- subperiosteum fracture - on the type of “green twig” (integrity of cortical layer is disintegrated on the one side, and from the opposite side the disentegration are not present), a periosteum is left intact, displacements are not present.
- Impacted fractures - when the fracture line appears how area decreased radiolucent – radiopaque line fracture.
- epiphysiolysis, osteoepyphysiolisis - the line of fracture passes trought area of epiphyseal cartilage. Radiological signs: displacement of epiphyseal centers of ossification in relation to metaphysis. Often epyphysiolisis is combined with the metaphysis fractures - osteoepyphysiolisis.
Specific feature of elderly age fractures.
As a result osteoporosis the fractures can arise at an action of insignificant injuring factors. Thus there often are the multifragmental, and sometimes multiple fractures, delayed union (hypoporosis).
Healing of fracture (see fig 14.6) result from formation of a callus.
Ø The connective tissue callosity - appears in the site of the fracture during 7-10 days after a trauma.
Ø The osteoid callosity is the transition of connecting tissue in osteoid one, with formation of osteoid trabecoules.
Ø A bone callosity is the process of calcification of osteoid tissue, takes from 3-4 weeks to 8 months (depending on the size of bone, features of the fracture and the patient age). In 4-8 months the fracture line disappears, fragments consolidation comes.
Ø Involution of callosity - a callosity resorbs partly, beginning from periphery, the bone structure renewels during 1-2 years.
Fig.14.6 Bone callosity
Complication of fractures: vicious union (malunion), excessive callus, false joint, bone defect, traumatic osteolisis, simple necrosis, traumatic osteomielitis and traumatic myositis ( see fig 14.7).
Dislocations include the following types: congenital and acquired. Among acquired ones selects: traumatic, pathological - in destruction of elements of the joint, distensional - at accumulation of liquid in the bag of a joint, ordinary dislocation.
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From American History
Reader for students of English
Civil War (1860 – 1876)
In the election of 1860 Republicans nominated Abraham Lincoln of Illinois. Lincoln had become known nationally when he staked out the Republican position on slavery in the territories and held his own in a series of public debates in a Senate race with Douglas in 1858. The election results were sectional. Lincoln carried every Northern state and thus won an overwhelming victory in the Electoral College—and he did so without a single electoral vote from a slave state. The Republican Party, with an antislavery platform had elected a president of the United States.
White Southerners fully realized what had happened: National politics now pitted the North against the South, and the North had a solid and growing majority. The South would never again control the federal government or see it controlled by friendly Northerners. Many saw no alternative to seceding from the Union.
Southerners justified secession with what was called the compact theory. This theory held that the Constitution had created not a perpetual union but a compact between independent states that retained their sovereignty. The compact could be broken in the same way that it had been created: with state conventions called for that purpose. By this means South Carolina seceded from the Union in late December 1860. By February 1 (before Lincoln’s inauguration) six more states from the Deep South had left the Union.
Northerners denied the right of secession. Secession, Lincoln argued, was revolution. Many Southerners agreed and claimed that they were exercising their right to revolt against oppressive government.
Congress tried to come up with compromise measures in early 1861, but there was no way of compromising in the argument over secession. The seven states of the lower South (South Carolina, Mississippi, Florida, Alabama, Georgia, Louisiana, and Texas) formed themselves into the Confederate States of America. Their Constitution was nearly identical to the Constitution of the United States, although it affirmed state sovereignty, guaranteed slavery, and limited the president to a single six–year term.
In his inaugural address, Lincoln was conciliatory without compromising on secession. He also hinted that the national government would use force to protect military garrisons in the Confederate states—in particular, Fort Moultrie in Charleston Harbor in South Carolina. When he tried to resupply the garrison (which had moved to the stronger Fort Sumter), the South Carolina militia fired thousands of artillery rounds into the fort, forcing its surrender. With that, the Civil War began.
