A practical and systematic treatise on fractures and dislocations . tion by the tendinous such a case crepitation could be readily elicited, and move-ments of the limb would cause sufiicient irregularity of thepieces to be discoverable with the aid of the fingers. Flexionof the limb would produce separation of some of the frag-ments, as the quadriceps must take one or more pieces ofbone along with it as contraction of the muscles ensues. In a longitudinal fracture of the patella there may be lateralseparation of the fragments, though the beveled and project-ing condyles on each
A practical and systematic treatise on fractures and dislocations . tion by the tendinous such a case crepitation could be readily elicited, and move-ments of the limb would cause sufiicient irregularity of thepieces to be discoverable with the aid of the fingers. Flexionof the limb would produce separation of some of the frag-ments, as the quadriceps must take one or more pieces ofbone along with it as contraction of the muscles ensues. In a longitudinal fracture of the patella there may be lateralseparation of the fragments, though the beveled and project-ing condyles on each side tend to keep them in place. Theaction of the vast! muscles, pulling in opposite directions, theforce being from ^he centre towards the sides of the limb,may separate the fragments when the leg is flexed. One of the peculiarities of a fractured patella is that thefragments unite yevy frequently with fibrous material, andrarely consolidate Avith bony matter. The length of thefibrous bands depends upon the distance existing betAveen the 218 Fractures. Fig. Ligamentous unionafter of thepatella. fragments during the healing process. It is not uncommonto find the fibrous connection nearly an inch in length. Inthe case of Mary Adams, of Covington, Ky.,who broke the right patella transversely by atumble on some out-door steps, I secured avery short ligamentous union, so that shewalked well at first, but in less than a jea,i theconnecting band hud stretched, torn, or yielded,so that there were two inches between thefragments when the leg was forcibly Coale presented to the Boston Society forMedical Improvement, a specimen of a frac-tured patella taken from a man sixty-fiveyears old, the fracture having occurred ten years before. reports that the fragments at first were so closely unitedthat no separation between them could be discovered; butsubsequently they became disjoined at their outer edges oneinch, and at their inner edges very much
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Keywords: ., bookcentury1800, bookdecade1870, booksubjectfractur, bookyear1870
