The principles of surgery . been restored, crepitus will beproduced by but very slight movement. Certain fractures, termed Impacted, rarely afford crepitus. Onefragment is driven into and lodged in the can-cellous textures of the other, by the same violencewhich caused the fracture; and so the bone isscarcely broken, when it again becomes fixed,with its continuity apparently restored. Thereis little deformity, no unnatural mobility, andusually no distinct crepitus under ordinary mani-pulation. Examples of this form of injury arefound, in fracture of the distal extremity of theradius, and at th
The principles of surgery . been restored, crepitus will beproduced by but very slight movement. Certain fractures, termed Impacted, rarely afford crepitus. Onefragment is driven into and lodged in the can-cellous textures of the other, by the same violencewhich caused the fracture; and so the bone isscarcely broken, when it again becomes fixed,with its continuity apparently restored. Thereis little deformity, no unnatural mobility, andusually no distinct crepitus under ordinary mani-pulation. Examples of this form of injury arefound, in fracture of the distal extremity of theradius, and at the trochanteric portion of thefemur. The manipulations necessary to ascertain thenature of an accident, and which are especiallydirected towards detection of crepitus, are to beconducted with all gentleness ; so as not to pro-duce unnecessary pain, or endanger further injuryto the soft parts, with aggravation of subsequentinflammatory excitement; and yet with determi-nation, sufficient for fully satisfying the examiner Impacted fracture, throughthe trochanters. The upperfragment is wedged into thelower. PROGNOSIS OF FRACTURE. 615 as to diagnosis. It is much better that one thorough examination shouldbe made at once, painful though it be, than that more gentle movementsand inquiries should be made, with frequent repetition; delaying themeans of cure. Also, let it be borne in mind that, at whatever costof suffering to the patient, it is our paramount duty to make such athorough examination; for two reasons. In the first place, in orderthat the required repose and treatment of the part may be immediatelyinstituted; in the second place, and mainly, that error of diagnosismay be avoided. For, suppose that in the hip insufficient examina-tion has led to the latter event; that a fracture is believed to exist,while in truth the injury is dislocation. The ordinary treatment forfracture is applied, and continued for the usual period. On finallyundoing the retentive apparatus, the tr
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