With the beginning of the war, Virginia, North Carolina, Tennessee, and Arkansas seceded and joined the Confederacy. Unionist legislative majorities kept the remaining slave states of Maryland, Kentucky, Delaware, and Missouri from joining the rebel states. Meanwhile the western counties of Virginia seceded from that state when Virginia seceded from the Union and became the new state of West Virginia. Thousands of men from these border states, however, travelled south and joined the Confederate Army.
On paper, the North possessed overwhelming military superiority over the South. The North had a free population of about 22 million. The South had a population of 9 million, including almost 4 million slaves. The North was a modern industrial power; the South was overwhelmingly rural. The North possessed nine–tenths of the nation’s industrial capacity, four–fifths of its bank capital, and three–fourths of its taxable wealth. The paper currency of the North inflated by only 80 percent during the whole war. The South, on the other hand, had to finance the war by printing paper money that inflated 9,000 percent in four years.
Yet the South had advantages as well. To succeed, the South did not have to invade and conquer the North. The South had only to prevent the North from invading and conquering the Confederacy. Many predicted that the Union would fail as well. The South had only to prolong the war until the North gave up and went home. In addition, the South’s economic backwardness was an advantage: Northern armies had to operate in hostile territory in which transportation and communications were very difficult. Finally, improved weapons gave a lethal advantage to entrenched defenders over opponents who attacked them across open ground. Union soldiers did most of the attacking.
In the west, Northern armies used the Mississippi and Tennessee rivers (navigable streams that ran into the South) to capture Confederate territory and to control the river system. By the spring of 1863 the Union controlled all of the Mississippi River except a Confederate stronghold at Vicksburg, Mississippi. That city fell in July, and the Confederacy was cut in half.
In northern Virginia, however, the South defended land with east–west rivers that the Union had to cross. The South also had General Robert E. Lee, an almost mystically skilled commander who constantly outthought his attackers and forced them to assault him under bad conditions. On two occasions, Lee invaded Northern territory. He suffered defeats at the Battle of Antietam (in Maryland) in 1862 and the Battle of Gettysburg, Pennsylvania, in 1863. For the remainder of the war he fought defensively. General Ulysses S. Grant took control of the Union Army opposed to Lee in early 1864 and attacked Lee that spring. In horrific battles in northern Virginia Grant took heavy casualties before trapping and besieging Lee at Petersburg, south of Richmond, Virginia.
At the same time, Union General William Tecumseh Sherman marched from Tennessee to Atlanta, Georgia. After a month-long siege, he captured and burned Atlanta. While Atlanta and Petersburg were besieged, Northern voters re-elected Lincoln in 1864 in an election that was regarded as a referendum on the war. The South had succeeded in avoiding defeat. But it had not, as Southerners had hoped, broken the North’s will to continue fighting.
While Grant and Lee faced each other at Petersburg, Sherman left Atlanta and set out across country to Savannah, Georgia, destroying everything in his path that was of military value and much that was not. Sherman then turned north, burned the South Carolina capital at Columbia and kept moving into North Carolina. Before Sherman could join Grant, Lee’s army fled Petersburg. Grant caught him and Lee surrendered. At a cost of 360,000 Union dead and 260,000 Confederate dead, the United States had been preserved.
At first, the Union and the Confederacy fought only over the question of secession. The leaders of both sides wanted to avoid talking about slavery—which all of them knew was the root cause of the war. Southerners did not present the war as a defence of slavery for two reasons. First, most white Southerners owned no slaves and might not fight to protect slavery. Second, the South was trying to win recognition and help from Britain and France—neither of which would have supported a war for slavery. The North included many abolitionists, but it also included Democrats and border–state slaveholders who would fight for the Union but not for abolition.
During the war slaves grew most of the South’s food and performed work that made white Southerners free for military service. At the same time, thousands of slaves started running away from their masters and fleeing to Union lines. Union Army commanders called these escaped slaves contrabands (captured property). As the number of contrabands grew, President Lincoln proposed a gradual, compensated emancipation of slaves in border states. Lincoln hated slavery on moral grounds. But he could justify emancipation only as a military necessity in the war to save the Union.
