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Any of the methods already described is available for their treatment the choice lying between Matas' operation and ligation of the external iliac. Aneurysm of the profunda femoris is distinguished from that of the main trunk by the fact that the pulses beyond are, in the former, unaffected, and by the normal artery being felt pulsating over or alongside the sac.
The surgeon said that the remains were those of a human being. The small fragment seemed a portion of one of the lumbar vertebrae the other the head of the os femoris but they were both so far gone that it was impossible to say definitely whether they belonged to the body of a male or female. There was no moral doubt that they were a woman's.
It pouches upward under the quadriceps femoris for a distance of two or three inches, a pad of fat separating the capsule from the muscle. Below the patella it is separated from the patellar ligaments by a thick pad of fat, but inferiorly it is in contact with the femerotibial capsules. The joint cavity is the most extensive in the body.
By an operation of subcutaneous section at the hips, knees, and feet, with application of plaster-of-Paris and extension, this hopeless cripple walked with crutches in two months, and with an apparatus consisting of elastic straps over the quadriceps femoris, peroneals, and weakened muscles, the valgus-foot being supported beneath the sole.
The adductor longus may be ruptured, or torn from the pubes, by a violent effort to adduct the limb. A swelling forms in the upper and medial part of the thigh, which becomes smaller and harder when the muscle is thrown into contraction. The quadriceps femoris is usually ruptured close to its insertion into the patella, in the attempt to avoid falling backwards. The injury is sometimes bilateral.
The chief physiological antagonistics of the glutei are the quadriceps femoris and tensor fascia lata. While the leg is supporting weight the stifle joint is fixed in position mainly by the quadriceps femoris group of muscles which are attached to the patella. Tendinous fibres intersect this muscular mass and relieve muscular strain during weight bearing.
In bilateral affections animals drag the toes because of the pain incident to flexing the stifles. This is particularly evident when the subject is made to trot. As the disease progresses, atrophy of the quadriceps femoris muscles becomes pronounced and as destructive changes involving the articular cartilages take place.
Since the femoral nerve supplies the quadriceps femoris muscles, it follows that when the psoic portion of this nerve becomes diseased, the stifle loses its support, and in a unilateral involvement when the subject attempts to walk on the affected member, the stifle sinks down for want of support and the leg collapses unless weight is caught up with the other leg.
This case is marvelous when we consider the proximity of several of the wounds to a vital part; the slightest deviation of position would surely have resulted in a fatal issue for this apparently charmed life. The following table shows the man's injuries in the order of their reception: Sabre-cut across the quadriceps femoris of right leg, dividing the tendinous and muscular structures.
I could not imagine a more graceful curve than that of the os femoris, and there was just that due gentle prominence in the rear of the fibula which goes to the conformation of a properly proportioned calf. I wish to God my young and talented friend Chiponchipino, the sculptor, had but seen the legs of Brevet Brigadier General John A. B. C. Smith.
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