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Updated: June 15, 2025
He had a broken patella a nasty case and he had gained the distinction of being the first man put to bed in that airy, charming ward. He will probably claim this honour with more or less emphasis during the rest of his lifetime.
"'But she could not stand on her feet when first lifted after the fall, and fainted immediately upon attempting to sustain her own weight, Mr. Camper replied. "I then made further examination, and found sad indications of her fall, in a fractured patella. The knee was, however, so swollen, that I could not ascertain the nature, nor extent of the fracture.
Jones crossed his legs, right over left, and Simms, standing before him, gave him a little sharp tap just under the right knee cap. The leg flew out. Jones laughed. "Exaggerated patella reflex," said Simms. "Nerve fag, nothing more. A pill or two is all you want. You don't notice any difficulty in speech?" "Not much," said Jones, laughing. "Say 'Peter Piper picked a peck of pickled peppers."
I will now present the following cases which have seemed of special interest to me: CASE FIRST. In 1874, while in the mountains on the Trinity river, Dr. was kicked by a mule in such a manner as to rupture the ligamentum patellae. The tendon of the quadriceps femoris, at once drew the patella at least two inches above its normal position.
Extension of the hock in upward luxation of the patella, permits of flexion of the phalanges. In upward luxation, then, the leg is extended as if too long, but the phalanges may be in a state of moderate flexion. If the foot rests on the ground when the extremity is not flexed, it is almost impossible for the subject to step backward.
There are even times, after he's been hugging my knees or perhaps stroking my cheek with his little velvet hands and murmuring "Maaa-maa!" in his small and bird-like coo, when he will suddenly turn savage and try to bite my patella or pull my ear out by the root. Most of this cruelty, I think, is born of a sheer excess of animal spirits. But not all of it.
On the patella it is attached around the margin of the articular surface, but on the femur the line of attachment is at a varying distance from the articular surface. On the medial side it is an inch or more from the articular cartilage; on the lateral side and above, about half an inch.
The head of the fibula lies at the outer and back part of the tibia. In extension of the knee, the patella is nearly all above the condyles. The inner border of the patella is thicker and more prominent than the outer, which slopes down toward its condyle. The short, front edge of the tibia, called the "shin," and the broad, flat, subcutaneous surface of the bone can be felt all the way down.
The patella is held in place from above by the heavy muscles of the anterior region of the thigh, and from below, by straight ligaments that attach it to the leg-bone. If the retaining structures mentioned become relaxed, the patella may, when the limb is extended, become so displaced as to rest on the superior portion of the external lip.
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.
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