452 



THE BLOOD-VASCULAR SYSTEM. 



injury, and attended with considerable displacement. On examination of the limb the lower 

 fragment may be felt deep in the popliteal space, being drawn backward by the Gastrocnemius 

 and Plantaris muscles, and upward by the Hamstring and Rectus 

 muscles. The pointed end of the upper fragment is drawn 

 inward by the Pectineus and Adductor muscles, and tilted for- 

 ward by the Psoas and Iliacus, piercing the Rectus muscle and 

 occasionally the integument. Relaxation of these muscles and 

 direct approximation of the broken fragments are effected by 

 placing the limb on a double inclined plane. The greatest care 

 is requisite in keeping the pointed extremity of the upper frag- 

 ment in proper position ; otherwise, after union of the fracture, 

 jthe power of extension of the limb is partially destroyed, from 

 the Rectus muscle being held down by the fractured end of the 



FIG. 268. Fracture of the 

 femur above the condyles. 



FIG. 269. Fracture 

 of the patella. 



FIG. 270. Oblique fracture of 

 the shaft of the tibia. 



bone, and from the patella, when elevated, being drawn upward against the projecting fragment. 

 In fracture of the patella (Fig. 269) the fragments are separated by the effusion which 



FIG. 271. Fracture of the fibula with dislocation of the foot outward-" Pott's fracture." 



takes place into the joint, and possibly by the action of the Quadriceps extensor; the extent of 

 separation ot the two fragments depending upon the degree of laceration of the ligamentons 

 structures around the bone. 



