chap, xx.] THE THIGH. 465 



found that the only vessel woimded was the internal 

 circumflex artery, just at its point of origin from the 

 profunda. The case was treated promptly and the 

 man did well. 



Fractures of the femur. The shaft of the 

 femur may be broken at any part, but the lesion is 

 most common at the middle third of the bone, and 

 least frequent at its upper third. If broken by direct 

 violence the fracture is usually transverse, and if by 

 indirec.t violence it is usually oblique. The probability 

 of a fracture being due to direct violence diminishes 

 in the bone from below upwards, while the probability 

 of a lesion from indirect violence increases in the 

 same direction. Thus it happens that the fractures 

 of the upper third of the bone are usually oblique, 

 while those of the lower third are more commonly 

 transverse. In the middle third the numbers of the 

 transverse and oblique fractures are more nearly 

 balanced. The femur has often been broken by 

 muscular violence, but it is doubtful if this has ever 

 occurred in other than a diseased bone. In many of 

 these cases the amount of force that breaks the bone 

 is most insignificant. Thus Vallin reports the case of 

 a girl aged eighteen, described as robust, who broke 

 the femur about its middle while in the act of 

 mounting a table for the purpose of undergoing a 

 vaginal examination. In oblique fractures in the 

 upper third of the bone the line of fracture usually runs 

 downwai-ds and inwards, while in oblique fractures of 

 the middle third the direction is more commonly 

 downwards and forwards, with a slight lateral inclina- 

 tion that is sometimes inwards and sometimes out- 

 wards. Fractures of the lower third of the bone are 

 discussed in connection with the region of the knee 

 (chap. xxi.). 



With regard to fractures of the upper and middle 

 thirds, the displacement of the fragments depends 

 BE 4 



