A treatise on fractures in the vicinity of the joints, and on certain forms of accidental and congenital dislocations / [Robert William Smith].

Robert William Smith

Date:: 1850

Credit: A treatise on fractures in the vicinity of the joints, and on certain forms of accidental and congenital dislocations / [Robert William Smith]. Source: Wellcome Collection.

85/334 (page 69)

$count of the preparations contained in the Museums of the Rich- mond Hospital, and Richmond School of Medicine, accompanying the description with a concise history of the symptoms which each case presented during the life of the individual: the reader will then be able to judge how far they warrant the conclusions which have been deduced from them. Case I.—Laurence Maguire, ext. 40.—Fracture of the neck of the femur within the capsular ligament, traversing the bone obliquely from above downwards and forwards; posteriorly the fracture has passed through the investing cartilage of the head of the bone; the anterior portion alone of the cervical ligament has been lacerated ; the synovial mem- brane of the articulation was ex- tremely vascular, but the joint con- tained scarcely any synovial fluid. A large abscess existed between the blad- der and the rectum, and the mucous membrane of the former organ was in- flamed. In this case the patient had been violently thrown to the ground, and fell directly upon the external surface of the trochanter. The foot was everted, and the limb shortened half an inch. Ten days after the occurrence of the accident severe febrile symptoms set in, and soon assumed a typhoid character: the tongue became dry and brown, the pulse feeble and rapid, and severe and fre- quent rigors, with retention of urine, and excessive irmitability about the neck of the bladder indicated the formation of matter in the vicinity of that organ. The patient died upon the four- teenth day after the occurrence of the accident. Cass I].—William Collins, «xt. 36.—Fracture of the neck of the femur within the capsule, passing through the cervix trans- versely with respect to the direction of its axis; the cervical liga- ment had been torn throughout its whole extent anteriorly, but posteriorly remained perfect; the articulation contained only a small quantity of synovia, and its lining membrane was preterna- turally vascular. The injury was caused by a fall-upon the tro-$