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Show ‘I'RACICRL OF THIS .lIIIUIl BONE. OI" FBACTURE 0F TIIE NECK OF THE THIGH BONE. rmcrnnn or THE THIGH BONE. 139 the neck, standing oli‘ at an angle to the shaft or pillar of the bone; when we consider the strength of the she ft, or cylindrical part of the bone, that it stands almost directly un der the weight of the body, and that the neck of the bone. on the. contrary, is smaller and weaker, as well as oblique,-~. we see why, in, all shocks from the descent of the body upon the thigh bone, the neck is the most apt to be broken across. The neck of the thigh bone then is broken when the weight of the trunk falls upon it; as when a person falls from a height upon his legs, or when thinking that he has come to the landing of a stair, he steps forward and falls down two or three steps, with a shock which the neck of the thigh bone cannot bear. A direct blow on the joint injures Elli mum it, but there is no fracture: a twist of the limb dislocates i or injures the apparatus of the joint, but there is no trac- ture. It is only the perpendicular impulse that can lrac» ture the neck of the thigh bonct. I have dissected the joint some months after the. fracture of the neck of the thigh bone, and have found the bones still loose. There was at least only a very imperfect union betwixt then), by a strong and irregular ligamentous mat if i. ter. I mention this not as a curiosity, but in confirmation of a general opinion, that the neck of the thigh bone will not unite, not readily, in the usual way by bone. It is of importance to notice the motion of the hip joint this is a sketch of the bones of the person mentioned in tit; new". The 'I'Ight thigh bone is natural, the left one much r'm'"? "'wlurrw '--'¢~‘ ~. o‘~d~,; .»h0riened [/‘I/ the fracture of the neck. A, the as Ilmonzinanun ; B, the shaft (f the thigh bone ; C, the neck of the 120716 fractured; D, the trochanter major broken of. The compa- rative elevation of this point above the level of the head oft/w bone, il'ill mark the reason of the shortening of the limb. The pieces of bone were united by a ligamcntous substance, not by on almost every occasion; in the natural state of the parts indeed, we are aware of every motion to which it is liable ; but when the sensibility of the joint is increased by disease or injury, we discover, that scarcely a 12.nsclc of the limb moves without moving the thigh bone in the acetabulum: and that the patient does not move his trunk in the slight est degree, but the pain of the joint is excited by the motion of the joint. bone. " Although at this time, when Iam correcting the sheet, I am made Wnnx we hold the thigh bone before us, and consider the position of the great shaft of the bone, and the oblirputy of sensible that a man may fall on the trochanter, and break the neck of the thigh bone; yet I am convinced it is so little. likely to happen. flm‘ I venture to keep die text as it stands |
