We report a case of avulsion fracture of the calcaneus in an 83-year-old woman. Nonoperative treatment was not considered satisfactory. However, the os calcis was osteoporotic, and internal fixation therefore was performed with a transverse Kirschner pin through the os calcis, securing a figure-of-8 metal tension band wiring to the fragment. We suggest that this technique provides a strong internal fixation in selected cases.
A consideration of tho effects of the rifles of reduced calibro is properly divided into (1) the theoretical, (2) the experimental, and (.'i) the observations in war.(1) Theoretical. -The theoretical considerations deal with the advantages claimed by Hehler and they relate to certain ballistic values which have been generally admitted, and to humane effects.(2) Experimental. -To an audience composed of distinguished military surgeons, many of whom have been among the foremost experimenters to determine the difference in destructive effects between the rules of large calibre and lower velocities ¡is compared with those of reduced calibre and high velocities, it, is needLess to dwell upon the conclusions that are based upon this experimental evidence. Suffice it to say that these conclusions were generally unanimous, and that they sustained the advantages claimed by Hehler to a marked degree, especially as to humane effects.(3) Observations in war. -The effects of reducedcalibre weapons in war now are becoming thoroughly understood, so that the material already accumulated, when properly worked out, will give us a definite idea of the real value of the new arm asa military weapon. I come before you in this instance to add some observations upon the effects of the 7-millimetre Mauser rille among 1,400 wounded in the SpanishAmerican War, a consideration of which may be discussed ¡is follows :(1) Shock.Shock on impact, ¡is you know, increases with the velocity and sectional area of the projectile. If you will remember the experimental evidence showed that, the shock from the reducedcalibre bullet, was always hiss than that of the larger calibre leaden bullet. Many surgeons have entertained the opinion that the small jacketed bullet would not, possess suHicieut, stopping power to arrest n man when hit, and that this would be a strong argument against its use in war. Upon inquiry among the line officers in the Santiago campaign I lind that as a rule, to which there wore but exceptions, men when hit fell hack at once. The universal impression therefore was that the Mauser possessed sufficient stopping power for the purposes of war.(2) Explosive e.ffects. -The terrilie explosive effects so universally observed by the experimenters with the reduced-calibre bullets on animate and inanimate objects were seldom witnessed in the campaign. This seemed to he a contradiction of the established notion of the experimenters who had witnessed explosive effects by the new bullet, upon impact with resistant structures up to a distance of 400 metres. If one slops to consider the nature of the terrain over which the various engagements were fought, the infreqiiency of explosive effects will not be so strange. The ground was broken, rocky and covered with trees and thick grass. It is fair to presume that the remaining velocity of the Mauser bullet was often very much reduced. This was substantiated by the large percentage of lodged balls, in 10% of all wounded; and to their deformed appearance, showing evidence of ricochet,. In an open He...
The fact that the accessory gland is sometimes found at so great a distance from the main gland can be ex¬ plained by assuming that the uranlagen become sep¬ arated very early, and one, or two, of them are carried away by the intestine as it increases in length (Glinski). SLIGHT CLINICAL INTEREST.
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