. Anatomy, descriptive and applied. Anatomy. 546 THE 2IUSCLES AND FASCIA end of the upper fragments is drawn inward by the Pectineus and Adductor muscles, and tilted forward by the Psoas and Iliacus, piercing the Rectus muscle and occasionally the integument. The greatest care is requisite in keeping the pointed extremity of the upper fragment in proper position; otherwise, after union of the fracture, the power of extension of the limb is partially destroyed from the Rectus femoris muscle being held down by the fractured end of the bone, and from the patella, when elevated, being drawn upward
. Anatomy, descriptive and applied. Anatomy. 546 THE 2IUSCLES AND FASCIA end of the upper fragments is drawn inward by the Pectineus and Adductor muscles, and tilted forward by the Psoas and Iliacus, piercing the Rectus muscle and occasionally the integument. The greatest care is requisite in keeping the pointed extremity of the upper fragment in proper position; otherwise, after union of the fracture, the power of extension of the limb is partially destroyed from the Rectus femoris muscle being held down by the fractured end of the bone, and from the patella, when elevated, being drawn upward against the projecting fragment. In fracture of the patella (Fig. 404) the fragments are separated by the effusion whichtakes place into the joint, and by the action of the Quadriceps extensor; the extent of separation of the two fragments depending upon the degree of laceration of the ligamentous structures around the bone. The tibia is fractured most commonly by indirect force at the junction of the middle third with the lower third of the shaft. Compound fractures are more common in the leg than in any other region of the body because the tibia is such a superficial bone and is so much, exposed to injury. Most fractures from indirect force are oblique. In oblique fracture of the shaft of the tibia (Fig. 405), if the fracture has taken place obliquely from above, downward and forward, the fragments override each other, the lower fragments being drawn backward and upward by the powerful action of the muscles of the calf; the pointed extremity of the upper fragment projects forward immediately beneath the integu- ment, often protruding through it and rendering the fracture a compound one. If the direc- tion of the fractui'e is the reverse of that shown in the figure, the pointed extremity of the lower fragment projects forward, riding upon the lower end of the upper one. By bending the knee, which relaxes the opposing muscles, and making extension from the ankle and counterext
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectanatomy, bookyear1913
