. Modern surgery, general and operative. s alone. Treatment.—Examine carefully to determine if the bowel, the bladder, theurethra, or the vagina is injured. If such an injury exists, radical operationis, of course, demanded. Always use a catheter to see if the urine is urine suggests, but does not prove, the existence of a torn may be due to simple contusion of the bladder or to contusion of the some cases the bladder is sutured. In others it is drained suprapubiclywithout suturing. In treating a pelvic fracture endeavor to restore the partsto a normal positi
. Modern surgery, general and operative. s alone. Treatment.—Examine carefully to determine if the bowel, the bladder, theurethra, or the vagina is injured. If such an injury exists, radical operationis, of course, demanded. Always use a catheter to see if the urine is urine suggests, but does not prove, the existence of a torn may be due to simple contusion of the bladder or to contusion of the some cases the bladder is sutured. In others it is drained suprapubiclywithout suturing. In treating a pelvic fracture endeavor to restore the partsto a normal position, employing external manipulation and inserting a fingerinto the rectum or in the vagina. If reduction is difficult, administer pelvis should be encircled by a canvas binder and the patient should beplaced upon a Bradford frame. If this is done he can be cleaned readily andthe bed-pan can be easily used. If movements of the thighs distort the pelvicbones, each thigh should be bound to the frame. In fracture with senaration. Fig. 338.—RuKh\^ case of fracture of the acetabulum with internal dislocation of Icmur. of the pubic bones the bones should be wired in place. If urinary extravasationfrom urethral rupture occurs, perform perineal section. If there are signs ofbowel injury or intraperitoneal rupture of the bladder, perform laparotomy;and if the bladder is found to be torn, apply sutures and drain visceral injuries are treated by general rules. Remove the dressings in sixweeks and allow the patient to get about in twelve weeks. * In fracture of theacetabulum, if the limb is shortened, give ether and reduce by extension andcounterextension. Treat these fractures in the same way as intracapsularfractures of the femur. Fractures of the ischium are best treated by theapplication of a pad and adhesive plaster, and rest in bed. E. P. Quain (Surgery, Gynecology, and Obstetrics, July, 1916) collected126 cases of rupture of the bladder associated wit
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