. Modern surgery, general and operative. ure is one in which one fragment is driven into the other andsolidly wedged (Figs. 304, 305, and 306). 590 Diseases and Injuries of the Bones and Joints Fracture with crushing or penetration is a fracture in which one fragment isdriven into the other, the encasing bone being so splintered that the impactingbone is not firmly held. Pathological, spontaneous, or secondary fracture is one occurring from a veryinsignificant force acting on a bone rendered brittle by disease. Ununited fracture is a fracture in which bony union is absent long after thepassage
. Modern surgery, general and operative. ure is one in which one fragment is driven into the other andsolidly wedged (Figs. 304, 305, and 306). 590 Diseases and Injuries of the Bones and Joints Fracture with crushing or penetration is a fracture in which one fragment isdriven into the other, the encasing bone being so splintered that the impactingbone is not firmly held. Pathological, spontaneous, or secondary fracture is one occurring from a veryinsignificant force acting on a bone rendered brittle by disease. Ununited fracture is a fracture in which bony union is absent long after thepassage of the period normally necessary for its occurrence. Direct fracture is one occurring at the point at which the force was primarilyapplied. Indirect fracture is one occurring at a point distant from the area of primaryapplication of force. Stellate or starred fracture (fracture par irradiation) is one in which severalfissures radiate from a center. If the fracture be complete, the condition is,in reality, a form of comminuted Fig. 306.—Impacted fracture of neck of femur (Conner). Helicoid, spiral, or torsion fracture is a fracture resulting in a long bone fromtwisting. Fracture by contrecoup is a fracture of the skull which is on the oppositeside of the head to that which was the recipient of the force. Epiphyseal Separation or Diastasis.—This injury occurs only before the ageof twenty-five. In order of frequency, the bones chiefly subject to epiphysealseparation are: the upper end of the humerus, the lower end of the radius, thelower end of the femur, and the lower end of the tibia (John Poland, in thePractitioner, Sept., 1901). This injury induces deformity, which is oftendifficult to reduce, and by damaging the cartilage may retard or inhibit a fur-ther lengthening of the limb by growth. Occasionally, after damage to anepiphysis suppuration will occur; sometimes thickening takes place. Non-union is very rare/ After a sprain of an epiphysis tuberculous disease
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