Surgical diseases of infants and children / by P. Guersant ; translated from the French by Richard J. Dunglison.

  • Guersant, P. (Paul Louis Benoit), 1800-1869.
Date:
1873
Catalogue details

Licence: Public Domain Mark

Credit: Surgical diseases of infants and children / by P. Guersant ; translated from the French by Richard J. Dunglison. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    Among the special predisposing causes of fractures in childhood, we may particularly mention rickets, an affection of frequent occurrence in very young children, who, owing to their debility, are more liable to falls, and in w^hom the osseous tissue is more likely to become fractured. We have not referred to scrofula as a predisposing cause of fracture, and, in fact, the osseous tissue of scrofulous patients has the same density and solidity as that of healthy individuals, as long as it has not become the seat of the ^ manifestation of that diathesis. As a general rule, every constitu- ' tional disease will predispose to fractures only when the morbid principle shall have attacked the osseous system. If we pass now to the exciting causes, we recognize the long list of violent agencies which standard writers have indicated in the fractures of adults. We must put falls in the front rank of causes, on account of the uncertain step of the youngest children, and of the sports, the races, and the wrestling of those more advanced in years. With regard to the special hones fractured, in seventy or eighty cases brought to our attention in a year at the hospital, we have established the fact that those of the thigh were much the most common, after which, in order of frequency, come those of the forearm, the elbow, and the humerus, the tibia alone, sometimes the fibula, and finally the clavicle, the ribs, and the jaw. Fractures of the patella are very rare, but three or four cases having come under our observation. In the arm, we meet with fractures of the body of the bone, but frequently the inferior part of the humerus is divided obliquely or longitudinally, in such a manner that the epitrochlea and epicondyle become detached. These fractures are often intra-articular. The middle portion of the bones of the limbs is usually the seat of the lesion, and we desire to draw more particular attention to a point connected with fractures of the forearm, which is fractured by preference at its middle or superior portion. Contrary to what takes place in the adult, we rarely meet with fracture of the inferior extremity of the radius. The cause of this inversion of frequency has appeared to us to depend on the entirely different manner in which children and adults resist external violence. In a fall, the latter throw out their hands instinctively to save themselves to the extent of their ability, and an indirect fracture of the radius at its lower extremity is thus produced. Little children, on the other hand, 3