The treatment of fractures . horizontalization of the neck capsule is, therefore, very lax and is much moreapt to be injured than in early, vigorous adult life; 124 The Treatment of Fractures. when the fracture occurs, shreds are more apt to fallbetween the fragments, and the roominess of the sacpermits greater excursion of the lower fragmentwhen any motion of the lower extremity takes place,and it also gives less lateral support to the result is that it is much more difficult to retainthe fragments of the shortened, horizontal neck toge-ther. Add to this the intoleran
The treatment of fractures . horizontalization of the neck capsule is, therefore, very lax and is much moreapt to be injured than in early, vigorous adult life; 124 The Treatment of Fractures. when the fracture occurs, shreds are more apt to fallbetween the fragments, and the roominess of the sacpermits greater excursion of the lower fragmentwhen any motion of the lower extremity takes place,and it also gives less lateral support to the result is that it is much more difficult to retainthe fragments of the shortened, horizontal neck toge-ther. Add to this the intolerance of pressure andextension of senile tissues, and it is not hard to be-lieve that these fractures are seldom followed by bonyunion. If they do unite it is usually with muchensheathing callus, and a greater shortening of theneck. This causes symptoms similar to rheumatoidarthritis of the hip-joint, and many months if notthe balance of the days of such a patient are full ofsuffering and distress. If the bones do not unite the. Fig. 26. Young Femur. fig. 27. Senile Femur, ends of the fragments round off, atrophy, as is usualin ununited fractures, and while false mobility andan inclination to slip up on the part of the loosefragment may persist, pressure symptoms are rarelysevere or even annoying, and with a well fitting hip-joint apparatus the person may walk and have a verycomfortable existence. Hence I said that I doubt inmany cases that we should attempt to obtain bony Fractures of the Femur. 125 union at the expense of long confinement, muchsuffering, and a probable greater lack of function andcontinued and persistent after-suffering from thepressure of a shortened, nodular and hypertrophiedneck. Neuralgic and rheumatoid pains are very apt tooccur about the hip-joint after fractures of the neckof the femur, as stated above, on account of the pres-sure of the enlarged and frequently irregular, short-ened necks, which is the result of the fracture whenthe bone unites. This is e
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