. A practical treatise on fractures and dislocations. is usually downward and inward theouter fragment is forced inward on the under side of the other andnecessarily turns the outer end of the latter upward. 2. Fracture of the Outer Third. This variety is next in frequency tothe preceding, and may be produced by direct or indirect direction of the line of fracture is more commonly transverse than ^ 3Ialgaigne : Loc. p. 468. FRACTURES OF THE CLAVICLE. 209 oblique. The degree of (lisplacement varies greatly in different cases,being very notable in some and slight or entirely a
. A practical treatise on fractures and dislocations. is usually downward and inward theouter fragment is forced inward on the under side of the other andnecessarily turns the outer end of the latter upward. 2. Fracture of the Outer Third. This variety is next in frequency tothe preceding, and may be produced by direct or indirect direction of the line of fracture is more commonly transverse than ^ 3Ialgaigne : Loc. p. 468. FRACTURES OF THE CLAVICLE. 209 oblique. The degree of (lisplacement varies greatly in different cases,being very notable in some and slight or entirely absent in others. When displacement exists it is usually an angular one, the apex ofthe angle being directed backward. In some specimens^ bony unionhas taken place between the clavicle and the scapula, presumably byossification of the coraco-clavicular ligament. It is in the form of aprop extending from the under side of the clavicle to the base of thecoracoid process, and sometimes to the notch of the scapula, andusually convex posteriorly. Fig. Fracture of the clavicle, outer third. Extreme angular displacement. (R. W. Smith.) When the fracture is external to the trapezoid ligament—that is,when it lies within the outer inch of the bone—angular displacement isthe rule, the outer fragment turning forward and inward until its axisis at right angles with that of the inner fragment; sometimes its brokensurface lies against the anterior border of the inner one, and sometimesthe outer fragment lies under the inner one. Malgaigne describes acase in which, after fracture within half an inch of the articular sur-face, the inner fragment was elevated an inch above the other, andthere was shortening of nearly half an inch ; the appearance, in short,was that of a dislocation upward of the acromial end of the clavicle. 3. Fracture of the Inner Third. The older division, which was intofractures of the body and fractures of the outer end, took no specialnotice of this variety which r
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