Identifier: treatmentoffract1901scud (find matches)
Title: The treatment of fractures
Year: 1901 (1900s)
Authors: Scudder, Charles L. (Charles Locke), b. 1860 Cotton, Frederic Jay, 1869-1938, joint author
Subjects: Fractures
Publisher: Philadelphia : W. B. Saunders
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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ture across pubes and ischium ; on the left, frac-ture involving acetabulum and sacrosciatic notch (Warren Museum, specimen 3857). there may be lesions of important viscera. These visceral lesionsrender fractures of the pelvis of the very greatest seriousness.The trauma causing the fracture may at the same time occasiona rupture of the kidney. The bladder, urethra, or bowel may ;i1m. be ruptured. The shock associated with a fracture of the RUPTURE OF THE URETHRA 103 pelvis is great. \( there is a visceral lesion, the primary andsecondary shock will be very great. Rupture of the Urethra.—This is sometimes associated withfracture of the pelvis (see Fig. 112). It may be clue to theoriginal trauma, as a fall or blow on the perineum, or it may becaused by bony fragments lacerating the urethra, or by a simple-separation of the symphysis pubis. Pain at the seat of the lesion,pain upon pressure in the perineum, retention of urine, urethral Bladder. Sacrum. — Rectum. —; Symphy-sis pubis.
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* Frethra. Fig. 112.—Median section of male pelvis. Notice close relation of bladder and urethra to the symphysis pubis. Fracture of pubic bone may injure bladder or urethra (frozen sectionby Professor Trios. Dvvight). hemorrhage, swelling in the perineum, usually exist. Under thesecircumstances perineal section is indicated in order to drain thewounded area and the bladder. If a catheter can be passed to the bladder and the local swelling does not increase, permanentor interrupted catheterization is indicated. The patient should,however, be watched carefully for the signs of extravasation ofurine. If at any time the catheter can not be passed, operationshould be done at once, as in the first instance. 104 FRACTURES OF THE PELVIS Rupture of the Urinary Bladder.—This may be either extra- or intraperitoneal. When the bladder is empty, it is low downin the pelvis and can be injured only by a fracture of the pelvis.The rupture of the bladder due to fracture of the pelvis is usuallyextra

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