Chap, xix.] THE UPPER END OF FEMUR. 405 



origin of the joint and the uterine nerves forms the 

 basis of Hilton's explanation of the relative frequency 

 of hysterical disease in the large articulations of the 

 lower limb. The explanation, however, is unsatisfac- 

 tory, since the uterus receives many of its nerves from 

 the ovarian plexus, and the theory is founded upon 

 the unwarranted supposition that all hysterical dis- 

 orders are associated with some affection of the 

 uterus or its appendages. 



Fractures of the upper end of tiie femur 

 may be divided into (1) fractures of the neck wholly 

 within the capsule ; (2) fractures of the base of the 

 neck not wholly within the capsule ; (3) fractures of 

 the base of the neck involving the great trochanter ; 

 (4) separations of epiphyses. It must be scarcely 

 possible, apart from gunshot injuries, to fracture 

 the neck of the femur by direct violence, owing to 

 the depth at which the bone is placed, and the 

 manner in which it is protected by the surrounding 

 muscles. The violence, therefore, that causes the 

 lesion is nearly always applied indirectly to the bone, 

 as by a fall upon the feet or great trochanter, or by a 

 sudden wrench of the lower lirnb. 



M. Rodet, by a series of experiments, concludes 

 that the situation of the fracture can be predicated 

 by a knowledge of the direction in which the violence 

 has acted. " Thus, a force acting vertically, as in 

 falling on the feet or knees, will produce an oblique 

 intracapsular fracture ; a force acting from before 

 backwards, a transverse intracapsular fracture ; one 

 from behind forwards, a fracture partly within and 

 partly without the capsule, and a force applied 

 transversely, a fracture entirely without the capsule." 

 (Quoted by Henry Morris; Holmes' "System of 

 Surgery.") 



1. The true intracapsular fracture may involve 

 any part of the cervix within the joint, but is most 



