. A practical treatise on fractures and dislocations . 168), that thelower end of the proximal fragment isthrown by the action of the psoas magnusand iliacus internus, so that in order tomeet the supposed indication it will benecessary to carry the lower part of thelimb outwards also, a position whichwould certainly be found very inconve-nient, if not actually impracticable, inthe majority of cases. Nor can the tendency of the upperfragment to rise, and consequently toseparate from the lower, be effectuallymet by posture alone, unless the thighis completely flexed upon the body; aposition, aga
. A practical treatise on fractures and dislocations . 168), that thelower end of the proximal fragment isthrown by the action of the psoas magnusand iliacus internus, so that in order tomeet the supposed indication it will benecessary to carry the lower part of thelimb outwards also, a position whichwould certainly be found very inconve-nient, if not actually impracticable, inthe majority of cases. Nor can the tendency of the upperfragment to rise, and consequently toseparate from the lower, be effectuallymet by posture alone, unless the thighis completely flexed upon the body; aposition, again, which will be found in-convenient, if not impossible. It is apparent, therefore, that by posture alone we can only veryimperfectly accomplish an approximation of the fragments; while, inadopting the flexed position, we have almost entirely, whatever maybe said to the contrary, deprived ourselves of the means of extensionand counter-extension. On the other hand, admitting that by thestraight position we have momentarily provoked a resistance which. 428 FRACTURES OF THE FEMUR. flexion of the limb might have prevented, we shall be able, slowly buteffectually, to overcome this resistance by steady and continued exten-sion. In the one case we have made a present gain, but a final loss;and in the other a present loss results in our final gain. So it is thatexperience has shown in more than one case which has come underour observation, that although for a few moments, or perhaps forseveral hours, after the straight position has been assumed in thesefractures, the upper fragment will rise spasmodically, after a time,longer or shorter, and especially after the application of the sidesplints and bandages, this tendency will cease altogether. My convictions upon this subject are clear, but since they do notcorrespond with the convictions of a pretty large proportion of prac-tical surgeons, I am compelled to regard the question of posture inthis particular fracture as still open. I wil
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