. A practical treatise on fractures and dislocations. y of 30, or 10 per cent., the causes of deathbeing sepsis, 10; shock, 7; delirium tremens, n; fat embolism, 3jgangrene, 3; nephritis, 1. The highest mortality was in fractures ofthe femur—25 cases with 7 deaths, 2<S per cent. The principles of treatment are to transform the fracture into asimple one as promptly as possible, to minimize suppuration and keepit superficial when it is inevitable, and to protect against other infec-tion while the wound is open, meanwhile immobilizing the fragmentsby suitable splints. Under the protection of s
. A practical treatise on fractures and dislocations. y of 30, or 10 per cent., the causes of deathbeing sepsis, 10; shock, 7; delirium tremens, n; fat embolism, 3jgangrene, 3; nephritis, 1. The highest mortality was in fractures ofthe femur—25 cases with 7 deaths, 2<S per cent. The principles of treatment are to transform the fracture into asimple one as promptly as possible, to minimize suppuration and keepit superficial when it is inevitable, and to protect against other infec-tion while the wound is open, meanwhile immobilizing the fragmentsby suitable splints. Under the protection of strict asepsis (including inthat rigid disinfection of the crushed soft parts in fractures by directviolence) the question of the need of amputation may often be post-poned until after the progress of the case shall have clearly shownwhether or not the limb can be saved. 5. Gunshot Fractures. The call for separate consideration of this variety of compound frac-tures comes through peculiarities of the lesions and dangers consequent Fig. 16. Fig. Contusion of side of femur by pistol-ball; symmetrical Transverse fracture of the claviclefissure of the opposite side. (Poitlet and Bousquet.) by a spent ball. (Ricakd.) upon the small size and the velocity of the projectile. The subject, 1 Mumford : Boston Medical and Surgical Journal, May 10, 1894. 34 FRACTURES. consequently, is rather more limited than its title might suggest, anddoes not include fractures by large balls or pieces of shell, in whichthe extensive laceration of the soft parts is even more important thanthe fracture. The special features are the usually extensive splintering and As-suring of the bone and the bruising of the tissues along the track ofthe bullet which may prevent prompt healing of the wound. Thesefeatures are found in varying degrees, corresponding to the velocity ofthe ball and to its size. A ball whose force is nearly spent may, onstriking the shaft of a long bone, do no injury at the point of imp
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