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There is little doubt that defective nutrition and bad hygienic surroundings are prominent factors in its production. The principal pathologic change is seen in the epiphyseal lines of long bones and beneath the periosteum. In rachitis epiphyseal swellings are seen at the wrists and ankle-joints, and in superior cases at the ends of the phalanges of the fingers and toes.
They are, however, subject to what is known as green stick fracture. Impacted fractures are usually occasioned by falls. When the weight of the body is suddenly caught by a member in such manner as to forcefully drive the epiphyseal portions of bone into and against the diaphysis, multiple longitudinal fractures occur at the point of least resistance.
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