. A practical treatise on fractures and dislocations. byoperation, and the patient made a complete recovery; and in a casefirst seen by Hamilton three months after the injury, the fragmentremained ununited and could be moved upward half an inch with dis-tinct crepitus and pain by flexing the knee. During the next two yearsthe usefulness of the limb increased steadily. Treatment. The treatment consists in reduction of such displacementas may exist by acting upon the fragment through the lateral ligiunentand the leg, and prevention of its recurrence by keeping the leg fixedin the position to whi
. A practical treatise on fractures and dislocations. byoperation, and the patient made a complete recovery; and in a casefirst seen by Hamilton three months after the injury, the fragmentremained ununited and could be moved upward half an inch with dis-tinct crepitus and pain by flexing the knee. During the next two yearsthe usefulness of the limb increased steadily. Treatment. The treatment consists in reduction of such displacementas may exist by acting upon the fragment through the lateral ligiunentand the leg, and prevention of its recurrence by keeping the leg fixedin the position to which it has been brought in making the the lateral ligaments are tense when the knee is extended, and relaxedwhen it is flexed, the extended position is the one which gives mostsecurity. The objection urged by Malgaigne, that it favors anchylosis,is, I think, unfounded; we know that the common cause of anchylosislies in the severity or the prolongation of an arthritis, not in the posi- ^» Braun: Arch, fiir klin. Chir., vol. xlii. p. Fracture of the internalcondyle of the femur. 406 FRACTURES. tion in which the joint is kept. In the flexed position of the knee aslight displacement upward of the fragment conld occur easily^ and itwould certainly pass unrecognized so long as the position was kept,and would show itself in abduction or adduction of the leg as soon asit was extended. I prefer, therefore^ to treat a case in the extendedposition upon a posterior splint or in a plaster bandage. After threeor four weeks the knee may be partly flexed if the fragment has lostits mobility. Massage is useful to shorten the period of convalescence and hastenthe restoration of function. Incision of the joint for the removal ofa large amount of blood from it could probably be safely done andwould diminish the chance of limitation of motion. D. Fracture of the Internal Epicondyle. This injury was first described by Stieda ^ on the basis of four casesobserved by himself. Vogel r
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