A treatise on orthopedic surgery . theupper segment by contact with the rim of the acetabulum, then closes the openingin the bone. 4. Replacement of the limb after union is completed elevates theneck to its former position. the subject. It is seen in two forms. In the first the fracture isof the neck and it usually follows direct violence. In the secondthe fracture is at the epiphyseal junction with the head. Thisform is practically limited to adolescence. SIMPLE FRACTURE. Fracture of the neck of the femur in childhood differs some-what in its symptoms and in its effects from that in later lif
A treatise on orthopedic surgery . theupper segment by contact with the rim of the acetabulum, then closes the openingin the bone. 4. Replacement of the limb after union is completed elevates theneck to its former position. the subject. It is seen in two forms. In the first the fracture isof the neck and it usually follows direct violence. In the secondthe fracture is at the epiphyseal junction with the head. Thisform is practically limited to adolescence. SIMPLE FRACTURE. Fracture of the neck of the femur in childhood differs some-what in its symptoms and in its effects from that in later life. 586 ORTHOPEDIC SUBGEBY. Although it may he complete, it is often what may be termedof the green stick variety. Thus, the immediate effects ofthe injury are far usually less disabling, and the patient isoften able to walk about within a few days after the the period of repair the limp and attendant discomfortare usually mistaken for symptoms of hip disease and at alater time it is classed as coxa vara. Fig. 1. Fracture of the neck of the femur. 2. Restoration of the normal angleby forcible abduction. 3. The limb in normal position. 4, 5, and 6 illustrateseparation of the epiphysis of the head of the femur treated by the same method. Diagnosis.^—The diagnosis is not difficult. There is a historyof injury, usually a fall from a height which confined thepatient to the bed for several days or weeks. On physical, ex-amination shortening of half an inch to an inch is found, ex-plained by the corresponding elevation of the in the joint is more or less restrained by voluntary andinvoluntary contraction of the muscles, but this restriction ismuch more marked in flexion, abduction, and inward rotationthan in other directions; a limitation explained by the natureof the displacement, the neck of the bone having been forceddownward and backward. CONGENITAL DISLOCATION OF HIP AND COXA VAEA. 587 Fig. 391. The immediate effect of the injury is, as ha
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