. Roentgen interpretation; a manual for students and practitioners . there aresoft tissues between the fragments which will interfere with repair,whether an uncalcified callus is present or whether or not there isfirm fibrous union. It must not be forgotten that non-union isprone to occur when the site of fracture involves a nutrient arteryor when the patient is syphilitic or asthenic. In the reduction of fractures normal weight-bearing lines shouldbe restored as far as possible and every attempt should be made toreplace articular surfaces in their normal planes with reference to3 34 FRACTURES
. Roentgen interpretation; a manual for students and practitioners . there aresoft tissues between the fragments which will interfere with repair,whether an uncalcified callus is present or whether or not there isfirm fibrous union. It must not be forgotten that non-union isprone to occur when the site of fracture involves a nutrient arteryor when the patient is syphilitic or asthenic. In the reduction of fractures normal weight-bearing lines shouldbe restored as far as possible and every attempt should be made toreplace articular surfaces in their normal planes with reference to3 34 FRACTURES AND DISLOCATIONS the shaft. In doubtful cases comparison plates of a symmetricalpart may help to decide whether a reduction is satisfactory. Fracture lines will usually become obliterated in from three tosix months, and if reposition of the fragments has been accurate allevidence of the injury may have disappeared in that time. Theshadow of linear fractures in the skull, however, may persist for alonger period, but ordinarily are not visible beyond one year after. Fig. 8.—Fracture of the skull in a child. Compare the fracture line with the suture line seen above it. the injury. In any fracture, when reduction has been poor or thecallus formation extensive, evidence of the deformity may persistfor life. The roentgenogram will often furnish evidence of value to thesurgeon aside from the position of the fragments, such as indica-tions of a pathological process in the bone or of the presenceof foreign bodies within the wound, and occasionally the earlyappearance of gas in the soft tissues as a result of infection withWelchs bacillus. FRACTURES 35 Skull.—From its structure the skull is subject to linear fractureswhich appear on the plate as thin black lines with sharp raggededges. They may run in any direction. They are to be differen-tiated from suture lines, diploic vessels and arterial grooves, all ofwhich have fairly definite courses, smooth margins and are lighter incolor.
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