A system of surgery . Fig. 28S, A compound snpra-condyloid Fracture—oblique, downwards and inwards. The shaftprojected 2 ins. through the slrin, internal tothe patella, and its end has undergone necro-sis. (St. Bartholomews Hospital Museum,No. 756.) (H. Marsh.) 846 INJURIES OF Fig. An irregular Y-Fracture of the lower Endof the Femur, one arm ofthe Y being prolonged up-wards on the inner side tothe top of the lower pointed shaft was im-pacted in the outer con-dyle, of which it depressedthe anterior end. Theinner condyle was presseda little upwards beforeunion occurred.
A system of surgery . Fig. 28S, A compound snpra-condyloid Fracture—oblique, downwards and inwards. The shaftprojected 2 ins. through the slrin, internal tothe patella, and its end has undergone necro-sis. (St. Bartholomews Hospital Museum,No. 756.) (H. Marsh.) 846 INJURIES OF Fig. An irregular Y-Fracture of the lower Endof the Femur, one arm ofthe Y being prolonged up-wards on the inner side tothe top of the lower pointed shaft was im-pacted in the outer con-dyle, of which it depressedthe anterior end. Theinner condyle was presseda little upwards beforeunion occurred. (Univer-sity College Museum, ) fragment is towards the vessels and nervesof the popliteal space, and this spot is onewhere vascular complications are speciallyfrequent. The T- and Y-fractures are dueto direct violence or to penetration of thelower end of the shaft into the lower end,splitting it up (Fig. 211); firm impaction ofthe pointed shaft into the lower end may-persist (Fig. 289). Separation of the lower epiphysis(Fig. 291) has generally been due to forcibletwisting and angular movements, as when thelimb is caught between the spokes of a wheel;direct violence will alsopush it off. Generallythe epiphysis is carriedforwards (Fig. 290), andthe lower end of the shaftf
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