428 SURGICAL APPLIED ANATOMY. [Chap, xix 



and stout muscle on the other. Abscesses so pent up 

 may travel for a considerable distance down the thigh 

 before they reach the surface, and Farabeuf relates a 

 case where a gluteal abscess travelled to the ankle 

 before it broke. 



Under other circumstances the gluteal abscess may 

 make its way into the pelvis through the sciatic 

 foramina, or a pelvic abscess may escape through one 

 of these foramina, and appear as a deep abscess of the 

 buttock. 



The thickened part of the fascia lata that runs 

 down on the outer side of the limb, between the crest 

 of the ileum above and the outer tuberosity of the 

 tibia and head of the fibula below, is known as the 

 ilio-tibial band. This band is tightly stretched across 

 the gap, between the iliac crest and the great 

 trochanter, and if pressure be made with the fingers 

 between these two points, the resistance of this part 

 of the fascia can be appreciated. It is obvious that 

 in fracture of the neck of the femur, when the great 

 trochanter is made to approach nearer to the crest, 

 this band will become relaxed, and Dr. Allis (Agnew's 

 "Surgery," voL L) has drawn attention to this fascial 

 relaxation as of value in the diagnosis of fractures of 

 the femoral neck. 



The lower free edge of the glutens maximus is 

 oblique, and is some way below the transverse line of 

 the fold of the buttock. 



It would appear that even this great muscle may 

 be ruptured by violence. Thus Dr. MacDonnell (Brit. 

 Med. Journ., 1878) reports the case of a robust man, 

 aged sixty-three, who, while trying to lift a heavy 

 cart when in a crouching position, felt something 

 give way in his buttock, and heard a snap. He fell, 

 and was carried home, when it was found that the 

 great gluteal muscle was ruptured near the junction 

 with its tendon. 



