A practical treatise on fractures and dislocations . , to complete fractures ;while double fractures, accord-ing to my experience, occur moreoften in children than in adults,and are of the character of partialfractures, without usually muchdisplacement; which facts, if sus-tained by subsequent observa-tions, would sufficiently explaintheir infrequency in hospital, andtheir relative frequency in pri-vate experience. SymiDtorns.—In all cases ofcomplete fracture with displace-ment, no difficulty will be ex-perienced in deciding upon thenature of the injury. The patient is found generallyleaning t
A practical treatise on fractures and dislocations . , to complete fractures ;while double fractures, accord-ing to my experience, occur moreoften in children than in adults,and are of the character of partialfractures, without usually muchdisplacement; which facts, if sus-tained by subsequent observa-tions, would sufficiently explaintheir infrequency in hospital, andtheir relative frequency in pri-vate experience. SymiDtorns.—In all cases ofcomplete fracture with displace-ment, no difficulty will be ex-perienced in deciding upon thenature of the injury. The patient is found generallyleaning toward the injured side,while the opposite hand sustains the elbow of the same side, to pre-vent its dragging downwards. The shoulder falls downwards, forwards, and inwards; while, atthe same time, the line of the bone is interrupted by the sharp andprojecting point of the sternal fragment. 1 London Med. Gaz., vol. ii. p. 382. 2 New York Med. Times, March 16, 1861.* Lente, N. Y. Journ. of Med., July, Rep. on Def. after Frac, Cases 5, 6, Complete Fracture.—Oblique; at junction ofouter and middle thirds. (From nature.) FRACTURES OF THE CLAVICLE. 185 If the fracture is the result of a direct blow, a swelling and discolor-ation may be seen at the seat of fracture; but if it is the result ofa counter-stroke, we must look to the top or point of the shoulder forthe signs of a contusion. The patient also experiences pain when an attempt is made to raisethe arm at a right angle with the body, and especially in attemptingto carry the arm across the body, by which the ends of the brokenclavicle are driven into the flesh. In two cases (Cases 19 and 50 ofmy Report on Deformities) of oblique fracture, accompanied with dis-placement, occurring in the middle third of the bone, I have particu-larly noticed that the patients could easily lift the hands to the head,and in one of these cases the patient, a boy fourteen years old, raisedhis arm perpendicularly over his head. Such exc
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