FRACTURE, 
ight be claffed 
ut _ this difference, that the 
riding over each other, recede one 
= and are always fotind Coed by a greater 
-as thofe of the patella, olecranon, &c.-m 
with the preceding kind; 
fra&tured ends,’ inllead of ti 
from the ot 
or lefs diftanc 
Boyer eae that the third fpecies of derangement, 
or that in which the twu portions of a broken bone form 
‘an angle one with the ale takes ie principally in cafes 
of comminnted fraétu However, a fimple fraQure of 
the leg might be ji ed in this hipaa as may e eafily be 
conceived, by fuppofing at foot placed on ai — ed 
phe, i in which cafe, the angle formed would be falient an- 
teriorly, if the heel were lowe than the fore part of ae 
‘foot; pofteriorly, if the ary. 
The fourth fpecies of fae noticed by Boyer, or 
that affecting the circumference, is produced by the rota- 
tion of the inferior portion of the fraétured bone on the fu- 
perior, in fuch a manner, that the part which was anterior 
becomes internal, or external. LS ave an gin of this 
{pecies o derangement in the fraCture of the n se the 
thigh bone, when the foot, being il fupported a ap- 
paratus, and che ne its weight, aided by that of a. leg, © 
an by the contraction ‘o {cles, turns outward, and 
carries the lower portion of the broken bone in the fame di- 
reCtion, » 
bone correfponds no longer to ee of then 
It is explained by the a mentioned writer that 
as the bones. are only | of locomotion, 
nal impulfes, the weight of the limb, and the contration 
of mufcles. The caufe of the fra ae -may be the 
of the derangement. i the fratured portions. Th 
the thigh is broken by a fall aa re height, the en 
of the ‘body on the leg, which refts on the ground, may, 
befides bending the thigh bey Pla and breaking it, 
alfo difplace the ends of the fr 
The celebrated furgeon 
broken, and the end 
éaufe. 
3 
~The an gular and the ratory ie cceness of the fractures 
e occafioned by 
LO 
miufcles, however. Is t 
werful circumitance by which the pate re of 
feed are difplace 
It was that great fivceons Mr. Pott, who firft fixed the 
_ earneft attention of the furgical ap ail on the pai 
able fhare which the aber On had in drawing the e 
fraQtures out of their gael gr ponaen, aad in di tecag ye 
again after they had bee 
The ears of every ie muit be familiarly aa 
with the phrafe of /etting a broken bone; and’ 
fcarcely a perfon who does not famed: think, "that 
when a limb is fraétured, fome force muft be direétly ufed; 
in — to bring on extremities of the fra€ture into a pari 
of even contaét with refpe& to: each other. Many 
call. citer fargeons, never take the trouble aed pda 
whether the .end a fraQure are difplaced o. ° 
fooner do they feel a crepitus, and afcertain rake a bone 
is broken, than they take it for granted that the extre- 
mities of the fraGure muft of courfe be out of their pro- 
In this: cafe the anterior part of ae body of the 
a 
per place, and that no = fhould be loft before they are 
The pulled back ag 
The 
writers on arg r y diredt us, in cafes in which 
or ey in fome ca by pieces of snach : 
fuch am extenfion or ftretching of the limb lengthways, 
as. fhall enable the furgeon to ae he ends n 
y 
acs foun ineflicacious 5 at a » not ‘ally to 
anfwer the intention of ne one, or the expectation of the 
fo) 
ot 
a 
Afte r dwelling on the difficulty, pare and mifchief 
attending fuch pradtice, Mr. Po a marks, that neither 
extenfion, nor counter-extenfion, ¢ er be neceflary, on 
aecount of the mere fracture, pee ene abftratedly. The 
Thy is a 
lo e Wha t creates the. etic hk we aaah) find in 
attempting to bring the fra@tured parts aptly together ? 
_— does it proceed, that when we ay Sood all that is 
n our power, (according to this mode o the ends 
of the fracture will, in many cafes, eee agai oe 
and lamenefs and deformity Veen a In fhort,: 
what are the parts, or powers, which act on the bones, and 
ich, i fo aéting on them, produce all thefe confe- 
unhurt, that-is, when the miulcles therefore cannot a& upon 
the former; the vifible. diate detormity, when 
both the beforementioned bones. are broken cages in the 
fame place, that -is, wken the mufcles can at upon and 
difplace fuch fracture ; the great difficulty frequently met 
from being much fhorter than the other, are a other 
ae pro ee fuch ftrong and irre raganle 
gals de Default par Bichat,” to fhew that the scragenent 
° 
