Complicated Fracture of the Trochanters. 237 



much higher than on the sound side. The knee and foot 

 were more easily turned from one side to the other, that is, 

 outwards and inwards, than in a sound state of the bone 

 could have been effected. Considerable tumefaction 

 had already taken place about the glutaei muscles, and 

 the whole of the upper part of the thigh, in the neigh- 

 bourhood of the fracture, was much swollen. No cre- 

 pitus of the fractured parts could, therefore, be felt or 

 heard ; but, from all the other symptoms, a prognosis 

 of a broken femur was formed without hesitation, and 

 the precise point of fracture was judged to be in its' 

 neck. 



The extension and counter-extension being made, 

 and the thigh covered with Scultet's bandage, Dr. 

 Hartshorne's apparatus was applied, an anodyne ad- 

 ministered at bed-time, and the patient appeared to be 

 as free from pain as could be expected. On the after- 

 noon of the second day, the bandage round the ankle, 

 for maintaining the permanent extension, was removed, 

 and Dr. Physick's extending gater*, which was not at 



* This gater, which is a late improvement of Dr. Physick's, in the 

 apparatus for the cure of fractured thighs, cannot be too highly com- 

 mended. It consists of a piece of very thick and firm buckskin lea- 

 ther, cut to fit the leg, in the form of the soldier's gater, except 

 that it is laced before. It extends nine or ten inches up the leg, and 

 completely covers the ankle and instep, having the inferior edges 

 to come beyond the hollow of the foot. These lower parts have a 

 broad and firm strap of the same leather passed twice or thrice 

 through them, by means of which the extension is made. This ex- 

 tending gater has the two-fold advantage of affording infinitely 

 more surface for making the extension, and of preventing that ex- 

 tensive and troublesome excoriation, which, in spite of every atten- 

 SUPPX. H h 



