45 f> SURGICAL APPLIED ANATOMY. [Chap. xxn. 



may be situated far away from the seat of trouble. 

 Thus Sir B. Brodie mentions the case of a gentleman 

 who suffered from severe pain in the left leg, from the 

 foot to the knee, in the course of the peroneal nerve. 

 No cause could be found for it. At the patient's 

 death, however, a large tumour was found attached to 

 the lumbar spine, which had evidently compressed the 

 left great sciatic nerve. 



There would appear to be little connection be- 

 tween disease in the rectum and a pain in the leg, 

 yet in one case at least that connection was marked. 

 " Only recently," writes Mr. Hilton, " I saw a 

 gentleman from South Wales, who was the subject 

 of stricture of the rectum from malignant disease. 

 He suffered pain in the knee-joint and in the back 

 part of the leg. This led me to suspect, what really 

 turned out, upon careful examination, to be the 

 case, that a large mass of cancer was involving the 

 nerves on the anterior part of the sacrum, and also, no 

 doubt, the obturator nerve." 



Fractures of tlie leg". Of the bones of the leg 

 the tibia and fibula are more often broken together 

 than singly, and of separate bones the fibula is 

 more often fractured than is the larger bone. 



1. The tibia and fibula. As regards the resistance 

 it offers to violence the fibula presents about the same 

 degree of strength in all its parts, save at the malleo- 

 lus and at its upper extremity. Its great length and 

 the manner of its attachment to the tibia (its two ends 

 being fixed and its main part being unsupported) 

 render it a slender bone, and but for the efficient 

 protection it derives from the thick pad of muscles that 

 surrounds it would no doubt be very frequently broken. 

 This is all the more likely to be the case, since the bone 

 is placed upon the more exposed aspect of the limb. 



The shaft of the tibia presents various degrees of 

 strength according as we regard its upper, middle, or 



