. A practical treatise on fractures and dislocations. most striking features of thedeformity are the prominence of the dorsum over the lower fragmentand that of the end of the ulna. The former so changes the outlineof the forearm and wrist that when viewed from the radial side itsappearance is like that represented in Fig. 167, and was aptly com-pared by Velpeau to the outline of a silver fork, a comparison whichhas survived in the name silver-fork fracture, by which it is some-times known. The cause of this change in the outline, so far as it isdue to the position of the fragments, is shown i
. A practical treatise on fractures and dislocations. most striking features of thedeformity are the prominence of the dorsum over the lower fragmentand that of the end of the ulna. The former so changes the outlineof the forearm and wrist that when viewed from the radial side itsappearance is like that represented in Fig. 167, and was aptly com-pared by Velpeau to the outline of a silver fork, a comparison whichhas survived in the name silver-fork fracture, by which it is some-times known. The cause of this change in the outline, so far as it isdue to the position of the fragments, is shown in some of the radio-graphs ; swelling of the soft parts and even projection of the first rowof the carpus accounts for some of it; that of the palmar aspect isdue mainly to swelling of the soft parts. 1 Bouchet: These sur les Luxations du Poignet. Quoted by Malgaigne FRACTURES OF THE HONKS OF THE FOREARM. 291 The radiographs show that the characteristic deformity i- presenfeven when the displacement of the fragment i- slight, and thai in Fig. 167. ,. Deformity in Colless fracture. general this displacement is much less than has heretofore been sup-posed. The prominence of the end of the ulna appears to be due to thedisplacement of the carpus and the fragment of the radius upwardand somewhat to the radial side, aided sometimes by avulsion of thestyloid process of the ulna, or, possibly, the equivalent rupture of theinternal lateral ligament. That ascent of the end of the radius issufficient to produce this prominence is shown by its gradual appear-ance in cases of arrest of growth at the lower end of that bone. (SeePlate XXIII.) If the surgeon marks the positions of the styloid processes by press-ing the end of a finger into the side of the joint below and against theend of eaeh, he will see that that of the radius has risen, so thatinstead of being about a quarter of an inch lower (nearer the hand)than that of the ulna, as it usually is, it has risen to the same leve ore^en abo
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