FRACTURE. 
@ patient may regain a good deal of the ufe of the weakened 
mufcles. 
When the kaze-pan is fra€tured by external violence, as 
‘by the kick of a hore, it often happens that the upper 
fragment is not drawn upward and feparated, in confe- 
quence of the parts not’ being fufficiently ruptured and la- 
rerat In this in — a ban age above the knée can 
-anfwer no purpofe, and as being Aicely to bo a bad effe 
ot be employed. 
mild. faline Sire medicines, and the app plication of linen 
wet with the lotio aque lithargyri acetati to the joint itfelf. 
Fradures of the Leg. 
: h s more frequently broken than the thigh ; 
epee ane it a the ftrength of two bones, one of whic has 
“ver e, it is greatly expofed to ete cil. 
- When Aa che fibula and tibia are fractured, the ay is 
3 but 
Cu 
is the onl 
his leg; for notwithftanding the fibula is entire, this bone 
-is fituated out of the sari ‘a gravity, and is too weak to 
-Juftain the weight of the ’ 
- .Fra€tures ia both bones wei ‘the leg may be either tranf- 
-verfe or obliq 
When es fraBure ‘is difplaced poten ey ‘the lower 
and A eagle 
ie rnufeles 0 on 1 
and the heel be too much elevated, the angle may be falient 
in the dirée€tion backward. pecies of difplacement ma 
alfo arife from an inclination of the foot too much-inward or 
outward, the re faulty pofition being that which is moft 
commo nly met with. 
The longit. “dinal cifplacement can fearcely ee in 
tran{verfe fraGtures, becaufe the oppofite bony furfaces re- 
ciprocally oppofe the paffage of one > eure the other. In 
cblique fractures, however, circumiftances 
e furf: he broken bones are incapable of preventing 
pe other from gliding upwards and downwards. Hence it 
pens, that the lower portions ae aa broken bones, in 
app of oblique fractures, are irawn upwards by 
pen 
Pa ‘mufcles of the calf of the leg, w while ne fharp end of ‘he 
upper-piece of the tibia projects forwards,.and may eafily be 
fein : 
felt under the 
Though fuch is the common difplacement of an oblique 
fracture of the leg, Boyer has Banger that i is vofitle 
a different appearance to prefent itfelf. may occur, 
that when the folution of continuity runs cb} nee down- 
wards and outwards, the lower porti f the fractur 
ones may produce the projection fo — inftead of the 
fharp end of. the upper piece of the broken tibia. 
Wemay readily conceive how eafy it mull be for a-fimple 
fracture of the leg. to e converted into’ a compound one, 
by the fharp proje 
through the in tegumen nts. fla 
mat alle increafes the degree of danger, is exceedin ngly 
comm 
A fratture of Both ones of the leg is ene attended 
with ad ee fymptoms ; 
‘lim b 5. motion 
ral and topical bleeding, the exhibition’ of joi 
‘limb. 
acute pain, — is exafpe- 
ind of motion of the limb ; an alteration in 
the seas Ligure of the member, in which a ad of angle 
is formed by the foot and lower fragments being drawn 
backwards; an inability of walking, or flanding on the 
in the rf and a plain and manifeft cre- 
‘pitus on fides ing t e pa 
When the leg is fractured high up, near'the knee, the 
furfaces of the tibia are fo broad, that fometimes no dif. 
placement whatever ca 
s 
be taken am ‘move the knee very tenderly and gen 
ae or four times a ara after the an has neque a 
certain degree of 
Fraures of the Tibia He 
When the tibia is the onl roken, the fraéture re- 
ceives a confiderable degree of fteadinefs and ft upport from 
the fibula, which remains perfeét, and aéts like a {plint on the 
Indeed, fraétures of the tibia, near the ankle or knee, 
are fometimes by no means eafily detected, becaufe there is 
ractur 
on each. other to communicate a diftinét 
-In certain examples, alfo, the de- 
ree of pain which patients wk rate ce not deterred 
them from making an imperfe of the 
n os a tibia fuipected w be faced "the furgeon 
ould trace the anterior fur. e bone, seer | 
called- the ihin, and its {fpine, or eens ior fharp edge 
fhould be done for the purpofe of ‘afcertaining whether ee 
preternatural projection or inequality exifts; for as fuch 
arts of the bone are very fuperficial, being only covered 
with fin, the leaft a age becomes perceptible to the 
urgeon’s fingers. When this- method does not art 
a fracture, the ae at may put his fin ngers on an 
aes joint, and then move the ankle joint with a "ttle 
freedom, by which means a crepitus will often be dete&ted. 
When the tibia is fraQured alone, the accident has gene- 
rally been produced by fome violence (fuch as a blow or 
ki ack} which has operated direétly on the broken part. 
Fradures of the Fibula alone. 
~The fibula may be broken Be! a fall, or a blow on the cut- 
fide of the leg, in which cafe the bone alw rays gives way at 
the oa - ie Oe orce 15 medi tely apple 
o has the leaft knowledge of anatomy, 
u and fuch information makes it 
ranifelt vie the ae can ca be broken by a force di- 
rectly applied to it, or by a twit hg the foot. Operative 
Surgery, vol. ii. p. 2c6. 
The latter kind of cafe was one, ee which the celebrated 
Pott took particular notice, as, when care is not taken to 
relax the nrufcles, confiderable trouble and di ifficulty occur in 
- treatmen’. It was rema 
° 
et 
> 
oO. 
FX) 
Sy 
~ 
et 
& 
S 
5° 
ec 
te 
ae ndicular pofition 
ligament, but.always ere {trong ligamentous fibres, which 
connéé ‘the lower end of the tibia wih the a aftrag: lus and 
os calcis, muft be lacerated. _ Such is the’cafe when the pibula 
eaks 
