238 OPERATIONS ON BONES. 



of the whole body as much as j)ossible, and especially of the sus- 

 pected region, by placing the patient in slings, in a stall sufficiently 

 narrow to preclude lateral motion, and covering the loins with a 

 thick coat of agglutinative mixtui-e, and wait for developments. 



Fracture of the Ribs. — The different regions of the chest are 

 not equally exjDOsed to the violence to which fractm-es of the ribs 

 are due, and they are therefore either more common or more easily 

 discovered during life at some points than at others. The more 

 exposed regions are the middle and the posterior, while the front 

 is largely covered and defended by the shoulder. A single rib 

 may be the seat of fracture, or a number may be involved, and 

 there may be injuries on both sides of the chest at the same time. 

 It may take place lengthwise, in any part of the bone, though the 

 middle, being the most exposed, is the most frequently hiu-t. In- 

 complete fractures are usually lengthwise, involving a portion only 

 of the thickness, or one or other of the surfaces. The complete 

 kind may be either transverse or obhque, and are most commonly 



, Fig. 263.— United Transversal and Longitudinal Fractures of the Ribs. 



denticulated. The fracture may be comminuted, and a single 

 bone may show one of the complete and one of the incomplete 

 kind at different points. The extent of sm'face presented by the 

 thoracic region, with its complete exposure at all points, explains 

 the liabihty of the ribs to suffer from all forms of external vio- 

 lence. 



In many instances fractures of these bones continue undiscov- 

 ered, especially the incomplete variety, without displacement, 

 though the evidences of local pain, a certain amount of swelling 

 and a degree of distm-bance of the respiration, if noticed during 

 the examination of a jDatient, may suggest a suspicion of their ex- 

 istence. Abnormal mobility and crepitation are difficult of de- 

 tection, even when present, and they are not always present. 



