Surgery, with Special Reference to PodiatryStern, Maximilian
Science
Surgery, with Special Reference to Podiatry
Stern, Maximilian
Foot -- Surgery; Surgery
+Degree of Fracture.+ A fracture which only involves a portion of the
thickness of the bones, so that its continuity has not been entirely
lost or a fragment has not been completely detached, is called an
_incomplete fracture_. A fracture which involves the entire thickness
of the bone, so that it is divided into two or more distinct
fragments, is called a _complete fracture_.
+INCOMPLETE FRACTURES+
Among the varieties of incomplete fracture are: greenstick; fissured;
depressed.
+Greenstick Fractures+ (really a bending rather than a break of the
bone) are mostly seen under the age of fifteen, and the bones of the
leg are rarely affected.
+Fissured Fractures+ are those in which there is a split or crack in the
bones; they are very rare in the bones of the lower extremity.
+Depressed Fractures+ are fractures in which one or more segments of
broken bone are depressed; they are most common in fractures of the
skull.
+COMPLETE FRACTURES+
+Complete Fractures+ are divided according to the line and the seat of
the breech of bone continuity.
DIRECTIONS OF THE LINES OF FRACTURES
+Transverse+, when the line of fracture does not deviate more than ten
to fifteen degrees from that of the transverse axis. This variety is
rare in the shaft of the long bones. It is usually found at the lower
end of the radius or of the femur, and in the short bones.
+Longitudinal+, when the break is parallel to the long diameter of the
bone; very few cases of this variety are seen.
+Oblique+, when the direction of the line of fracture may form any angle
with the transverse axis of the bone up to a right angle. When it
approaches the latter, it belongs to the group of longitudinal
fractures. In the oblique variety, the line of fracture may be single
or multiple. This and the spiral form are most frequent in the shafts
of the long bones.
+Spiral+, when the break line is spiral. This variety of fracture was
formerly considered to be very rare. The more systematic use of the
X-ray as part of the routine of diagnosis has shown that spiral
fractures are quite frequent in the shafts of the tibia and fibula.
They are usually the result of a rotating or twisting force.
CLASSIFICATION OF FRACTURES
+Comminuted+, when there is extensive splintering of the bone adjoining
the fracture or one of the fragments.
+Impacted+, when the fragments are driven into each other. This variety
usually occurs in the neck of the femur.
+Compression, or Crushing Fractures+, when the broken bones are
compressed or crushed; this variety usually occurs in the tarsal
bones. The spongy portion and cortical layer are both crushed. In some
cases there is a perfect pulpification of these bones. This condition
occurs after falls from a height upon the sole of the foot.
LOCATION OF FRACTURE
+In the Diaphysis of a Bone.+ Breaks in the diaphysis of a bone are
spoken of as fractures of the _shaft_, and to be still more exact, it
is stated whether of the upper, middle, or lower third.
Public-domain text, read in full here on John Shaqi.
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