The international encyclopaedia of surgery; a systematic treatise on the theory and practice of surgery . presenting an inverted X- Hamilton states that he has seenabout three inches of the ilium, in-cluding the anterior superior spinousprocess, torn off by muscular action ;the patient, a man aged 70, havingmerely risen from his seat in a railroadcar, when he felt something wrong. Riedinger^ claims that muscularaction plays a much more important part in the production of fractures ofthe pelvis generally than has been ascribed to it by most writers. Fractures of the ischium alone are very rare,
The international encyclopaedia of surgery; a systematic treatise on the theory and practice of surgery . presenting an inverted X- Hamilton states that he has seenabout three inches of the ilium, in-cluding the anterior superior spinousprocess, torn off by muscular action ;the patient, a man aged 70, havingmerely risen from his seat in a railroadcar, when he felt something wrong. Riedinger^ claims that muscularaction plays a much more important part in the production of fractures ofthe pelvis generally than has been ascribed to it by most writers. Fractures of the ischium alone are very rare, the six cases collected byMalgaignc being the only ones knoAvn. Three of them were due to violentfalls on the buttocks, and all to direct violence. Malgaignc has devoted a special section to what he calls ^^ double verticalfracture of the pelvis. This he defines as a combination of two vertical • American Journal of the Medical Sciences, January, 1876.« Philadelphia Med. Times, February 11, ISSi. • Arch, fiir klin. Chirurgie, Bd. xx. Heft 2 ; American Journal of the Medical Sciences, April,1877. T-fractnre of the Ilium. FRACTURES OF THE PELVIS. 05 fractures, separating at one side of the pelvis a middle fragment comprisingthe hip-joint; according as this fragment is carried upward or inward, tliefemur follows its movements, and hence result changes in tlie length anddirection of the limb which have often misled practitioners. An injury ofthis kind might readily be mistaken, at first sight, for fracture of the neck ofthe fenmr, as there would be crepitus, some degree of shortening—althoughin one case, according to Larrey, there was lengthening—of the limb, andvery probably impairment of motion; certainly inability to walk or examination, however, into the precise seat of the crej>itus and diili-culty of movement would, iu most cases, be apt to reveal the true nature ofthe lesion. Besides the fractures of the various portions of the pelvis which have be
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