. A practical treatise on fractures and dislocations. )rosonts several varietiesdiffering notably in the extent of the lesions, the immediate disability,and the prognosis. The fibula may be alone broken at or close abmethe base of the malleolus or at the ej>iphyseal line in the youno-, or 452 FRACTURES. with its fracture may be associated that of the tip of the internal mal-leolus or one passing obliquely upward and inward through the tibiaand separating a fragment composed of the internal malleolus and aconsiderable portion of the adjoining bone (Figs. 322 and 334). Thevariations appear to
. A practical treatise on fractures and dislocations. )rosonts several varietiesdiffering notably in the extent of the lesions, the immediate disability,and the prognosis. The fibula may be alone broken at or close abmethe base of the malleolus or at the ej>iphyseal line in the youno-, or 452 FRACTURES. with its fracture may be associated that of the tip of the internal mal-leolus or one passing obliquely upward and inward through the tibiaand separating a fragment composed of the internal malleolus and aconsiderable portion of the adjoining bone (Figs. 322 and 334). Thevariations appear to be due to differences in the amount or force ofthe inversion and to the extent to which the weight of the body actsas a factor. Thus, the first effect of inversion is to break the fibula,either by the pressure of the upper edge of the astragalus against it orby the pull of the external lateral ligament; if the movement is con-tinued, or possibly if its direction is somewhat different, the astragalus Fig. Fracture of both malleoli by inversion. presses against and breaks off tiie tip of tlie internal malleolus; but ifthe weight of the body is added, as in a fall upon the inverted foot, theastragalus presses upward and inward against the inner portion of thetibia and breaks off the larger fragment. The first form of the injury, fracture of the external malleolus orfibula alone, is of slight importance if the tibio-fibular ligament is notalso torn, producing no displacement of the astragalus and getting wellunder a simple protective dressing. The same is nearly equally trueof the second form, added fracture of the tip of the internal malleolus,but more time is required before the limb can be freely used. Thethird form is much more serious and usually results in considerablerestriction of motion at the joint. FRACTURES OF THE BONES OF THE LEG,Fig. 334. 453
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectfractur, bookyear1912
