The practice of surgery . as tomotion and the sustaining of weight, may bewonderfully preserved—continuity in the bonehaving been restored by the impaction, immedi-ately after it had been dissolved by the unfrequently, however, impaction is not socomplete as this; and sometimes it neither does norcan occur, on account of comminution attending onthe fracture; and then the amount of displacementand shortening may be very considerable. Thisform of injury usually results from direct and severeviolence, as by falls or heavy blows on the differs from the preceding; in the mode of
The practice of surgery . as tomotion and the sustaining of weight, may bewonderfully preserved—continuity in the bonehaving been restored by the impaction, immedi-ately after it had been dissolved by the unfrequently, however, impaction is not socomplete as this; and sometimes it neither does norcan occur, on account of comminution attending onthe fracture; and then the amount of displacementand shortening may be very considerable. Thisform of injury usually results from direct and severeviolence, as by falls or heavy blows on the differs from the preceding; in the mode of oc-currence, as just stated ; in its liability to occurat any age; in a greater amount of swelling andpain following—the fleshy textures being more orimpacted Fracture, through less extensively implicated ; in a greater amountthe Trochanter*. Tin- „p,,or of constitutional sympathv being manifested—the fragment is wedged into the . . i ° v^wv. * « i0Wer. injury being altogether more severe ; in there Fig. FRACTURES OF THE FEMUR, 649 being usually a less amount of shortening and eversion, with a greateramount of power and motion; and in crepitus being very palpable onlywhen full extension, and consequent disentanglement, have been effected—obscure, or altogether wanting, until then. When impaction has notoccurred, often the slightest motion causes very distinct crepitus ; therebeing comparatively little retraction of the lower fragment. The degreeof shortening may be said to vary from half an inch to an inch and a more important difference exists, in this fracture being capable ofsatisfactory union. The best mode of treatment is by application ofthe straight, light, wooden splint. It should extend from a little belowthe axilla, to a little beyond the ankle, when the patient is straight and Fig. 264.
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