File:A system of surgery (1895) (14595335799).jpg

Identifier: systemofsurgery01trev (find matches)
Title: A system of surgery
Year: 1895 (1890s)
Authors: Treves, Frederick, Sir, 1853-1923
Subjects: Surgical Procedures, Operative Surgery
Publisher: Philadelphia : Lea Brothers
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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uring adressing, a passive movement (Fig. 201), or asequestrotomy. Fracture of a fixed total seques-trum is very rare; as also is fracture of the sheath,so long as the sequestrum lies within it. But afterthe removal of the sequestrum, bending and fractureof imperfect sheaths are more common. Osteomyelitis ending in abscess without theformation of any, or any considerable sequestrum,rarely leads to a spontaneousfracture. The femur has mostoften been the seat of the injuryowing to an abscess in the shaft,close to, but not involving theepiphysial line. Tubercular caries rarelyleads to fracture of the shaftsof long bones, into which itseldom penetrates deeply; butBillroth saw the tibia thus eatenthrough. The ribs, the verte-bral bodies, and the odontoidprocess suffer more commonly. Syphilitic caries, the resultof gummatous periostitis andosteomyelitis, is another causeof spontaneous fracture, whichis, howTever, very rare in pro-portion to the wide distributionof syphilis. The bones of the
Text Appearing After Image:
Fig. 201.— A longitudinal Section of the lowerEnd of a Boys Femur. He was admittedfor necrosis of the femur and suppurationof the knee joint, and the tibia appeared tobe dislocated backwards ; but after amputa-tion it was found that the femur had beenbroken, probably by passive movement,about 1 in. above the epiphysial line, and thatthe fragments had been united with angulardeformity forwards. A considerable se-questrum of the popliteal surface, still ad-herent, is shown in section, its lower endlying in a cavity in the lower fragment.The bone is excessively porous, and depositof new bone is wide-spread. (UniversityCollege Museum, No. 277.) CAUSES OF FRACTURES. 729 tipper limb, especially the clavicle, are the commonest seats. Ahistory of syphilis, of bone pains preceding the fracture, of aperiosteal swelling—though, according to Chiari, a central gummamay give no superficial sign of its presence—the existence ofsigns of syphilis, and the satisfactory results of antisyphilitic t

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