In an Emancipation Proclamation, issued after the Northern victory September 1862, Lincoln declared that slaves in all states that remained in rebellion on January 1, 1863, would be “forever free.” It transformed the Union Army into an army of liberation—fighting to end slavery as well as to preserve the Union.
In January 1865 Congress passed the 13th Amendment, which ended slavery forever. It was ratified and became part of the Constitution in December 1865.
The Civil War finally established the United States as a nation–state. However, the unification of the country went further than most Northerners had wanted. The enormous government debt incurred during the war, followed by the postwar occupation of the South, created a central government more powerful than even the most nationalistic Americans had imagined before the war.
The Civil War had long-term economic and social results as well. The South was the theatre of war, and the physical destruction of that region was enormous. White Southerners lost their plantation labour system and their huge investment in slaves. Egyptian and Indian cotton had entered world markets during the war, and American cotton never regained its pre-war dominance. The South remained the poorest region of the United States for a very long time. The Northeast’s economic dominance was secured by the war, and the war seems to have sped Northern economic development.
As the Civil War ended, the United States faced unprecedented tasks: to bring the defeated Confederate states back into the Union and to determine the status in American society of almost 4 million former slaves. These goals dominated the years from 1865 to 1877, the era known as Reconstruction. During these years, Congress imposed a legislative revolution that transformed the South.
The process of reconstruction had in fact begun in 1863 when President Lincoln announced a plan to restore the Southern states to the Union. Radical Republicans in Congress opposed Lincoln’s plan. After Lincoln was assassinated in April 1865, they turned hopefully to President Andrew Johnson. In May 1865 Johnson announced his restoration plan, called Presidential Reconstruction. His plan disqualified former Confederate civil and military officers from holding office but brought the ex-Confederate states back into the Union on undemanding terms.
Presidential Reconstruction took effect in the summer of 1865. Johnson gave pardons to thousands of Southerners, and former Confederate states passed “black codes” that reduced the freed slaves’ rights. But when the 39th Congress, dominated by Republicans, convened in December 1865, Republicans planned to revoke the black codes and to replace Johnson’s program. In 1866 they passed a law over the president’s veto: the Civil Rights Act to protect the rights of freed slaves.
Although in general the Republicans’ ambitious plan for Reconstruction failed, it left two positive legacies: The 14th and 15th Amendments ensured black rights and gave the vote to black men. To maintain the rights of Southern blacks, however, would have meant a far longer period of military rule—which both Republicans and Democrats of the 1870s wished to avoid—and postponed any hope of national reunion. Only in the 1960s would the nation begin to confront the consequences of failing to protect the rights of black citizens. In the last third of the 19th century, Americans turned to their economic future—to developing the nation’s vast resources, to wrestling profit from industry, and to the settlement of the trans-Mississippi West.
War, Prosperity, and Depression (1900 – 1930)
Progressive presidents sought to impose order on the world, and especially to find markets for American products. For example, Theodore Roosevelt believed that a world power such as the United States was obliged to maintain global peace. He brought Russia and Japan together to sign a treaty in 1905 that ended the Russo-Japanese War and gave Japan rights in Korea. Roosevelt also supported expansion of U.S. influence abroad.
Big Stick Diplomacy. Roosevelt intervened in Latin America to build a canal connecting the Atlantic and Pacific oceans; the canal would link U.S. East Coast ports with East Asia. The United States negotiated a treaty with Colombia for rights to build a canal in Panama, at that time controlled by Colombia. When the Colombian Congress rejected the treaty, Roosevelt encouraged Panamanian desire for independence from Colombia. This tactic succeeded, and a revolution occurred. The United States promptly recognized the new government of Panama and negotiated a treaty that enabled Americans to build the Panama Canal.
Relations with Japan also became an issue during Roosevelt’s administration. A conflict erupted in 1906 over Japanese immigration to the United States. Prejudice against Japanese immigrants caused a crisis when San Francisco forced Asian children into a separate school. The Japanese government protested. In a “gentlemen’s agreement” in 1907, both nations agreed to discourage immigration from Japan. In the Root-Takahira agreement of 1908, Japan and the United States agreed to respect the territorial integrity of China and the Open Door Policy.