. Modern surgery, general and operative. Fig. 408.—Intertrochanteric fracture. Fractures of the Shaft of the Femur 679 Symptoms.—The chief symptom in fracture of the shaft of the femur isgreat displacement, except when impaction occurs, when the break is due todirect force, or when the injury is in a child. In a child the Hne of fractureis often transverse and the periosteum may be untom. Green-stick fracturesoccur in children. As a rule, in fracture of the shaft of the femur the lowerfragment is drawn upward and the upper end of the lower fragment is foundposterior and somewhat to the inside
. Modern surgery, general and operative. Fig. 408.—Intertrochanteric fracture. Fractures of the Shaft of the Femur 679 Symptoms.—The chief symptom in fracture of the shaft of the femur isgreat displacement, except when impaction occurs, when the break is due todirect force, or when the injury is in a child. In a child the Hne of fractureis often transverse and the periosteum may be untom. Green-stick fracturesoccur in children. As a rule, in fracture of the shaft of the femur the lowerfragment is drawn upward and the upper end of the lower fragment is foundposterior and somewhat to the inside of the lower end of the upper fragment,and the lower fragment also undergoes external rotation (the drawing up isdue to rectus and hamstrings; the passing inward is due to the adductor muscles;the rotation outward arises from the weight of the limb). If a fracture of thelower two-thirds of the shaft is produced by direct force, there is usually but. Fig. 409.—Deformity following fracture of upper third of femur. little deformity, because the line of fracture is nearly transverse. If producedby indirect force, there is often great deformity, the line of fracture being fracture of the lower third of the shaft the gastrocnemius pulls upon thecondyles and tilts the lower fragment, so that its upper end projects into thepophteal space and may damage the vessels. In fracture of the upper third theupper fragment is apt to be thrown strongly forward and outward (Fig. 409).Some attribute this to the action of the psoas, iliacus, and external rotatormuscles, but AlHs thinks it is due chiefly to the lower fragment pushing the upperfragment into this position, a part of the tendon of the gluteus maximus actingas a hinge for the fragments.^ In rare cases the angular deformity is fracture of the shaft of the femur there is complete loss of function, the thigh ^ Fracture in the Upper Third of the Femur Exclusive of the
Size: 1366px × 1829px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1910, bookidmodernsurger, bookyear1919
