process

9. Simultaneous fracture of all three bones

Treatment ....

PAGE

Chapter XXII

A. Fractures in the vicinity of the elbow-joint

1. Of the olecranon . . .

Symptoms ....

Repair ....

Treatment ....

2. Of the coronoid process of the ulna .

3. Of the head and neck of the radius .

B. Fractures of the shaft

1 . Of both bones

Treatment .

2. Of the shaft of the ulna

3. Of the shaft of the radius

C . Fractures in the vicinity of the wrist

1. Fracture of the radius. Colles's fracture

Causes ....

Course and prognosis

Treatment ....

2. Fractures at the wrist other than Colles's

Chapter XXIII. Fractures Of The Carpus And Hand

1 . Fractures of the carpus

2. Fractures of the metacarpal bones .

466 467 469

IX

CHAPTER XXIV Separation of the symphysis pubis

Separation in front and behind

Separation of the sacro-iliac synchondrosis

Separation of all three joints

Fracture of the pubic portion

Fracture of the lateral portion

Course and prognosis

2. Transverse fracture of the sacrum

3. Fractures of the coccyx

4. Fractures of the ilium

5. Fractures of the ischium

6. Fractures of the pubis

7. Fractures of the rim of the acetabulum

PAGE

472 473 475

Chapter XXV

1. Fractures at the upper end .

A. Fractures of the neck of the femur .

Causes

Anatomical varieties

a. Fractures of the small part of the neck

Symptoms

Repair

b. Fractures at the base of the neck

Repair Symptoms ....

Diagnosis ....

Prognosis .

Treatment ....

B. Fracture through great trochanter and neck

C. Fracture of the great trochanter

Prognosis ....

Treatment ....

In children ....

A. Supra-condyloid fracture and separation of epiphysi

B. Inter-condyloid fracture

C. Fracture of either condyle .

CONTENTS.

Chapter XXVI Page

FRACTURES OF THE PATELLA .

. 546

Cause ... . .

. 546

Pathology . . . .

. 547

Symptoms .......

. 550

Course and terminations ......

.550

. 556

Of compound and ununited ....

. 561