. I principi e la pratica della chirurgia moderna. disagio risultati e se la pelle solo essere molto muchdistended, può essere forato. Ma se l'aria si accumula nella pleura * Vedere un paper interessante onFractiu-e delle nervature, byM. Malgaigne, in Arch. Gen. deMed., 1838, citato in Forbes, Rev., vol. vii., p. 554. Le fratture del bacino. 239 e comprime il polmone, che sarà conosciuto dal grande dispnea e ahollow suono su percussioni, e se il respiro non è alleviato byfree esaurimento, un'apertura deve essere fatta nel petto per lasciare che il airescape.-vedere il capitolo sulle lesioni del

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. The principles and practice of modern surgery. inconvenience results, and if the skin merely be very muchdistended, it may be punctured. But if the air accumulates in the pleura * See an interesting paper onFractiu-e of the Ribs, byM. Malgaigne, in the Arch. Gen. deMed., 1838, quoted in Forbes, Rev., vol. vii., p. 554. FRACTURES OF THE PELVIS. 239 and compresses the lung, which will be known by great dyspnoea and ahollow sound on percussion, —and if the breathing is not relieved byfree depletion, an aperture must be made into the chest to let the airescape.—See the chapter on the Injuries of the Chest. IX. Fracture of the Sternum. Symptoins.—Crepitus may be feltduring inspiration or other movements of the trunk, and displacement(if any) can be detected by examination. Treatment.—The same as for fractured ribs. X. Fractures of the Pelvis can be caused only by most tremendousviolence, and are often attended with some fatal complication;—such aslaceration of the bladder or rectum, or of the great arteries or veins. Fig. 36.*. Treatment.—The only thing to be done is, to place the patient at per-fect rest, and in as easy a position as possible;—to keep a catheter inthe bladder; to make incisions if urine is extravasated into the perineum, as it will be if the urethra is lacerated by fractured portions of the ramiof the ischium and pubes, and to treat any symptoms that may arise. Ifit can be borne, a broad belt may be passed round the pelvis; and an-other under the natesj which might be attached to a pulley over the bed, so that the patient may raise the pelvis, without exerting any of the mus-cles attached to it. There are some cases of fracture of the os innominatum, passingthrough the acetabulum, and caused by falls on the hip, which might bemistaken for fracture of the cervix femoris. For instance, in somecases related by Mr. Earle, t the foot was everted, and there was loss ofprominence of the trochanter; but there was no shortening, and the limb * [This

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• bookcentury1800
• booksubjectgeneralsurgery
• booksubjectsurgery