A practical treatise on fractures and dislocations . eet the supposed indication it wouldbe necessary to carry the lower part ofthe limb outwards also, a position whichwould certainly be found inconvenient,if not actually impracticable, in the ma-jority of cases. Nor can the tendencyof the upper fragment to advance in theforward direction, and consequently toseparate from the lower, be met effectu-ally by posture alone, unless the thighis completely flexed upon the body. In-deed, it is apparent that the position ofmoderate flexion will rather favor theaction of those muscles which are sup-pose
A practical treatise on fractures and dislocations . eet the supposed indication it wouldbe necessary to carry the lower part ofthe limb outwards also, a position whichwould certainly be found inconvenient,if not actually impracticable, in the ma-jority of cases. Nor can the tendencyof the upper fragment to advance in theforward direction, and consequently toseparate from the lower, be met effectu-ally by posture alone, unless the thighis completely flexed upon the body. In-deed, it is apparent that the position ofmoderate flexion will rather favor theaction of those muscles which are sup-posed to be chiefly responsible for thedisplacement. When the thigh is ex-tended upon the body, the psoas magnusand iliacus internus are acting in thedirection of, and parallel to, the axis ofthe femur, and consequently to a disadvantage; but when the limb islifted, their action is more nearly at a right angle with the shaft, andtheir ability to displace the fragment is greatly increased. Moreover, it ought to be understood that broken bones are seldom. Fracture of femur just below trochanter minor. Fracture Tables, by F. H. Hamilton, 1853. FRACTURES OF THE SHAFT OF THE FEMUR. 443 or never displaced or separated, in the same manner they would be ifthey were not surrounded with many other structures which have suf-fered little or no disruption : they pass each other, but do not separatewidely, being held together by shreds of periosteum, muscles, tendons,ligaments, etc. The same happens when this bone is broken just belowthe trochanters; the upper fragment lies always, or almost always, inimmediate contact with the lower, and whatever force is brought tobear upon the lower fragment more or less directly influences theupper; we can then by extension, applied to the leg, draw down notonly the lower fragment, but we can drag into line the upper doubt in this attempt we shall meet with some resistance from themuscles above named; but experience has always shown that evenmode
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Keywords: ., bookcentury1800, bookdecade1870, booksubjectfractur, bookyear1875
