The Röntgen rays in medical work (1899) (14733928156)

Identifier: rntgenraysinmedi00wals (find matches)

Title: The Röntgen rays in medical work

Year: 1899 (1890s)

Authors: Walsh, David

Subjects: X-rays Radiography X-Rays Radiography

Publisher: London : Baillière, Tindall and Cox

Contributing Library: Francis A. Countway Library of Medicine

Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

Text Appearing Before Image:

be stated thatthe first picture, showing the unbroken bone, was the result ofan exposure taken for purposes of diagnosis in a stiff knee. Inter-articular adhesions were clearly demonstrated (by exclusion) tobe the cause. Forcible flexion led to the subsequent fracture ofthe knee-pan. The resemblances and the contrast between thesetwo cases are not a little suggestive and striking. In fractures of the leg, when either the tibia or the fibula isalone broken, the diagnosis, as every practical surgeon knows, isoften extremely difficult. Indeed, if there be much swelling, itis in many instances impossible to determine whether the injuryis a fracture or merely a sprain. Any such doubt, however, couldbe speedily cleared away by the rays. The most conservative ofsurgeons will hardly deny that the ability to settle such a pointmust constitute a solid advance in practice. When both bones of the leg are broken, the diagnosis is usuallyso clear as to need no confirmation. Nevertheless, the method

Text Appearing After Image:

Fig. 62.—Kape Spipal Fpactupe of Tibia.Dr. Tafts case. MEDICAL AND SURGICAL APPLICATIONS 143 may be of use in determining whether the degree of obliquity ofthe fracture or the amount of displacement of the fragmentswould call for immediate screwing of the bones. A rare spiral fracture of the tibia was discovered under therays by Dr. Taft,* and by the kindness of that gentleman is re-produced in Fig. 62. It is instructive to learn that the sensitiveplate yielded a clear and unmistakable record of the fracture,which, nevertheless, could not be seen by the aid of Edisonsfluoroscopy Dr. Taft accounted for this failure by the difficultyof getting the screen sufficiently near the bone on account of thesplints and pads, as well as the swelling of adjacent parts. Asecond record, taken from the side, showed that the fracture ranup the tibia in a spiral fashion for a further distance about equalto that shown in the figure. Another unusual fracture of tibia was reported by Mr. Hatch,of Johanne

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1899

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