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Updated: June 3, 2025
The diagnosis had been fracture of the neck of the femur, but as there was no crepitation and passive movements caused but little pain, Kuster suspected rupture of the sciatic nerve. The subsequent history of the case confirmed this diagnosis. The patient was confined to bed six weeks, and it was five months afterward before he was able to go about, and then only with a crutch and a stick.
The characters of this type of loose body are remarkably constant. The body is sometimes found to be lodged in a defect or excavation in one of the articular surfaces, usually the medial condyle of the femur, from which it is readily shelled out by means of an elevator. It presents on section a layer of articular cartilage on the convex aspect and a variable thickness of spongy bone beneath this.
Rodenbaugh mentions a most interesting case of beans sprouting while in the bowel. Harrison relates a curious case in which the swallowed lower epiphysis of the femur of a rabbit made its way from the bowel to the bladder, and was discharged thence by the urethra.
About two quarts of laudable pus was discharged. By introducing the finger upward and downward, the periostium could be felt smooth except within the knee joint, for this could be distinctly felt, the finger passing readily between the ends of the femur and tibia, and beneath the patella; the crucial and lateral ligaments seemed to be gone, and the cartilages somewhat roughened.
In another case, in a white male of thirty, the same author successfully performed a hip-amputation for a large sarcoma of the left femur. The removed member was sent entire to the Army Medical Museum at Washington. The fatality and incurability of malignant growths has done much to stimulate daring and marvelous operations in surgery.
The greater part of the long extensor has been removed. 1, 2, 3. Stumps of patellar ligaments. 4. Tuberosity of tibia. The ligaments are femerotibial, femeropatellar and capsular. In addition to the usual provision for articulation of bones there are situated cartilaginous menisci between the condyles of the femur and the head of the tibia.
A large and long bone was selected, as the femur of a man or deer, and it was channeled by deep longitudinal incisions. The projections left between the fissures were rasped with another bone or a shell, and thus a harsh but varied sound could be produced. The tetzilacatl, the "vibrator" or "resounder," was a sheet of copper suspended by a cord, which was struck with sticks or with the hand.
Dislocation of the wrist is reduced by gentle extension from the hand and counter-extension from the forearm, and dislocation of the fingers by a similar manipulation. Fractures of the femur are to be treated like those of the humerus, except that the ends of the fractured bone are to be separated by the space of an inch, and a bandage six fingers in width carefully applied.
Thus in his discussion of dislocation of the femur Roger says: Si crus a coxa sit disjunctum, eadem sit cura quam et in disjuncturam brachii et cubiti diximus, etc. The general subject of fistulae is treated at considerable length on folio 205b, and fistula lachrymalis and fistulae of the jaw receive special attention in their appropriate places.
The Dayaks call the upper one Darat, which means headwaters. One man had a skin formation which at a superficial glance might be taken for a tail. It was about the size of a man's thumb, felt a little hard inside, and could be moved either way. On the outside of each thigh, over the head of the femur, was a similar but smaller formation.
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