. A practical treatise on fractures and dislocations. erior spinous processes. Thus, inFig. 255 a c represents thev^ertical plane passing throughthese processes, and b is thetop of the great fracture of the neck Avithshortening b is brought nearerto c. The same care must betaken to have the limbs insymmetrical positions, and Ihave found it convenient tomark the vertical plane by placing a small stick or pencil upright besidethe pelvis and in line with the processes, and then to measure the dis-tance between it and the trochanter. The same measurement can bemade, roughly but usual
. A practical treatise on fractures and dislocations. erior spinous processes. Thus, inFig. 255 a c represents thev^ertical plane passing throughthese processes, and b is thetop of the great fracture of the neck Avithshortening b is brought nearerto c. The same care must betaken to have the limbs insymmetrical positions, and Ihave found it convenient tomark the vertical plane by placing a small stick or pencil upright besidethe pelvis and in line with the processes, and then to measure the dis-tance between it and the trochanter. The same measurement can bemade, roughly but usually with sufficient accuracy, by placing thethumbs on the superior iliac spinous processes and the tip of a fingeron each trochanter, and thus estimating the comparative levels. Another but less accurate method of recognizing the elevation ofthe trochanter is to find its position with reference to Xelatons line,the line taken by a cord stretched between the tuberosity of the ischiumand the anterior superior spine of the ilium. Under normal conditions. Bryants ilio-femoral triangle, for diagnosis of frac-ture of the neck of the femur. FRACTURES OF THE FEMUR. 373 this line crosses the top of the trochanter when the thigli is slightlyflexed on the pelvis. Attention has been called by Dr. Allis to an effect of this shorteningwhich can be easily recognized ; the relaxation of the fascia lata betweenthe ilium and the trochanter and just above the knee on the outer side. Another effect is the broadening and thickening of the upper por-tion of the thigh, a change in shape which the eye learns to recognizeas almost pathognomonic. The shortening can sometimes be overcome, entirely or in great part,by gentle traction upon the limb combined with enough rotation inwardto correct such eversion as may exist. I think the dread of separatingimpacted fragments by traction has been exaggerated. The penetra-tion is transverse, and longitudinal traction that is not violent enoughto cause much pain c
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectfractur, bookyear1912
