Atlas and epitome of traumatic fractures and dislocations . ent is ofthe greatest importance when, on account of swelling pal-pation of the trochanter is difficult or impossible. Infractures of the upper end of the femur, especially of theneck, the diagnosis can be made by measurements to elicit crepitus are unnecessary, and wouldbreak up impaction if present.—Ed.] The injured limb can be moved in all directions, butnot without giving pain. Crepitus is present unless the 264 FRACTURES AND DISLOCATIONS. displacement has been so great that the fragments are nolonger in contact
Atlas and epitome of traumatic fractures and dislocations . ent is ofthe greatest importance when, on account of swelling pal-pation of the trochanter is difficult or impossible. Infractures of the upper end of the femur, especially of theneck, the diagnosis can be made by measurements to elicit crepitus are unnecessary, and wouldbreak up impaction if present.—Ed.] The injured limb can be moved in all directions, butnot without giving pain. Crepitus is present unless the 264 FRACTURES AND DISLOCATIONS. displacement has been so great that the fragments are nolonger in contact. When the leg is extended and rotatedabout its longitudinal axis, a phenomenon is developedAvhich is readily explained : In a median fracture the shaftof the femur revolves about an axis, the length of whichcorresponds to the fragment of the neck that is preservedintact and still remains attached to the femur. In a lateralfracture, on the other hand, the shaft of the femur turnsonly about its longitudinal axis, providing of course thereis no Fig. 122.—Displaceincnt ot the trochanter in fracture of the neckof the femur. Posterior view, on the right side. The illustrationshows the upward displacement of the trochanter toward the anteriorsuperior spine, which is indicated by a horizontal line. The left sideshows the normal relations. Impacted fractures of the neck of the femur, as a rule,present no diagnostic difficulties ; they are always charac-terized by shortening and outward rotation of the leg,though both these symptoms are less pronounced than infractures without impaction ; in addition, there is some-times a slight degree of adduction. These phenomena areall dire(;tly due to the displacement and subsequent impac-tion of the fragments. Crepitus is absent in impacted FUACTURES OF THE LOWER EXTBE^IITY. 265 fractures, but considerable movement is often possible atthe hip-joint. Rotation of the leg about its long axis atthe hip-joint takes place about a radius
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Keywords: ., bookcentury1900, bookdecade1900, booksubjectfractur, bookyear1902
