The treatment of fractures . of the second portion of the sternum, near the junc-tion of the first and second portions. The upper fragment isdisplaced backward behind the upper end of the lower fragment(see Fig. 104). The displacement, the abnormal mobility, andpossibly crepitus after each respiratory act or upon coughing, 96 TREATMENT OF KRACTUKK OK THE STERNUM 97 the localized area of pain, all increased by pressure, help to makethe diagnosis certain. The patient stands in a characteristic fashion with body bentforward. It is almost impossible to distinguish a dislocation atthe junction of t
The treatment of fractures . of the second portion of the sternum, near the junc-tion of the first and second portions. The upper fragment isdisplaced backward behind the upper end of the lower fragment(see Fig. 104). The displacement, the abnormal mobility, andpossibly crepitus after each respiratory act or upon coughing, 96 TREATMENT OF KRACTUKK OK THE STERNUM 97 the localized area of pain, all increased by pressure, help to makethe diagnosis certain. The patient stands in a characteristic fashion with body bentforward. It is almost impossible to distinguish a dislocation atthe junction of the first and second portions of the sternum froma fracture within the first portion of the sternum. Careful palpa-tion alone and consideration for the age of the patient will enableone to decide. The ossification of the sternum takes placeirregularly. At the twenty-fifth year all parts are usually ossi-fied. The lesions sometimes associated with fracture of thesternum—viz., fracture of the ribs and injury to the lungs and. Fig. 105.—Position in, and method of reduction of, fracture of the sternum. Notice positionsof hands of surgeon and assistant. heart—are usually so severe that the patient does not recoverfrom them. If no complicating lesions are present, the outlookfor recovery is favorable. Treatment of Fracture of the Sternum.—Spontaneous reduc-tion has occurred in several instances upon coughing or the patient is placed upon his back with his head extended overthe end of the table and the arms are then raised above the headand rotated outward slowly and forcibly, the deformity is some-times reduced. The body of the patient, meanwhile, is steadiedby an assistant. Traction and countertraction are thus made uponthe two fragments (see Fig. 105). An adhesive-plaster swatheshould be placed about the chest high up, and held firmly in 9«S FRACTURES OF THE STERNUM position by straps across the shoulders. Union takes place infrom three to four weeks. The fractu
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Keywords: ., bookcentury1900, bookdecade1900, booksubjectfractur, bookyear1901
