The Mechanism of Dislocations And Fracture of the Hip Ii Litholapaxy Or Rapi

Cover The Mechanism of Dislocations And Fracture of the Hip Ii Litholapaxy Or Rapi
The Mechanism of Dislocations And Fracture of the Hip Ii Litholapaxy Or Rapi
Henry Jacob Bigelow
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The influence of these is well illustrated in the case already detailed (Figs. 4, 5), where the mass of large and small rotators evert the upper fragment only, leavino- the shaft to be inverted by the anterior fibres of the gluteus medius, and especially of the gluteus minimus, which is inserted lower down. This occurs when both the trochan- ters are detached, whether separately or (as in this specimen) in a single piece. Smith's four cases of inversion 1 sufficiently illustrate these points, a...s does also a specimen in the Chatham Museum, 2 where, in addition, " an arch of new osseous matter . . . Extends from the anterior inferior spinous process of the haunch-bone across the joint to the upper part of the shaft of the thigh-bone, " and which, it may be inferred from its inser- tions, was the Y ligament and the neighboring fibres (see Fig. 22, page 74 of this volume). Shortening not unfrequently results from mere depression of the neck without correspond- ing rotation of the shaft, as in the regular impacted fracture ; and the transverse neck may then be displaced outward upon the shaft, so as to resemble a hammer upon its handle.

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