. A practical treatise on fractures and dislocations. the exclusion, or at least the great subordination, o^^depression, which has long held the attention of the surgeon, to thehopeless conft)undiug of radically dillerent cases anil the useless or 138 FRACTURES. harmful generalization of therapeutic measures the value of which isstrictly limited. I have long sought such a name that would be dis-tinctive and short; possibly ^^circumscribed fracture of the vaultwould serve the purpose, although it is far from meeting all the indi-cations. The vast majority of fractures of this class involve the
. A practical treatise on fractures and dislocations. the exclusion, or at least the great subordination, o^^depression, which has long held the attention of the surgeon, to thehopeless conft)undiug of radically dillerent cases anil the useless or 138 FRACTURES. harmful generalization of therapeutic measures the value of which isstrictly limited. I have long sought such a name that would be dis-tinctive and short; possibly ^^circumscribed fracture of the vaultwould serve the purpose, although it is far from meeting all the indi-cations. The vast majority of fractures of this class involve the vault, butthey occasionally occur at the base, the vulnerant body reaching itthrough the mouth or orbit, and in a very few cases even the condyleof the lower jaw has been driven through the roof of its socket,^ orthe ethmoid driven in by a blow on the nose. The prognosis is worsein these basal cases because important parts of the brain are usuallyinjured, efficient treatment is impracticable, and infection is morelikely to occur. Fig. 65. Fig. Circumscribed depressed fracture, innerside; healed. (Konig.) Gunshot contusion of cranium, with fracture ofinternal table, interior view. (A. M. M., spec. 2313.) The other group of fractures, those produced by a force actingbroadly upon the cranium to modify its shape as a whole, includealmost all fractures of the base, and all so-called ^^indirect fracturesand fractures by contrecoup which have had so large a part in thediscussion of this subject. In these, I repeat, the important lesion isthat produced in the brain; the fracture is an incident, it usually hasno influence upon the progress of the case and gives rise to no thera-peutic indications. Similar brain lesions can be produced withoutfracture, and these cases belong among injuries of the brain rather than among fractures. This makesforms, their relative frequency, and a detailed account of the manytheir more or less hypothetical FRACTURES OF THE SKULL. 139 relations to dif
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectfractur, bookyear1912
