Annual and analytical cyclopaedia of practical medicine . f the fracture is oblique theouter fragment slips below and behindthe inner one, whose edge is prominentunder the skin. Transverse fracturemay give rise to angular deformity, theangle pointing upward and the fracture is comminuted the smallfragments are markedly displaced; if itis bilateral the weight of the two shoul-ders on the chest may cause urgentdyspnoea (relieved by dorsal decubitus).Injuries to the great vessels, nerves, andlungs are rare complications. The armcan be moved forward or backward, butcannot be abducted o
Annual and analytical cyclopaedia of practical medicine . f the fracture is oblique theouter fragment slips below and behindthe inner one, whose edge is prominentunder the skin. Transverse fracturemay give rise to angular deformity, theangle pointing upward and the fracture is comminuted the smallfragments are markedly displaced; if itis bilateral the weight of the two shoul-ders on the chest may cause urgentdyspnoea (relieved by dorsal decubitus).Injuries to the great vessels, nerves, andlungs are rare complications. The armcan be moved forward or backward, butcannot be abducted on account of thepain rather than the musclar disability. In fractures of the outer third the lineof fracture is usually transverse and thedisplacement angular, with the apexbackward. Disability and deformity arenot srreat. FRACTURE OF THE CLAVICLE. 295 In fracture of the inner third theouter fragment passes below the innerone or is aceomi)anie(l by it, producingangular deformity. Prognosis.—Union is almost certainto take place at the end of four weeks. Fig. 3.—Sayres adhesive-plaster dressing forfracture of clavicle. First piece. ii^tinison.) whether the fracture is immobilized ornot. Some persistent displacement isthe rule, especially in adults. Treatment.—Reduction is effectedby pushing the shoulder upward, out-ward, and backward. Manipulation ofthe arm or simple dorsal decubitus willeffect this. To maintain perfect reduc-tion dorsal decubitus with the headslightly raised and the forearm restingacross the chest is usually essential. Inthe green-stick fractures of children asimple sling may be sufficient, and thesame dressing may be applied to all pa-tients who are impatient of restraint inthe more complicated dressings and arewilling to accept the subsequent de-formity. In other cases Sayres or Yelpeaus dressings will produce an aestheticallysatisfactory result. Sayres dressing (Figs. 3 and 4) re-quires two strips of adhesive plaster,each three inches broad and long eno
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