Modern surgery, general and operative . cord, the vertebrae return into place, and no deformity is Symptoms of Fractures and Dislocations of the Spine 853 detectable. Fracture-dislocation from direct force may occur at any part ofthe column, and in this accident the posterior vertebral segments are driventogether, and the cord, as a rule, escapes injury. Fracture-dislocations fromindirect force most commonly happen in the dorsolumbar region, but are metwith in the cervical and dorsal regions. In the cervical region reduction canusually be secured, but in the lumbar region reduction is impossib
Modern surgery, general and operative . cord, the vertebrae return into place, and no deformity is Symptoms of Fractures and Dislocations of the Spine 853 detectable. Fracture-dislocation from direct force may occur at any part ofthe column, and in this accident the posterior vertebral segments are driventogether, and the cord, as a rule, escapes injury. Fracture-dislocations fromindirect force most commonly happen in the dorsolumbar region, but are metwith in the cervical and dorsal regions. In the cervical region reduction canusually be secured, but in the lumbar region reduction is impossible. Symptoms.—In fracture-dislocation great displacement is unusual, butsome is almost always recognizable (irregularity of the spines or angulardeformity). There are pain (which is increased by motion), tenderness,ecchymosis, and motor and sensor\- paralysis. Priapism, cystitis, and reten-tion of urine often occur. Horsley has pointed out that in many casesparalysis passes away only to recur subsequently, the recurrence being due to. Fig. 544.—Fracture of third lumbar \-ertebra. edema of the cord. In some cases of spinal injur} there is temporary paral-ysis due to shock. Persistent paralysis may be due to laceration of the cord,di\dsion of the cord, or compression of the cord by bone, blood-clot (), or products of inflammation. The extent of paralysis depends on theseat of the cord injurv. We must always trv and decide if the spinal cord iscompletely divided or hopelessly crushed (Fig. 546). When the s^Tiiptoms arenot immediate in onset; when all the muscles below the seat of injury are notcompletety paralyzed; when there is some retention of sensation; when reflexesare present and muscular rigidity exists, we may be sure that the cord is notcompletely di\-ided. When the cord is completely divided the s^onptomsare immediate, there are absolute flaccid motor paralysis and complete sen-sory paralysis (loss of appreciation of pain, touch, and temperature). The 854 Surg
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Keywords: ., bookcentury1900, bookdecade1910, bookpublishe, booksubjectsurgery
