Fractures of the Patella. 135 



on his head, his foot slipped, and in the attempt to recover himself the 

 actions of the muscles of the thigh pressed the popliteal artery against the 

 projecting point of bone, and the artery -was ruptured, and an aneurism 

 was formed. It was found necessary finally to amputate the limb. (For 

 the remainder of the case, see the series illustrating arterial disease.) 



Tlie epiphysis has been united to the lower end of the 

 shaft, with its back part projecting downwards, and its inferior 

 parts looking forwards. The lower end of the shaft projects 

 behind the epiphysis, and is rough and irregular. Although 

 the epiphysis and the shaft are in bad position, the union 

 between them has been exceedingly solid. (Figured in Bell's 

 "Observations on Injuries of the Spine and Thigh-Bone," 

 plate iv. fig. 3.) B. C. i. 1. M. 9. 



FKACTUKES OF THE PATELLA, 



3* 250. United Transverse Fracture of the Patella.— 



Patella — macerated, showing the above. 



There has been a longitudinal break on the inner side, and 

 another extending transversely from the middle of the first. 

 'So new bone has been formed on the joint surface, and 

 only a little on the outer surface. This fracture has probably 

 been caused by direct violence. (See Bell's " Observations on 

 Injuries of the Spine and Thigh Bone," p. 57, also plate iv. 

 fig. 1.) B. C. I. 1. M. 61. 



3. 251. United Irregular Fracture of the Patella.— 



Patella — macerated, showing the above. 



There is a deep longitudinal fissure on the articular surface, 

 and considerable irregularity on the anterior surface. This has 

 probably been a fracture by direct violence. 



B. C. I. 1. M. 62. 



3. 252. Ununited Transverse Fracture of the Patella.— 



Patella — muscles cleaned off and in spirit, showing the above. 



