Fractures of the Femur. 125 



cede and follow it renders more probable the theory of old- 

 standing fracture. 



The lower part of the shaft shows signs of a slight perios- 

 titis. B. C. I. 1. M. 32. a. 



3. 223. United Fracture a little below the Lesser Tro- 

 chanter. — Left femur of an aged man— macerated, showing 

 the above. 



The upper fragment has been tilted outwards and slightly 

 forwards, and the level of the head is below that of the great 

 trochanter. There is much thickening round the fracture, 

 extending downwards in the shaft. The broken ends have 

 been hidden in front by the callus, but are still distinct behind. 

 The lower end of the shaft preserves its normal forward bend, but, 

 as in the former case, the inner condyle is prolonged downwards, 

 and there has probably been knock-knee. The whole bone is 

 lightened, probably, however, from advanced age. The articular 

 surfaces show changes indicative of arthritis deformans. 



B. C. I. 1. M. 32. b. 



3. 224. Badly united Fracture a little below the Lesser 



Trochanter. — Right femur of an adult — macerated, showing 

 the above. 



The upper fragment is tilted greatly outwards, and is 

 displaced behind the lower one. The head of the bone is 

 on a level with the great trochanter, and the whole shaft 

 has had an outward bend at the seat of fracture, which is only 

 partially compensated for by a slight bend inwards at the 

 lower end. The inner condyle i§ prolonged downwards, and 

 there has evidently been knock-knee. The bone, although not 

 thickened, is unusually heavy. From the roiihding off of the 

 prominences at the seat of fracture, and from the evidently 

 secondary changes in the lower end of the shaft, the fracture 

 may be considered one of long standing. B. C. i. 1. M. 28. 



