. Atlas and epitome of traumatic . tures extending into the trochantericregion usually form part of a lateralfracture of the neck or, as will beseen presently, of infratrochantericfracture of the femur. The symp-toms and treatment call for no specialremarks. Isolated fracture of the greatertrochanter is significant both from apractical and from a theoretic stand-point. It is a very rare injury,produced by direct violence, and logi-cally characterized by longitudinaldisplacement with separation of thebony process {ad longitudinem cumdistractione). The fragment is dis-placed upward and backward
. Atlas and epitome of traumatic . tures extending into the trochantericregion usually form part of a lateralfracture of the neck or, as will beseen presently, of infratrochantericfracture of the femur. The symp-toms and treatment call for no specialremarks. Isolated fracture of the greatertrochanter is significant both from apractical and from a theoretic stand-point. It is a very rare injury,produced by direct violence, and logi-cally characterized by longitudinaldisplacement with separation of thebony process {ad longitudinem cumdistractione). The fragment is dis-placed upward and backward by theaction of the gluteal muscles and isdirectly accessible to palpation; be-tween it and the femur is a widediastasis. The simplest treatment consistsin nailing on the fragment after replacing it as accuratelyas possible. This is facilitated by bringing the leg intoabduction. (d) Fracture of the Shaft of the Femur belowthe Trochanter {Fraetura femoris mfratrochanterica).(Plate 56.)—Fracture of the shaft of the femur Fig. 123.—The samespecimen as shown infigure 1 of Plate 56,seen from without. Theupper fragment is in aposition of flexion; theshaft is displaced for-ward and upward. 270 FRACTURES AND DISLOCATIONS. PLATE 56. Various Fractures of the Femur.—Fig. 1.—Oblique fractureof the left femur below the trochanter ; posterior view (fractura femo-ris infratrochanterica). United by robust masses of callus, with dis-placement of the fragments. The fracture was probably produced byoverextension. (Pathol. Inst., Greifswald.) Fig. 2.—Oblique fracture of the upper half of the femur. Tor-sion-fracture with displacement of the fragment. The line of fractureinvolves the greater trochanter. (Pathol. Inst., Miinchen.) Fig. 3.—Oblique fracture of the lower half of the femur withlateral displacement and shortening ; union by moderate developmentof callus. (Authors collection.) Fig. 4.—Transverse fracture of the lower half of the femur withmarked displacement; unit
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