The American journal of roentgenology, radium therapy and nuclear medicine (1906) (14757963602)

Identifier: americanjournroen05ameruoft (find matches)
Title: The American journal of roentgenology, radium therapy and nuclear medicine
Year: 1906 (1900s)
Authors: American Radium Society American Roentgen Ray Society
Subjects: Radiotherapy X-rays
Publisher: Springfield, Ill. C.C. Thomas
Contributing Library: Gerstein - University of Toronto
Digitizing Sponsor: University of Toronto



Text Appearing Before Image:
dsof the femur are particularly hard tohandle. The method of treatment which the pull of strong muscles or you will bedisappointed. Rather take as much strainfrom the screws as possible by placing theleg in a position to minimize the strain.Fractures of the femur just above thecondyles are subject to displacement bythe pull of the gastrocnemius, and thefractured end of the lower fragment isusually found in the popliteal space. Inan early series of fourteen cases not onewas reduced without an open operation.While many of them were plated, I donot think it necessary. In the adult, it isoften impossible to reduce this fracturewithout some form of traction apparatusor by operation, prying the displaced lowerfragment into place with a chisel or othersuitable instrument. The tendency then isto plate to maintain reduction, and the legis put up in plaster in extension or atbest with some form of knee splint thatallows only moderate flexion. This I thinkis absolutely contraindicated. It puts a
Text Appearing After Image:
Fig. 15. ■I ^ , , 1 J .- ■ • 1 Showing proper angle for insertion of screw in Dest prevents angular deformities must be mechanically fastening a fracture of the neck of the used, and bone plating mav be necessary, femur. In this position the weight of the body will -r>w^ .I , , t not be borne bv the screw but bv the bone, the screw UO not aepend upon the plate to oppose preventing the fracture ends fromsliding on each other. Functional Disability Following Fractures 465 severe strain upon the screws used to fastenthe plate. This strain should always beavoided, as far as possible, after platingoperations. The logical way to treat thesefractures would seem to be that used with In fractures of the lower leg the mostimportant consideration is to preserve theproper axis for weight-bearing and to pre-vent a lateral tilting of the ankle. I alwaysmake an anteroposterior plate of the ankle