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Show 156 When the limb is merely laid on the outside, and gently 5335M mum ‘ bent, as directed by Mr. Pott, and secured by splints and bandages, the body and limbs of the patient lie well, for some little time ; the thigh rests on its outside, and the body is inclined the same way : but, by and bye, the patient turns directly on his back, While the leg remains lying with the outside of the foot flat to the bed! 0r, again, if the limb has been set with the patient lying on his back, and the heel of the broken limb to the bed, the weight of the foot in a short time twists the leg, so that at last it lies flat on the fibula, while the patient continues on his back. This could not take place was the thigh bone entire; but now the lower piece of the thigh rolls outwardly, while the upper part remains in its place. i The bones thus twisted, unite, and, when the patient rises from bed, we find that he points the toe too much out in walking, that he carries the side of his foot forward, and has consequently lost the use of the elastic arch» of the foot. This sketch will illustrate my meaning. the muscles, while the lower part of it is twisted outward, by the falling of the foot on the outer ancle, there being no impediment to this motion from the trochanters and the hip joint as when entire. FRACTURE OF THE EXTERNAL CONDYLE OF THE THIGH BONE. WHEN we turn our attention to the natural position of the thigh bone, or when we place the condyles of the bone on the table, we find that the shaft, or cylindrical part of the bone, stands obliquely. So it happens that, in a person Who falls on his feet, the weight of the body operates oblique: ly, and the external condyle receives the shock. In this way, there is sometimes an oblique fracture of the lower head of the thigh bone, and the external condyle is broken oil‘. The utmost care is required to prevent the inflamma» tion rising in the first instance, and to provide against obli« quity in the joint. a r.-'Q‘~."'fi;'- -'»»..;,;.»f..~.~< .. "a... In Fig. 1, I have given a sketch of the limb, as I have seen it lying-the knee bent, the side of the foot flat on the bed, the leg shorter; (though this is not easily ascertained. from WOTI' 11!. 1 1374' the different aspects of the limbs), while the patient lies flat on his back. Fig. 2. shows what has taken place-that the broken ends of the bone have shot past each other, by the retraction of R':- E , ERACTURE or THE THIGH BONE. runway. or my: "my eons. |
