A manual of modern surgery : an exposition of the accepted doctrines and approved operative procedures of the present time, for the use of students and practitioners . urs and, as theman tries to save himself from falling, the violent muscular contractionbends the patella across the condyles and fractures it by the cross-breaking strain or else tears it asunder simply by the powerful tractionupward. A similar result may occur in efforts at kicking or usual causation of the fracture is proved by the fact that in fallsupon the bent knee the impact is usually received on the head oft
A manual of modern surgery : an exposition of the accepted doctrines and approved operative procedures of the present time, for the use of students and practitioners . urs and, as theman tries to save himself from falling, the violent muscular contractionbends the patella across the condyles and fractures it by the cross-breaking strain or else tears it asunder simply by the powerful tractionupward. A similar result may occur in efforts at kicking or usual causation of the fracture is proved by the fact that in fallsupon the bent knee the impact is usually received on the head ofthe tibia rather than on the patella, and by the further circumstancesthat the line of fracture is usually transverse, that in fractures knownto be caused by direct violence the bone shows vertical, oblique or com-minuted fractures, and that no bruise is seen over the patella in theordinary cases. The fracture from muscular contraction is usually more or less trans-verse, is situated near the middle of the bone and is generally repairedby fibrous uuion. Comminuted and oblique fractures usually unite bybony instead of fibrous tissue. Fig. 239. Fig. 240. Fig. Transverse fracture ofpatella.
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