A system of surgery . iphysisof the crest is said to have beentorn off by the abdominal fractures are rarely com-pound through the skin, the forcethat causes them acting over awide area. Injuries to internal organs and parts by the fragments consti-tute the chief dangers of these injuries. Rupture of the bladderfrom the violence causing the fracture, rather than wound by afragment, occurs occasionally. But the special danger is partialor complete laceration of the subpubic (membranous, sometimesbulbous) urethra by displacement of the fragments of the pubicarch in the relatively c
A system of surgery . iphysisof the crest is said to have beentorn off by the abdominal fractures are rarely com-pound through the skin, the forcethat causes them acting over awide area. Injuries to internal organs and parts by the fragments consti-tute the chief dangers of these injuries. Rupture of the bladderfrom the violence causing the fracture, rather than wound by afragment, occurs occasionally. But the special danger is partialor complete laceration of the subpubic (membranous, sometimesbulbous) urethra by displacement of the fragments of the pubicarch in the relatively common anterior vertical fracture. Fixedas this portion of the urethra is, it may be simply kinked; butthis is rare. Laceration of the rectum has not infrequently accom-panied fractures and luxations of the sacrum and coccyx. Injuriesof the great vessels and nerves are very rare; the gluteal arteryhas generally been the vessel to suffer. An injury of such severityis frequently accompanied by other internal lesions. B B. Fig. 272.—A left Hip Bone. The ilium abovethe acetabulum has been split off andbroken into two pieces by a T-fracture ;the fragments have united with displace-ment. There had been a vertical fracturealso of the horizontal ramus of the pubisand of the pubic arch. (St. GeorgesMuseum, Series I., No. 122.) (rick.) 834 INJURIES OF BONES. Signs.—-The diagnosis of fractures not breaking the pelvic ringis made by attention to the nature of the accident, the seats ofinjury, of pain and tenderness, and by careful examination fromoutside, from the rectum and vagina. Passive movements of thelower limb may help. As a rule, deformity, mobility, and crepitus,one or all, can be obtained. A dislocation of the femur easilyreducible and easily recurring, characterises fractures of the ace-tabular edge. In fractures breaking the pelvic ring there is often great shock;if the patient has attempted to bear weight on the limb of theinjured side, he has found it impossible: there is
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