Surgery.

Date:: [1913]

Credit: Surgery. Source: Wellcome Collection.

91/412 (page 73)

$What arc the Causes of Traumatic Fracture ? Fractures of this type are the result of violence applied to the bone in three different ways : (a) Direct violence. The bone breaks at the point of impact and the line of fracture is usually trans- verse. In the case of fracture of both bones of the forearm or leg the bones are broken at the same level. (b) Indirect violence. The force is usually a torsion or shearing strain transmitted along the limb from the site of impact and the bone breaks at its weakest part and the line of fracture is oblique. In the case of fracture of the leg and forearm bones the line of fracture differs in the two bones. (c) Muscular action. Opinions differ regarding the possibility of bones being broken by the unaided action of muscles, but in sites in which a muscle is acting at a great mechanical advantage it is possible and transverse fracture of the patella is an example of this type of injury. What are the Clinical Features of a Fracture ? (a) The history of injury. (b) Pain. (c) Loss of power. (d) Alteration in the contour of the limb due to swelling. (e) Deformity. (/) Abnormal mobility. (g) Crepitus :—the name given to the grating sensation felt and heard when the ends of the broken bone are moved one on the other. It is not necessary or advisable to seek for this sign of fracture. (h) The X-ray will show the exact state of affairs and in all cases of fracture this examination must be carried out. How would you Examine a case of Supposed Fracture ? {a) Hear what the patient or his attendants have to sa\ (b) Inspect the injured limb (c) Palpate the injured area {d) Measure the limb (e) Arrange X-ray examination l I in all cases comparing with the sound limb. it$

Surgery.

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