A practical treatise on fractures and dislocations . resumedtheir unnatural position when the head was flexed. They finallyunited, but with a slight projection and Gross hasreported one more Malgaigne expresses a doubt whether all these can be consideredas the results of muscular action, since, in a certain number of theexamples cited, the head seems to have been thrown forwards by theconcussion, and in others, also, there is no evidence that the musclesattached to the sternum were put upon the stretch. The only remain-ing explanation is that in such cases the sternum h
A practical treatise on fractures and dislocations . resumedtheir unnatural position when the head was flexed. They finallyunited, but with a slight projection and Gross hasreported one more Malgaigne expresses a doubt whether all these can be consideredas the results of muscular action, since, in a certain number of theexamples cited, the head seems to have been thrown forwards by theconcussion, and in others, also, there is no evidence that the musclesattached to the sternum were put upon the stretch. The only remain-ing explanation is that in such cases the sternum has been broken bythe violent shock, or contrecoup. 1 Boyer on Bones, p. 57. 2 Malgaigne, from Sabatier, Mem. sur la Fract. du Sternum. 3 Ibid., from Bull, de Therap., torn. vi. p. 288. 4 Ibid., from Bull, de la Soc. Anat., Juin, 1826. 5 Ibid., from Archiv. de Med., Janv. 1827.« Ibid., from Gaz. Med., 1842, p. 361. 7 London Rev., vol. xvii., new series, p. 536, Gross, System of Surg., vol. ii. p. 167. FRACTURES OF THE STERNUM. 167. ^ rttrelif unite,| except i>i older a e 35-1,0. ZO-25fh year soon afterpulertTf Ttli/ cartilaginous i/badt/amxd life Sternum, showing the periods at which its severalparts unite by bone. (From Gray.) Seat and Direction of Fracture.—The sternum is separated most fre-quently either in the long cen-tral portion, or at the junction Fig. 38-of this with the upper portion,where the bone is weakest. Infact, a separation at this latterpoint may be regarded fre-quently as a diastasis or dislo-cation rather than as a fracture,since the two portions do notbecome firmly united by boneuntil late in life. The very lateossification and fusion of thexiphoid cartilage with the cen-tral piece, also, will explain theinfrequency of its fracture. Boyer believed that the xi-phoid cartilage was not suscepti-ble of being permanently dis-placed backwards, except inaged persons, after it had become ossified, for, he says, thoughviolently struck and driv
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