82. Fractures of the neck of the os femoris may occur, 1st, in the
middle part of it, where it is smallest, and where nature has not
thrown together, as she does in the middle of the long bones so often
exposed to fractures, a great quantity of compact substance: 2dly, at
its upper end, where it is united to the head of the bone: 3dly, at its
junction with the great trochanter, where the solution of continuity
may be outside of the joint, a circumstance which doubtless happens
much more frequently than has been hitherto suspected.
83. The division, rarely oblique, is almost always transverse:
sometimes, in the latter case, the neck remains enclosed or imbedded,
as it were, in the body of the bone, being fractured in such a way, as
to present a hollow or notch of greater or less depth. Several cases
of this kind occurred to Desault; one of them, modelled in wax, is
deposited in the collection of the School of Health, and the original
preparation is in my possession. The fracture, though frequently
simple, is sometimes complicated with that of the great trochanter.
CASE V. A man having received a kick from a horse, on the external
and upper part of the left thigh, fell down, and, not being able to
move, was carried home. Desault being called to him, discovered, 1st,
that the great trochanter, separated from the bone, yielded readily
to every impression it received: 2dly, that the limb was perceptibly
shortened; that the least effort was sufficient to restore to it its
natural length; and, that the foot was turned outwards, all which are
characteristic signs of a fracture of the neck.
§ XIV.