Page:A descriptive catalogue of the Warren Anatomical Museum.djvu/209

 1086. A fracture that, in the recent state, must have very closely resembled No. 1057, and strongly united by bone.

From a woman, set. seventy, who fell upon her side, and was thought unequivocally by Dr. C. to have fractured the neck of the bone, when he saw her soon after the accident. He did not wish to distress the patient by making a crit- ical examination of the limb, but founded his diagnosis simply on the total loss of power that she had over it. For two and a half or three months she was kept upon her back, with the kne flexed, and two pillows beneath it ; and then she began to sit up, with the limb extended. Crutches were afterwards used ; then a crutch and a cane ; and for the last two and a half years she used neither, though she was able to go about the house, and somewhat out of doors, limping a very little, but without any pain. There was, however, a great deal of pain during the first few weeks after the fracture. Her general health had been quite good ; and she died, of internal disease, four years and seven months from the time of the accident. After her death there was a shortening of the limb to the extent of about three-fourths of an inch, but no eversion was noticed.

The head of the bone is depressed, and bent obliquely downwards and backwards towards the lesser trochanter, with rotation outwards of the shaft. Anteriorly the neck projects somewhat beyond the margin of the head, whilst posteriorly it is impacted beneath it, and into the head ; leaving a fissure, or separation of the fragments at the seat of fracture, as usual.

A longitudinal section having been made through the middle of the head and great trochanter, and in front of the small trochanter, the cut surface shows throughout a most complete bony union. Upon the posterior half the cortex or outer shell of the neck extends quite across this surface. Upon the other half it extends nearly one-half across, from below, and beyond this the cancellated struc- ture is as continuous with that of the neck as if the bone had never been broken.

This case, and No. 1057, have been reported by Dr. H. J. Bigelow, in his work on Dislocation and Fracture of the

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