On intra-capsular fracture of cervix femoris with bony union, and an interesting case of urinary calculi / by Alden March.

  • March, Alden, 1795-1869.
Date:
1858
Catalogue details

Licence: Public Domain Mark

Credit: On intra-capsular fracture of cervix femoris with bony union, and an interesting case of urinary calculi / by Alden March. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

    12/32
    absolutely so ; as the recorded cases, and also the one I am about to present, will fully prove. I believe that in all fractures of the neck of the femur, wheth- er intra or extra capsular, (with the exception of the impacted) angular distortion, (anterio posteriorly) is always clearly marked. The projecting ridge3 or more or less sharp angle in front, is due to the separation of the fragments ; and when bony union exists, to the deposit of new material in the space, and to the projec- tion of the compact outer shell of the fragments ; and by the ac- tion of the rotator muscles of the hip, the limb is everted, which contributes to widen the fissure anteriorly at the seat of fracture, This space is filled up with bony deposit, and hence the angle is permanently maintained. While at the posterior site of the fracture, the compact surface of the bone may be intact, the fractured surfaces firmly resting upon each other, and there maintained by the very means that produced the separation or fissure in front. Mr. Smith, from whose work we have before quoted, says, that in a great majority of cases of intra-capsular fracture, the pos- terior portion of the cervical ligament remains uninjured, and that large fragments of the compact tissue of the corresponding part of the neck of the bone, are frequently found adhering to it. All this I conceive to be most clearly consistent with the ex- istence of complete fracture absolutely within the capsule, and ossific union, without the aid of impaction. We think the question of osseous union of intra-capsular frac- ture of the neck of the femur, need no longer be regarded as a debatable one. The well-authenticated cases of Mr. Langstaff, Brulatour, Stanley, Swan, Adams, Jones, Chorly, Mussey, and many more that could be collected from the records of modern periodicals, would be sufficiently conclusive to settle the ques- tion. The age of the respective patients ; the time of the injury; the symptoms ; the length of time they survived after the acci- dent ; and the post-mortem appearances on dissection, are all ac- curately recorded. The age of the patients varied from eighteen to eighty. In some the symptoms of fracture were well marked