Wounds in war : the mechanism of their production and their treatment . es treated conservativelyare distinctly good. The loosened splinters becomeincluded in the callus thrown out, and eventually firm consolidation takes place; butfrom two to six months mayelapse before recovery is farenough advanced to enable thepatient to get about with crutches,and perhaps twice as long beforerecovery is complete. The usualdeformity which is found, whenany occurs in these cases, isa convexity of the femur out-wards (fig. 61). Shortening ofthe femur almost always occurs ;it is usually well marked, andsometi
Wounds in war : the mechanism of their production and their treatment . es treated conservativelyare distinctly good. The loosened splinters becomeincluded in the callus thrown out, and eventually firm consolidation takes place; butfrom two to six months mayelapse before recovery is farenough advanced to enable thepatient to get about with crutches,and perhaps twice as long beforerecovery is complete. The usualdeformity which is found, whenany occurs in these cases, isa convexity of the femur out-wards (fig. 61). Shortening ofthe femur almost always occurs ;it is usually well marked, andsometimes may extend to manyinches. Ankylosis, either partialor complete, of the knee orhip is also a common result, de-pending on implication of thearticular surfaces in the frac-ture, or on the long-continuedconfinement of the limb in fixa-tion apparatus. The mortality following con-servation during the AmericanWar was per cent., while thatof all the primary amputations was per cent. Themortality of conservative treatment according to the siteof fracture was—. Fig. 61. Showing usual deformity inbadly united gunshots offemur (after Otis). Upper third per cent Middle „ . „ Lower „ • 38-2 all of which ratios are less than those furnished by amputa-tion at the same situations. Again, the total mortality of cent, for conservation may be compared with that of WOUND OF THE SCIATIC NERVE 241 all amputations of the thigh for gunshot of the femur itself,which was per cent. Amputation for Gunshots of the Femur.—Some ofthe indications for this operation have been referred tounder conservative treatment. It is required when thelimb has been wholly or partially torn away by a largeprojectile or by a large fragment of shell ; in severelycomminuted fractures with extensive destruction of thesoft parts, denuding the bone of its coverings for a con-siderable distance—usually the results of shell wounds ;and in comminuted fractures complicated by lacerat
Size: 1086px × 2300px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1800, bookdec, booksubjectsurgicalproceduresoperative
