. A practical treatise on fractures and dislocations. lla. (.Spec-imen 1201 of the MuseePuiniytren.) 412 FRACTURES. part if the contact is very exact (Figs. 286, 294, 295, 296, and 297),but which in cases not treated by operation almost always remainsfibrous and usually lengthens somewhat under use during the firstfew months. Even in some operative cases which have again cometo direct inspection after many months, the union which was soclose that no independent mobility could be recognized has been foundto be fibrous. Some of the skiagrams I have taken have shown bonyunion only in the posterio
. A practical treatise on fractures and dislocations. lla. (.Spec-imen 1201 of the MuseePuiniytren.) 412 FRACTURES. part if the contact is very exact (Figs. 286, 294, 295, 296, and 297),but which in cases not treated by operation almost always remainsfibrous and usually lengthens somewhat under use during the firstfew months. Even in some operative cases which have again cometo direct inspection after many months, the union which was soclose that no independent mobility could be recognized has been foundto be fibrous. Some of the skiagrams I have taken have shown bonyunion only in the posterior half or three-fourths. They also show anangular displacement producing a slight concavity of the articularsurface which, according to Chaput,^ favors full restoration of func-tion. If the fragments are not kept together, or if one is turned so Fig. 287. Fig. 288. Fig. 289 Fibrous union with great xav^waseparation, after fracture ll^lljof the patella. The bandadheres to the broken sur-face of the lower fragment. Long fibrous(Holmess System.) Hypertrophy of patella after fractureand wiring. that its fractured surface is directed forward or backward, the unionbetween them is by a bond formed mainly by the overlying soft parts(Fig. 287), but sometimes by a thicker one apparently of new forma-tion (Fig. 288); it seems probable that the latter form is produced bythe elongation of a shorter bond formed under favorable conditions ofproximity and position. Hypertrophy of the fragments is frequently noticed and sometimesappears mechanically to limit flexion of the knee; occasionally alsobony nodules, sometimes quite large, form within the connecting band. 1 Chaput: These de Paris, 1885, and Bull, de la See. Anat., April, 1888, p. 459. PLATE XXLV
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectfractur, bookyear1912
