On the injuries and diseases of bones : being selections from the collected edition of the clinical lectures of Baron Dupuytren, Surgeon-in-chief to the Hôtel-Dieu at Paris / translated and edited by F. Le Gros Clark.
- Guillaume Dupuytren
- Date:
- 1847
Licence: Public Domain Mark
Credit: On the injuries and diseases of bones : being selections from the collected edition of the clinical lectures of Baron Dupuytren, Surgeon-in-chief to the Hôtel-Dieu at Paris / translated and edited by F. Le Gros Clark. Source: Wellcome Collection.
Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.
42/486 page 20
![easily conceive that, for tlieir successful treatment, tlie theory of these fractures ought to be clearly understood. An oblique fracture may be defined as a complete solution of continuity, which deviates in direction from the longitudinal axis of the fractured bone. The varying amount of this ob- liquity may be measured, by taking the distance from the highest point of the fracture to its lowest or terminating ex- tremity. I have ascertained, by frequent examination of the bodies of those v/ho have fallen \dctims to accidents, that in the femur the obliquity in question varies from an inch or an inch and a half, even up to three inches ; and the obhquity measured on the dead body may be pretty accurately calculated on the living, by the aid of sight and tact, or the phenomena attendant on fracture, such as pain, displacement, the promi- nence or riding of the fractured ends, the difficulty experienced in reducing them, and, above all, the trouble of preserving them in proper relation when they are reduced. When a bone is fractm^ed transversely, displacement readilj'- occurs in a horizontal direction but not longitudinally : in these cases, unless the fractured ends completely overlap, there is no shortening; the opposing muscles acting on either extre- mity of the bone antagonise each other, and their efforts to produce displacement are negatived by the point of rest or resistance which the two portions of the fractured bone mutually afford to each other at the seat of fractm-e. Even should the ends of the bone originally overlap each other, when once placed in apposition, very slight force is sufficient to retain them so; and the provisional callus^ formed at the expiration of forty days is of sufficient consistence to prevent any risk of tlieir subsequent displacement. But in oblique fractures, the longi- tudinal displacement or shortening easily takes place, and is renewed with a pertinacity proportioned to the amount of ob- liquity ; whereas, the horizontal deviation is almost always trivial and unimportant. If it be asked why this minute dis- tinction between oblique and transverse fractures is made, the answer is this ; not only is there a natm-al tendency on the part of the muscles to produce, by their contraction, the dis- ' [The definition and proper limitation of this word will he found in the next chapter.—Tr.]](https://iiif.wellcomecollection.org/image/b23982573_0042.jp2/full/800%2C/0/default.jpg)
