FRACTURE OF THE LEG. 47 



gation of the splint as high as the axilla, which will prevent any 

 lateral inclination of the body ; and the application of a similar splint 

 to the fractured limb. 



FRACTURE OF THE PATELLA. 



The accident may result from muscular contraction or direct vio- 

 lence. It is sometimes attended with an audible snap and falling of 

 the patient; the pain is not severe, and a simple fracture is not dan- 

 gerous. The limb is bent partially, and there is no ability to ex- 

 tend it. 



The direction is usually transverse, and a separation of the frag- 

 ments can be felt. There is no crepitus. Considerable swelling 

 usually follows. 



Longitudinal fractures are rare, and are not attended by the same 

 symptoms. 



Treatment. — Leeches and lotions should be applied to reduce 

 swelling and inflammation, and then the limb should be extended, a 

 roller and figure of 8 bandage applied to coaptate the fragments and 

 compress the muscles of the thigh. A long splint, reaching from the 

 ischium to the heel, applied to the back of the limb, will prevent 

 motion. 



Bony union is not to be expected ; a strong ligamentous connexion 

 is usually formed, which answers the purpose extremely well. Pas- 

 sive motion should be made after five or six weeks. Sixty or 

 seventy will elapse before the limb can be used, and even then 

 caution should be taken that the newly-formed ligament is not 

 broken, or the patella of the opposite side, from increased muscular 

 exertion of the sound limb, and possessing the same structure which 

 disposed to the fracture in the broken limb. ^ 



FRACTURE OF THE LEG. 



A frequent accident, occurring in one or both bones, from a fall 

 or direct violence. The tibia is most frequently fractured, on ac- 

 count of its exposed position, and sustaining the weight of the body. 

 The fracture may occur at any part, but the deformity is greater, as 

 it may be nearer the lower extremity ; if nearer the upper extremity 

 the deformity may be slight and the patient even walk about. 



The fibula maybe fractured by direct or indirect force. Little 

 deformity results, unless the fracture is below its middle. When 

 nearer the ankle, dislocation may be produced. The most frequent 

 seat of fracture is from two to three jnches above the malleolus. 

 There is immediate lameness ; the foot is turned out ; crepitus is 

 distinct, and a depression exists over the fractured part. 



Both bones are often fractured at once by falls or blows ; they 



