Identifier: atlasepitomeoftr00helf (find matches)
Title: Atlas and epitome of traumatic fractures and dislocations
Year: 1902 (1900s)
Authors: Helferich, Heinrich, 1851- Bloodgood, Joseph Colt, 1867-1935, ed
Subjects: Fractures Dislocations Fractures, Bone Dislocations
Publisher: Philadelphia London : W.B. Saunders & Company
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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ter vertical dislocation, depending on whetherthe cartilaginous surface of the knee-cap presents inwardor outward. Internal vertical displacement is prob-ably the more frequent of the tw^o. It is produced bya direct violence acting from in front or from the side, andis also said to be produced by simple muscular action.The position of the patella is readily recognized when theleg is extended. (c) Complete Inversion of the Patella.—This is arotation through 180 degrees, or, in other w^ords, an ex-aggeration of the vertical dislocation just described. TheartiGular surface of the patella presents forivard. The in-jury is exceedingly rare. The diagnosis is difficult, unlessaccurate palpation is possible, and the twisting of the quad-riceps and of the ligamentum patellae can be recognized. (C) Fractures of the Patella. (Plates 61 and 62.) Fractures of the knee-cap are much more common thandislocations. They occur frequently in adults, usually inmales under fifty years of age. T(t(). (io.
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Fig. 4-. fiq.:;;. Fig.3. I.ilh. An.sl /■: Rpidiholil. Miinrlu:, FRACTURES OF THE LOWER EXTREMITY. 291 The patella in common with the entire region of theknee-joint is greatly exposed to injury. Fracture due todirect violence may follow a fall or a blow on the knee.Direct fractures sometimes assume the form of so-calledradiating or stellate fractures; that is, the patella sustainsa blow on its flat surface and is shattered into several frag-ments, separated by radiating lines. The fragments usu-ally remain in good position. Direct violence may alsolead to the production of oblique, longitudinal, and trans-verse fractures; as, for instance, after a fall on the groundon a sharp stone, or the edge of the curb, etc. Indirect fractures are produced by contraction of themuscles. It is a common saying among the people that adrunken man rarely or never breaks any bones when hefalls. This is quite true, for he falls to the ground like asack. A sober man, on the contrary, will consciously, or,

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