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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