77. Fractures of the great trochanter are the effect either of falls
on that protuberance, or of the action of bodies striking against it.
Oblique or transverse, situated sometimes at its summit, and sometimes
at its base, these fractures may be either simple or complicated.
They are rendered complicated sometimes by splinters and a swelling,
as happens when a ball produces the division, and at other times by a
fracture of the neck of the bone, an example of which we find in the
Journal of Surgery, in the case of a man seventy years of age, who had
been long subject to the itch.
78. Whatever the varieties may be, the fracture will be characterized,
1st, By a facility of moving the great trochanter in every direction,
while the pelvis and the thigh remain without motion: 2dly, By a
crepitation, arising from the friction of the divided surfaces against
each other: 3dly, By there being no shortening of the limb, when the
fracture exists alone: 4thly, By the fragments being brought together
in abduction, and separated in adduction: 5thly, By the position of
the great trochanter being higher and more anterior than natural. The
presence of these signs is the more readily perceived, because, being
superficially situated, this protuberance can be easily felt, and
yields to the motions impressed on it.
§ XI.