Fractures of the Pelvis

Abstract

UNTIL early in the twentieth century, the chief cause for fractures of the pelvis was thought to be falls from buildings, scaffolding, trestles, etc., and it was not until the development of the coal mining industry and of automobile accidents that this injury became particularly common. Before the days of the Bucky diaphragm real diagnostic films of the pelvis were comparatively rare and only the gross lesions in this region were interpreted. The physical findings are very indefinite even at the time of injury and are of little value three to six months after the trauma has occurred. In this series of cases the peculiar conditions found in the mining industry in the soft coal region are responsible for the rather unusual traumas. To understand the various applications of force with which we have to contend, the conditions under which the coal miners in the large mines in Southern Illinois work may be briefly described as follows: All the coal mines in this State, except the so-called “strip mines,” are shaft operations. A shaft is sunk to the level of the vein of coal which is to be mined, which in Franklin and Williamson counties lies 500 to 600 feet below the surface, with the vein of coal itself running six to eleven feet. From the bottom of this shaft so-called “main entries” are driven in various directions—usually north, south, east, and west—and from these main entries cross-entries are cut. Opening off the cross-entries are the rooms in which the actual coal mining process takes place. From the bottom of the shaft, extending in various directions in the entries, are railway tracks, on which the trains of coal cars are hauled from the distant parts of the mine to the bottom of the hoisting shaft. Under the Illinois law there must be two and one-half feet on one side of these tracks, without any specified distance on the other, and it is on this other, or off-side, that most of the so-called “squeeze accidents” occur. In mining parlance the man is caught between “the car and the rib,” the “rib” meaning the mine wall on this off-side. Other sources of the “squeeze” are the catching of men between the cars and the “face,” the “face” meaning the end of an entry, and between cars. Another important cause is the fall of coal, or rock, from the roof. These accidents are brought about by the desire of the men to get out as much coal as possible before setting props, and carelessness on the part of the inspectors in marking off dangerous territory. Occasionally the fall occurs without warning. In this particular type of accident the individual is first knocked down and then covered with tons—few or many—of coal, rock, or slate. All sorts of forces are applied and the men in the coal country have a stock saying that “when coal falls all bets are off,” meaning that anything may happen. The trauma extends all the way from a mere shaking up to a completely crushed body—and death.