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August 4, 1906

The Operative Treatment of Fractures.

JAMA. 1906;XLVII(5):377. doi:10.1001/jama.1906.02520050061018

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This book is a statement of and argument for the author's well-known advocacy of operative accurate adjustment and retention of bone fragments. First are considered the changes in the skeleton produced by unusual function, as the habitual carrying of heavy loads. The skeleton is subject likewise to vicious structural change as the result of abnormal transmission of weight due to malunited fractures. Particularly the joints, whether or not near the fracture, may thus suffer. The individual fractures are then taken up. At the end the operative technic is described. Screws, silver wire or staples and silver plates are used; "generally speaking, the screw is by far the most efficient and most powerful means by which the fragments can be retained immovable on one another." These are removed later. The need for the most exacting asepsis is emphasized; only the unhandled ends of long instruments are allowed in the wound. Age

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