A system of surgery : pathological, diagnostic, therapeutic, and operative . ty in maintaining apposition. It is very uncommon for the bone to break atVOL. I.—57 898 DISEASES AND INJURIES OF BONES. CHAP. Tin, several points ; such an accident, in fact, can only happen from the applicationof direct force. Simultaneous fracture of both clavicles has been observed onlyin a few instances. I have two clavicles in my possession, from the same subject,which were broken at the same point, but whether by the same accident, I amunable to say. The seat of fracture is usually at or near the middle of the
A system of surgery : pathological, diagnostic, therapeutic, and operative . ty in maintaining apposition. It is very uncommon for the bone to break atVOL. I.—57 898 DISEASES AND INJURIES OF BONES. CHAP. Tin, several points ; such an accident, in fact, can only happen from the applicationof direct force. Simultaneous fracture of both clavicles has been observed onlyin a few instances. I have two clavicles in my possession, from the same subject,which were broken at the same point, but whether by the same accident, I amunable to say. The seat of fracture is usually at or near the middle of the bone, where it isthinnest and weakest. Of twelve preparations now before me, it is about thispoint in eight; in three it is towards the acromial extremity, and in one towardsthe sternal. Fracture of either end is, I suppose, very uncommon, as I havenever met with an instance, either during life or after death. Great displacement, as shown in fig. 367, generally attends fractures of theclavicle; now and then, however, we see cases where the broken ends maintain Fig. Fracture of the clavicle. their natural relations, as I have myself noticed in four instances. Such an eventcan occur only when the fracture is incomplete, as sometimes happens in children,or when the periosteum is only partially divided, and the patient has taken carenot to permit any dragging of the shoulder. Generally the outer fragment willbe found to be drawn downwards, forwards, and inwards, by the weight of the limb and by the action of the deltoid, smallpectoral, and subclavian muscles; the inner,on the contrary, is usually somewhat raisedby the sterno-cleido-mastoid, but not so muchas its extraordinary prominence would seemto indicate, its tendency to displacement inthat direction being pretty effectually coun-teracted by the great pectoral muscle and thecosto-clavicular ligament. These appear-ances are well seen in fig. 368. In fractureof the extremities of the clavicle, the loss ofapposition is usu
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