A practical treatise on fractures and dislocations / by Frank Hastings Hamilton.

  • Frank Hastings Hamilton
Date:
1863
Catalogue details

Licence: Public Domain Mark

Credit: A practical treatise on fractures and dislocations / by Frank Hastings Hamilton. 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.)

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    rience has shown that it is not always, the fragments being kept asunder partly by the action of the oblique fibres of the vasti and partly by the pressure of the condyles of the femur, especially when the leg is slightly flexed. Whether the fracture is transverse or longitudinal, a bony union may occasionally be obtained when the fragments are retained in absolute contact for a sufficient length of time; but the failure to procure a bony union is not a matter of consequence, since a short ligament is equally useful. Post, of New York, has reported three cases of compound fracture of the patella extending into the knee-joint, brought to a successful termination.^ In a case mentioned by Eve, of Augusta, occasioned by the kick of a horse, and in which amputation became necessary on the tenth day, the knee-joint was found filled with dark grumous blood; a portion of the cartilage of the internal condyle of the os femoris was chipped off, and the patella broken into a number of fragments.^ Lewitt, of Michigan, has related a case of fracture in a lad set. 16, produced by striking his knee against a piece of timber, which re- sulted in suppuration of the knee-joint, but from which he finally recovered with the perfect use of the limb. The fracture of the patella was oblique, traversing only its upper and outer margin, and it was never much displaced.' Dr. Levergood, of Pa., has reported a similar case in which it be- came necessary to open the joint freely, yet it was followed by an excellent recovery, only a slight anchylosis remaining at the knee- joinf Treatment.—Sanborn, of Lowell, Mass., has contrived a method of treating transverse fractures of the patella, Figs. 174, 175, and also cases of rupture of the ligamentum patellae, which I shall take the liberty of describing in his own language. While repairing one of the public buildings in this city, two men, masons by trade, were precipitated, by the breaking of a staging, a distance of twenty-five feet on to a plank floor. One of the men received a fracture of the base of the skull, and died in consequence; the other escaped with a rupture of the ligamentum patellae. The man was conveyed home, and a neighboring physician applied the usual dressing of a ' figure-of-eight' bandage, with a splint behind the joint. In the course of the following night, the pain in the knee became intolerable from the swelling and consequent tightness of the bandage, and all dressings were removed. The following day the case was transferred to my care by the attending physician. I found the knee a good deal swollen and inflamed, and there was evidence of extensive extravasation of blood into the joint and surrounding tissue. The patella was drawn up the thigh for a distance of four inches; and, although it could be brought down nearly to its proper situation by ' Post, New York Journ. of Med., vol. ii., first series, p. 367. 2 Eve, Southern Med. and Surg. Journ., 1848 ; also Bost. Med. Journ., vol. xxxvii. p. 427. ' Lewitt, Medical Independent, Sept. 185iJ. ' Levergood Amer. Journ. Med. Sci., Jan. 1860.