American practice of surgery : a complete system of the science and art of surgery . ndition in which fractures occur from slight in which one would naturally expect union to be slow, does not interferewith the process of union, as is shown by the reported cases. The writer sawat the Philadelphia Hospital a case of this kind in which at different timestwenty-four fractures had occurred, every one uniting with the usual rapidity. While the local causes are more frequently apparent than the constitutional 21S AMERICAN PRACTICE OF SURGERY. and can in sonic cases be positively demonstra
American practice of surgery : a complete system of the science and art of surgery . ndition in which fractures occur from slight in which one would naturally expect union to be slow, does not interferewith the process of union, as is shown by the reported cases. The writer sawat the Philadelphia Hospital a case of this kind in which at different timestwenty-four fractures had occurred, every one uniting with the usual rapidity. While the local causes are more frequently apparent than the constitutional 21S AMERICAN PRACTICE OF SURGERY. and can in sonic cases be positively demonstrated, there is considerable differ-ence of opinion as to their individual importance. That which will demandthe greatest attention from the physician is the lack of sufficient immobilizationof the fracture. It is probably the most frequent cause of pseudarthrosisand maybe the result of a faulty dressing, too frequenl examination by thephysician, or of interference on the part of the patient, who. in seeking relieffrom pain or fatigue, loosens the bandages or relaxes the Fig. 106.—Ununited Fracture of Roth Rones of the :. with Overlapping Or. II. K. Pancoast. (Skiagraphed by Too wide on interval between the fragments, as from necrosis in a compoundfracture or the removal of detached fragments in a compound comminutedfracture, may result in an insufficient deposit of callus to bridge the gap. Onthe other hand, cases have been reported in which a separation of the fragmentsof from two to six inches has been overcome and the bone reunited with littleor no shortening in the affected limb. The time required for union in these PSEUD ARTHROSIS. 219 cases is, of course, prolonged and the liability to failure is increased. Too greatoverlapping may also interfere with union by removing the fractured surfacesfrom each other by too wide an interval (see Fig. 106). The interposition of foreign tissues, such as tendon, muscle, bullets, or necrosedbone, sometimes seems to offe
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