FREE BOOKS

Author's List




PREV.   NEXT  
|<   140   141   142   143   144   145   146   147   148   149   150   151   152   153   154   155   156   157   158   159   160   161   162   163   164  
165   166   167   168   169   170   171   172   173   174   175   176   177   178   179   180   181   182   183   184   185   186   187   188   189   >>   >|  
nge unknown, probably either mean or long. The bullet entered from the front, grooved the under surface of the acromial end of the clavicle with increasing depth, and eventually perforated the posterior margin of the bone, raising the compact tissue in an angular manner. The commencement of an incomplete groove extending from the anterior margin is seen, resembling the groove of the humerus, fig. 58.] 1. _Stellate comminuted fractures._--A shows the primary nature of the lesion in all comminuted fractures of compact bone, consisting in the production of a number of radiating fissures, which assume a stellate form of which the point of impact corresponds to the centre. B shows an incomplete development of this form, the fragments being simply displaced laterally with slight loss of substance, so as to simulate a real punctured fracture. An illustration of this fracture produced by a bullet travelling at a low degree of velocity is seen in plate XXIII., which also shows the unaltered bullet lying in close proximity to the injured fibula. The degree of comminution in these fractures depends first on the range of fire and consequent striking force retained by the bullet, a high degree of velocity producing extreme comminution of compact bone. The severity of the latter again may be influenced by the measure of resistance dependent on the density and brittleness of any individual bone, or on the possession of the same characters as a special property by the tissues of the man struck. Thus plate IV. shows a fracture of the humerus produced by a bullet shot from a short range, and the fragments are comparatively large and of even dimensions, while plate XIV. shows extreme comminution of the portion of the femur exposed to direct impact, with elongated large fragments at the sides of the track. Plate XIX. shows less extreme comminution and less separation of the fragments, and was probably produced by a bullet from a longer range of fire. The separation of elongated lateral fragments is a special feature, and best marked when the portion of bone struck is considerably wider than the bullet, as in the case of the shaft of the femur. These fragments correspond in the method of their production to those seen in the wedge fractures described below, while their separation leaves a pointed extremity to either segment of the shaft. This fracture in its purest type is, I believe, spoken of as the 'butterfly fracture.' With
PREV.   NEXT  
|<   140   141   142   143   144   145   146   147   148   149   150   151   152   153   154   155   156   157   158   159   160   161   162   163   164  
165   166   167   168   169   170   171   172   173   174   175   176   177   178   179   180   181   182   183   184   185   186   187   188   189   >>   >|  



Top keywords:

bullet

 

fragments

 

fracture

 
fractures
 

comminution

 

extreme

 

produced

 
separation
 

degree

 

compact


production

 

impact

 
special
 

struck

 

comminuted

 
portion
 

elongated

 

velocity

 

incomplete

 

margin


groove
 

humerus

 
comparatively
 

dimensions

 

entered

 

direct

 

butterfly

 

exposed

 
dependent
 

density


brittleness
 

resistance

 

measure

 

influenced

 
individual
 

property

 

tissues

 

characters

 
possession
 

grooved


correspond

 

method

 

leaves

 

purest

 
segment
 

pointed

 

extremity

 

unknown

 
longer
 

lateral