It develops in a small number of patients who were neglectful of treatment for syphilis or were not treated at all. 
Old and very young age, traumas (physical, psychic, medicamentous), chronic diseases and toxicosis, and alcoholism are conducive to the developm

This is commonest abdominal surgery emergency
Surgical anatomy
The vermiform appendix can lie in a variety of positions. The relative frequency of the more usual positions occupied by the organ is:
retro cecal 74%
pelvic 21%
post ileal 5%

Classification of fractures:

-Primary open fracture:- soft tissues are damaged by the injuring agent.
-Secondary open fracture :- Soft tissues are damaged by bone fragments.

Gustilo and Anderson classification:
 
Type 1 :- Wound is l