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Show o) I‘RACTURE 01T THE THIGH BONE. FRACTURE OF THE THIGH BONE. the radius can no longer keep its natural shape, as indicated tioned to the size of the member which is injured and the vio lence it has suffered. The THIRD consideration is, perhaps, the most important one-it relates to the great mass of flesh by which the bone is surrounded. For this great mass of muscle being in unceasing action, the lower portion of the bone, on which it operates, is drawn towards the body, so as to make the broken extremia 132 by the dotted outline, C ; but that, on the contrary, the sharp and broken part of the bone will be pressed near the ulna, as at B. The consequence of this is, some distortion of the wrist, and an impediment in the rotation of the radius and hand. FRACTURE OF THE BONES OF THE HAND AND FINGERS. giggar'**n.r M- Tun bones of the carpus and metacarpus are seldom brok~ en, without being accompanied by a bursting, or laceration of the integuments. The hand is caught in machinery, or injured by the bursting of tire arms-the fracture of the bones then is the least of the evil. As to the setting of the bones, that is an easy matter : to preserve them in their natural situation, the palm of the hand is laid over a cushion or pad, accurate. 1y adapted to the hollow of the palm and fingers, and then a roller is to be brought down from the fore arm, over the hand and wrist, including the pad. When the bones of the fingers are broken, they are to be neatly set, with pieces of pastevboard, moistened and soft; over which a small roller is applied, and to secure the posi~ tion of the fingers, it" several have been shattered, they may be laid over a small cushion, so as to embrace it. -.- IT is evident, on the first consideration of the subject, that, in the fracture of the thigh bone, these circumstances must make a peculiar case : FIRST, The great strength of the bone which implies that there must be great violence and injury done to the limb, at r, Wyn-:1. -‘u-g-yggm- p.354 ,. "4.; . ‘ n." OF THE FRACTUIIE OF THE THIGH BONE: the same time that there is fracture. SECONDLY, The magnitude of the thigh, and the great proportion which the injured part bears to the whole body should lead us to infer that the injury to the system and the effect on the constitution, will be, in a good measure, propol‘ 130 ties of the bone ride over each other ; which, in the end, often occasion a short and lame thigh for life. Lastly, we must take into account the position of the thigh bone? for, as it stands nearly perpendicularly under the weight of the body, and is broken most commonly by a shock perpendicular to the pillar of the bone, it must be liable to be rent and fractured obliquely. There are very important distinctions to be made in rela» tion to fracture of the thigh bone, from the circumstance of the place and direction of the fracture. FRACTURE OF THE SHAFT 0R CYLINDRICAL PART OF THE BONE" WHEN the cylindrical part of the thigh bone is broken, we should consider well the place and degree of obliquity of the fracture, before we speak of the event. The higher the bone is fractured, the greater probability is there that the limb may be shortened during the cure. The reason is that the nearer to the upper end of the bone the fracture is, the great er is the number of muscles inserted into the lower portion, and the greater the retracting force. But if the fracture should be at the lower head of the bone, and also oblique, (as it is apt to be in that case), then is there danger of the bone uniting with an oblique position of the condyles, pro ducing distortion and weakness of the knee-joint. In the treatment of t‘" " actured thigh bone, we have man my things recommended, and a variety of apparatus advised, because, in truth, every surgeon has experienced dilficulty and disappointment in managing it, What I have now to |
