A manual of modern surgery : an exposition of the accepted doctrines and approved operative procedures of the present time, for the use of students and practitioners . one is torn away at the pointwhere a ligament is attached, is an incomplete fracture. Rupture of 350 FRACTURES. the main artery, laceration of the chief nerve, extension of the line offracture into a joint, dislocation and other lesions may occur simulta-neously with a fracture and complicate the treatment. A diastasis, or forcible separation of an epiphysis from the shaft ofa bone, presents the symptoms of a fracture and requir
A manual of modern surgery : an exposition of the accepted doctrines and approved operative procedures of the present time, for the use of students and practitioners . one is torn away at the pointwhere a ligament is attached, is an incomplete fracture. Rupture of 350 FRACTURES. the main artery, laceration of the chief nerve, extension of the line offracture into a joint, dislocation and other lesions may occur simulta-neously with a fracture and complicate the treatment. A diastasis, or forcible separation of an epiphysis from the shaft ofa bone, presents the symptoms of a fracture and requires like treat-ment. Ossification of all the epiphyseal cartilages has usually occurredbefore the twenty-fifth year; hence epiphyseal fracture, as it is called,can rarely happen at a later period of life than this. The line of sepa-ration is of necessity usually transverse ; and commonly some scales ofbone are torn from the shaft with the layer of cartilage. The innom-inate bone may be separated by injury into its three primary seg-ments by a similar separation through the cartilages. Arrested growthis not unusual after epiphyseal detachment. Fig. 137. Fig. Fissure of humerus. (Gurlt.) Diastasis, or epiphyseal separation, of the headof humerus. (Moore.) Pathology.—When a bone is broken, hemorrhage occurs from thearteries and veins in the Haversian canals and medullary cavity andthe periosteum is more or less extensively lacerated. The muscles andfascias about the seat of fracture are usually implicated in the violence,even in closed fractures with little displacement; hence extravasationof blood in and from the surrounding soft parts is common. Theblood from the torn soft parts usually shows as a blue discoloration ofthe skin a few hours after the injury. That effused from the osseousstructure itself does not reach the surface for two or three days, be-cause it can only leak through the deep fascial coverings by means ofthe openings where nerves and blood vessels approac
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