The Penn's Grove record., 1894-03-30
BROKEN BONES.
Acres HOW THE UNFoRru.
NATE MAY MEND THEM.
Che Different Varieties of Fractures
and the Signs and symptoms by
Which They Are Recognized
Methods OF Treatment.

M sist SO frequently in the fracture
of some bone, that it may be
interesting to give some general infor-
nation about the way in which a frac
ture is produced, the varieties it is cap.
liable of presenting, the signs wheNby il
may be recognized, the treatment most
suitable for it and peculiarities concern.
lug the consolidation Of a bone.
Every sudden and violent solution Of
continuity In a bone constitutes a fracl
ture, which Is always the result of tho
action Of some force that is greater than
the resistance the bony tissue is capable
Of opposing to it. The power brought
10 bear on a bone may, Of course, be in.
definitely great, and the strength with
/ which the latter resists may also be below
the normal; we may thus have a fracture
caused by a fall of rock in a quarry, or,
to 60 to the other extreme, by a simpld
movement in bed. In the former case
the destructive agent is infinitely above
the normal resistance OF the bone, where
IS in the latter the mildest muscular con
traction is enough to break a bone that
q extremely brittle, as can be observed
u certain diseases.
A whole series of constitutional trou
bles exist. such as rachitis, or osteomal-
acia, in which the different portions Of
the skeleton are lacking in salts of lime
and are honeycombed with numerous
cavities which make them more especial
" B%redisposed to accidents of this nature.
According to whether a bone is broken
INTO two Independent portions or whether
the fracture is only a partial one, we
have the terms complete or incomplete
| fracture; and, liz addition, there is tho
, class Of fractures in which the bone is
crushed. When a fracture takes place
without any harm being done to the
skin, it is known as a simple one; but
| when the tissues which cover the broken
lone arc divided, either from the outside
10 the inside by the object which gives
the blow, or from the inside to the out
side by enc of the fragments of the bone,
| the fracture is called compound, and is
in direct communication with the open
air.
Finally, a fracture is called direct
when it is produced at the very point
at which the force is brought to bear,
and indirect when it occurs at some Other
point.
The surface of the broken bone i.
transverse, oblique, deutelated or com
minuted. In the first case the bone i.
cut OF in y clean section perpendicularly
| to its axis, in the second the direction oil
the solution OF continuity is such that il
forms a more or less acute anglo with the
axis OF the bone, in the third irregular
points are found fitting into each othei
on the two pieces of bone, aud in the
fourth the long fragments are numerou'
and OF unequal size.
Various kinds of signs enable us t.
detect the existence of a fracture. These
signs are termed rational, or tangible.
The first class comprises the noise pro-
duced by the swapping of the bone, pain
and loss of power over the limb; the
latter, ecchymosis, reformation of the
part, abnormal mobility and grating Of
the bone.
The rational signs of which the patient
Is conscious are the direct and immedi-
ate result Of the fracture. After the
sound that sometimes accompanies the
fracture Of a bone, but which may not
be perceived on account of the
rapidity with which the accident
takes place, a very acute pain is felt ex-
,ctly limited to the seat OF the fracture,
increased by the slightest movement,
but disappearing almost entirely with
rest. Lastly, there Is loss of power to
move thu damaged limb, owing to the
break in the lever to which the muscles
are fastened.
The tangible signs are those whicd
the surgeon himself eau perceive. Toe
confusion of the soft tissues about the
fracture give rise to, an ecchymosis. The
separation of the fragments often de-
forms a limb in such a character 5tic
manner as to allow the diagnosis of the
fracture to be made from a distance.
All Of the signs that have just been al
iuded to are not found 10 every case OF
fracture and are not equally characteris-
tic, whereas the noise which the bone
makes in breaking, the pain, the i'm
pul0nCS VA thC lHmV aAA thO ONShJhSSH
are signs of probability. the loss OF
shape, abnormal mobility and grating
found are positive signs Of, fracture, but
it must never be forgottenItha they may
Ill be lacking, or else that those which
exist maj be so doubtful that it is i'm
possible to say absolutely whether there
10 FRACTURE. or not.
! When q fracture has been produced
me first thing to be done ia to prevent
aiSt movement Of the fragments from the
t,uie. the accident occurs untiiths injured
petson ais definitely laid in bed. Tbs
region should then be placediin an APP
psrstns q soon as the fragments have
been brought back to their proper posi-
ton. This is accomplished BY bringing
traction to bear on the two eStremitiss
az tie bone until II haslis ptopetjsngthi
ana. Until II has heshl TSplaqadinths de