FRACTURE, 
crifta o m, while the eel one extended Lee to 
the fuperior part of the thigh. The a eae of oe aa 
td — O- 
ained ; one 
tel Dia a 
soya te eens the effect of the contraCtion of mufcles 
In cafes of fra€ture. Default here fpeaks of permanent ex- 
tenfion ; a method a sae ed by the generality. of pratti- 
tioners, as fubie&t to inconveniences, which Default re- 
3 he as never obferved in the very confiderable num- 
er of patients fubmitted to the erial: 
The patient was already fo ie to the head of the bed, 
by proper ban ean round the body and under the axilla, 
that the trunk could not = fcend, The celieson then left 
then eas at aes and fixed to the foot-board of the bed. 
his extenfion, fo far from aad aia inconvenience to 
gh sean afforded him inttant 
from olting he experienced in sw 
fev 
but was free from fever: no medici ee a iw, ptifan 
was ordered, and he was left to pa his reit, which he 
Hh uch in e next day, his fymptoms, in 
ood m need of,’ 
évery particular, were. eens mild 5 it was only necef- 
fary to regulate his diet, and to keep t the parts moit with 
* fer, ‘he fame plan was obferved ; 
but, on the fourth day, the loofenefs of the bandage, from 
the dimi nee of the {wellin ings rendered its re-application 
ceffa Supp ration joel eae o take place in the. wound : 
it was dreffed | in ibe fame way as‘on the firft ad and the 
aaa were ame? plied: with the fame precau 
as dreffed every two days till the feces, 
when ity was pene ed. ol ieee the dreffi me were not 
whe The k 
conftantly wn with the aq. veg. ou care- was taken that 
the bandages, which procured the a. were kept al- 
tight. 
‘The bandages, &c. were not totally left off till -the 
feventy-ffth day, though the callus was fufficiently firm 
fome time before that period: all the fragments were united 
without Rape and the rier within a few a was 
a3 lon he oppofite fide; but the foft parts, 
round he sonia were comida: rably thickened, and 
saa aaaenee this, the motion o 
reftored, by ng and eee: alternately the leg or 
ie fh by ed ce ion, which, one day, was 
placed Sunder the ham, aa, ‘the next day, under the leg ; 
a: moving the patella, by means of the fingers, in every 
poffible direction. ‘The Leena was foon capable of exer- 
pea t himfelf, and was able to walk with the affiftance of 
rutches. The ftiffnefs of the ‘joint foon fublided, and, in 
re weeks, he was capable of bending, at a right angle, 
the leg on the thigh. He was ere ed from the hofpital 
at this time, with a certain affurance of foon recovering, by 
means of exercife, the per erfed ufe of his joint. 
Chirurgica cal Journal, vol. 1 
Fradures of the Neck of the Thigh-bone. 
. _'Thefe cafes are generally confi dered as the moft trouble- 
fome fractures to which the os femoris is liable. "The high 
eas ane boas fuccefs fully em-. 
were loof Nk were kept, 
Parifia jan 
fituation-of the folution of continuity'in the bone confers.on. 
avait number of mufcles the power of d 
thigh, the knee, beg ¢ lee, and the ig 
b 
roken about t ddle, we know that fome of the tri- 
. ceps, together w veh | ae rectus, eee y ete onl oa 
femi-tendinofus,. gracilis, and fartorius, has the power of 
pulling up the al er portion of the bone towards the pelvis ; 
ut, es the n the os femoris is eases a multi 
tude of other aes alfo acquire this po 
cr. par 
Se nter, 
afin ure of the nee of the fieciiones is generally oc- 
Pista thes all on the great a but the accident 
a y arife from a “fall either on the | _— or fole of the 
oot. 
The folution of continuity may happen either at the 
middle of the neck, where the neck joins the head of the 
bone, or, laflly;, aa the neck: unites: with the e great tro- 
chanter. In the lait cafe, the fra@ure is fituated on the: 
outfide of id orbicular ligament of the joi 
e trochanter major itfe 1g fomeumes broken off, at. 
the fame cae that the neck of the bone is fraCtured. 
In the majority of cae the folution of continuity is 
i be tran{verfe, with r ect t to the diretion- of the 
De ; 
a) 
the ge 
ome. 
ee of the j 
t hin plain; that, 
he main por ortion of the thigh'booe cannot be 
ae ae na spire ard, 
he’ see er of fr a€tures of the neck of the os foneGe i is 
not always eafy. Sometimes the beft and moit ees 
furgeons cannot extricate themfelves from doubt and uncer- 
tainty. 
The ient always complains of . acute pain on the 
flighteft motion of the limb, and-in general he becomes fud- 
a inc ee of w ralking. The limb is fhortene: t 
this cha lace in very different degrees in different 
er i Wi ie the fr acture occurs on. the outfide of the 
capfular ligament 5 ; or when the fracture is on the infide of 
the joint, but the Figanent is lacerated ; 5 the main portion o 
the os femoris i is like aly tob 
viien t 
and circu erry egree or pee ae f the 
limb, not being pa can on nly be found out by a careful 
comparifon of one limb with the other. Finally, when the 
= of continuity in the neck of the-bone is tran{ver a 
one- fragment is locked in the other, there can be: 
fhortening of the limb at all, and the patient may even be 
capable of walking. 
The hurt limb may in general be rendered as long as bile 
‘no fooner 
elling makes its appearance at the upper rand front 
part of the thigh, ee in fize to the extent to 
which the member is fhortened. 
When 
