FREE BOOKS

Author's List




PREV.   NEXT  
|<   410   411   412   413   414   415   416   417   418   419   420   421   422   423   424   425   426   427   >>  
e. The aperture of entry was cleansed by Major Harris, R.A.M.C., who determined the fact that penetration of the peritoneal cavity had occurred, and removed the fuse (see fig. 94) by a separate incision. The patient made an uneventful and uninterrupted recovery, the wound healing by granulation and leaving little weakness of the abdominal wall. He returned to England at the end of five weeks. In a second case the fuse, together with a fragment of the iron case, entered the buttock by a ragged opening. The fragment of iron escaped by an exit aperture of about the same size. When the patient arrived at the Base some days after the injury, a hard body was felt in the wound, and on exploration the fuse was found and removed. In a third case the fuse struck the side of the foot below the outer malleolus and comminuted the astragalus, and then passing forwards lodged beneath the extensor tendons of the toes. The wound was explored at the time of the injury and some fragments of bone removed; considerable cellulitis supervened, and the fuse was only discovered some days later when the patient came under the care of Sir W. Thomson in the Irish Hospital in Pretoria. It was there removed, together with some more fragments of bone, and the wound slowly granulated. The patient then returned to England, when the wound rapidly healed after the removal of some further necrosed fragments of cancellous tissue. The astragalus had been reduced to a mere shell of compact tissue, and the convexity of the articular surface was altogether lost. The deformity, together with the formation of adhesions in the ankle-joint, led to the development of a firm anchylosis. [Illustration: FIG. 94.--Pom-pom Percussion Fuse, exact size] My friend Mr. Abbott removed a similar fuse from the substance of the lung after the lapse of nine months, the patient having developed an empyema, and a chronic fistula, which rapidly closed after the removal of the foreign body. [Illustration: PLATE XXV OBLIQUE FRACTURE OF THE HUMERUS CAUSED BY A FRAGMENT OF A VICKERS-MAXIM OR POM-POM SHELL The entire absence of comminution is very striking] I will add one further case, that illustrated by plate XXV. In this a fragment of a pom-pom shell entered the outer aspect of the right shoulder to escape on the inner aspect of the arm, just below the confines of the axilla. An oblique, non-comminuted fracture of the humerus resulted,
PREV.   NEXT  
|<   410   411   412   413   414   415   416   417   418   419   420   421   422   423   424   425   426   427   >>  



Top keywords:
removed
 

patient

 

fragments

 

fragment

 

Illustration

 

returned

 

England

 
rapidly
 

removal

 
comminuted

entered

 

astragalus

 

tissue

 

aspect

 

injury

 
aperture
 

substance

 
similar
 

Abbott

 

deformity


formation

 
adhesions
 

altogether

 

surface

 

compact

 

convexity

 

articular

 
Percussion
 

months

 

development


anchylosis
 

friend

 
shoulder
 

illustrated

 

striking

 

escape

 

fracture

 

humerus

 

resulted

 

oblique


confines

 

axilla

 

foreign

 
OBLIQUE
 
FRACTURE
 

closed

 
developed
 

empyema

 

chronic

 

fistula