Interstate medical journal (1909) (14783493742)

Identifier: interstatemedica1619unse (find matches)

Title: Interstate medical journal

Year: 1909 (1900s)

Authors:

Subjects: Medicine

Publisher: St. Louis, : Interstate Medical Journal

Contributing Library: The College of Physicians of Philadelphia Historical Medical Library

Digitizing Sponsor: The College of Physicians of Philadelphia and the National Endowment for the Humanities

Text Appearing Before Image:

om the familiarColles fracture and put them in a class by themselves. 24 INTERSTATE MEDICAL JOURNAL The automobile fracture is produced by indirect trauma to the lowerend of the forearm, and because of the position assumed in cranking, thetrauma is always expended upon the outer side of the arm, namely uponthe radius. The right arm is always involved, unless the patient be lefthanded. There is practically no separation of fragments on this type of frac-ture and as a result there is practically no deformity. This close appo-sition of fragments, together with the fact that crepitus is very difficultor impossible to elicit, makes it more than probable that the automobilefracture is a subperiosteal one. When we consider the nature of theforce producing this fracture it is readily conceivable that the resultingcrack might very well be subperiosteal. There is but one clinical sign of this fracture, namely point tender-ness above the radial stylus. The swelling is slight and discoloration is

Text Appearing After Image:

FIG. 2. Outline sketch made from Fig. 1. absent. There is no deformity, and crepitus is often impossible to ob-tain, while the disturbance to the functions of the wrist may be surpris-ingly slight. Comparing the automobile fracture with Colles fracture, we find thefollowing points of difference: Colles fracture usually follows a fallupon the extended hand; it is not subperiosteal; it is accompanied bymuch deformity and crepitus can (except in the impacted varieties) beeasily obtained, while loss of function of the wrist is usually complete.Furthermore, in Colles fracture the x-ray usually shows the line of breakto be more or less transverse across the lower end of the radius, withbackivard displacement of the lower fragment, and very frequently a con-comitant tearing off of the ulnar stylus. LANGE: AUTOMOBILE FRACTURES 25 By exercising care in cranking, this accident may be avoided. Theobject of the cranking is to compress the gasoline in the cylinder pre-paratory to its ignition. The

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1909

The College of Physicians of Philadelphia and the National Endowment for the Humanities

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