. Modern surgery, general and operative. n and fixation or removal. jric_ ^^S. Fracture of Fractures of the metatarsal bones are almost in- metatarsal bones, variably due to direct force and are almost always compound. Robert Jones has published skiagraphs of a fracture of the fifthmetatarsal bone from indirect force. Crepitus may be absent because ofimpaction or fixation by interosseous ligaments. Jones says such a fracturemay be produced by the pressure of the body weight on an inverted footthe heel of which is raised (Annals of Surgery, June, 1902). When onlyone bone is broken, displacement
. Modern surgery, general and operative. n and fixation or removal. jric_ ^^S. Fracture of Fractures of the metatarsal bones are almost in- metatarsal bones, variably due to direct force and are almost always compound. Robert Jones has published skiagraphs of a fracture of the fifthmetatarsal bone from indirect force. Crepitus may be absent because ofimpaction or fixation by interosseous ligaments. Jones says such a fracturemay be produced by the pressure of the body weight on an inverted footthe heel of which is raised (Annals of Surgery, June, 1902). When onlyone bone is broken, displacement is slight, there is severe pain on motion andpressure, and crepitus can generally be obtained. Pain is produced by flexingthe toes, putting weight upon the toes, as in walking, and by inverting or evert-ing the foot. Fracture of the third metatarsal is apt to destroy the arch of thefoot. A simple fracture of a metatarsal bone is treated by an immovabledressing for four weeks. Fractures from crushes usually demand excision 702 Diseases and Injuries of the Bones dnd Joints Fractures of the phalanges of the toes are due to direct force and are oftencompound. They may require immediate amputation. Treatment.—In a compound fracture where amputation is unnecessary,drain with strands of catgut for forty-eight hours and dress antiseptically,at the end of this time apply over the bichlorid gauze a gutta-percha or apasteboard splint extending from beyond the end of the toe to well up uponthe sole of the foot, and fix the splint in place with a spiral bandage of thetoe and instep. The splint is to be worn for four weeks. In a simple fracturefasten the injured toe to an adjacent toe or toes by a plaster bandage andwear the dressing for three weeks. Diseases of the Joints Synovitis is a primary inflammation of the synovial membrane other structures besides the synovial membrane are involved the conditionis known as arthritis. Two forms of simple synovitis exist—
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