American practice of surgery : a complete system of the science and art of surgery . in some kind of immobilizing apparatus. Unusual pain should al-ways demand a careful investigation, and, if there be any doubt with referenceto the nature of the injury, the foot should be treated as if a fracture did is in some cases a broadening of the heel with discoloration, and thegrooves on either side of the tendo Achillis are often obliterated. Fractures of the Astragalus. Fractures of the astragalus are commonly the outcome of falls from aheight and striking squarely on the feet. Under the
American practice of surgery : a complete system of the science and art of surgery . in some kind of immobilizing apparatus. Unusual pain should al-ways demand a careful investigation, and, if there be any doubt with referenceto the nature of the injury, the foot should be treated as if a fracture did is in some cases a broadening of the heel with discoloration, and thegrooves on either side of the tendo Achillis are often obliterated. Fractures of the Astragalus. Fractures of the astragalus are commonly the outcome of falls from aheight and striking squarely on the feet. Under these conditions the bodyof the bone is broken between the tibia and the os calcis. Fracture of oneor more of the immediately contiguous bones not unfrequently happens at thesame time. There is no established line of fracture and the fragments vary innumber and in their relations with each other. Fracture is frequently producedby a violent flexion of the foot. A fracture of the neck of the bone is oftenattended with a slight fracture of the internal malleolus. There may be little or. Fig. 104.—Fracture of the Calcaneus by Crushing. (Anger.) no displacement, and in some cases there is a backward displacement, the frag-ment sometimes appearing posteriorly between the bones of the leg and thetendo Achillis. The diagnosis of fracture of the astragalus may be determined by the fol-lowing symptoms: A limitation of motion, tenderness on pressure, and inabil-ity to stand or walk upon the foot. There is little or no displacement, andthe condition is oftentimes mistaken for a severe sprain. Persistent swellingwith marked tenderness and some extravasation of blood, and crepitus, should VOL. IIT. —14 210 AMERICAN PRACTICE OF SURGERY. be regarded as sufficient evidence of a fracture. In fracture of the neck ofthe bone, the head, when displaced, may be noted. In all doubtful cases, how-ever, it is well to anaesthetize the patient and thus determine the presence of afalse point of motion and
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Keywords: ., bookauthorbuckalbe, bookcentury1900, bookdecade1900, bookyear1906
