Chronic Traumatic Osteomyelitis; Its Pathology and Treatment

Purchase of this book includes free trial access to www.million-books.com where you can read more than a million books for free. This is an OCR edition with typos. Excerpt from book: CHAPTER III THE PATHOLOGY OF COMPOUND FRACTURES AND OF CHRONIC TRAUMATIC OSTEOMYELITIS The following anatomical types of compound fractures represent not only such various pathological conditions, but also such different therapeutic problems as to justify their separate description and consideration: textit{A. Compound fractures in which infection is absent from the beginning or else fails to develop. textit{B. Infected fractures that develop into cases of osteomyelitis. (1) Complete fractures of the shafts of long bones with or without displacement, with or without comminution. (2) Incomplete fractures. textit{(a) Of the shaft of long bones in which the whole circumference of the compact cylinder is not fractured through, and in which the infection does or does not gain access to the medullary canal. textit{(b) Of short bones and of epiphyses, in which the infection gains access to a mass of cancellous tissue. textit{(c) Of flat bones, in which a layer of cancellous tissue lies enclosed between two plates of compact bone. textit{C. Infected articular fractures that become cases of septic arthritis as well as cases of osteomyelitis. textit{A. Compound Fractures In Which Infection is Either Absent From The Beginning Or Else Fails To Develop. Pathologically such cases among gunshot fractures may be divided into three classes: (1) Cases of compound fractures, complete or incom plete, with more or less comminution, with or without retention of the projectile, but with complete absence of all signs of infection. In the great majority of these the projectile is a rifle or machine-gun bullet, less often a shrapnel ball. Practically all cases of fracture due to shell or bomb fragments suppurate unless a radical operation has been p...