On Fractures   

is much more easily concealed, the bone being well covered with flesh;
and the patients speedily get on foot, for it is the inner bone of
the leg which supports the most of the weight of the body. For along
with the thigh, as being in a line with weight thrown upon the thigh,
the inner bone has more work to sustain; inasmuch as it is the head
of the thigh-bone which sustains the upper part of the body, and it
is on the inner and not on the outer side of the thigh, being in a
line with the tibia; and the other half of the body approximates more
to this line than to the external one; and at the same time the inner
bone is larger than the outer, as in the fore-arm the bone in the
line of the little finger is the slenderer and longer. But in the
joint of the inferior extremity, the disposition of the longer bone
is not alike, for the elbow and the ham are bent differently. For
these reasons when the external bone is broken, the patients can soon
walk about; but in fractures of the inner, it is a long time before
they can walk.


PART 19
When the thigh-bone is broken, particular pains should be taken with
regard to the extension that it may not be insufficient, for when
excessive, no great harm results from it. For, if one should bandage
a limb while the extremities of the bone are separated to a distance
from one another by the force of the extension, the bandaging will
not keep them separate, and so the bones will come together again
as soon as the persons stretching it let go their hold; for the fleshy
parts (muscles?) being thick and strong, are more powerful than the
bandaging, instead of being less so. In the case then which we are
now treating of, nothing should be omitted in order that the parts
may be properly distended and put in a straight line; for it is a
great disgrace and an injury to exhibit a shortened thigh. For the
arm, when shortened, might be concealed, and the mistake would not
be great; but a shortened thigh-bone would exhibit the man maimed.
For when the sound limb is placed beside it, being longer than the
other, it exposes the mistake, and therefore it would be to the advantage
of a person who would be improperly treated that both his legs should
be broken, rather than either of them; for in this case the one would
be of the same length as the other. When, then, proper extension has
been made, you must adjust the parts with the palms of the hands,
and bandage the limb in the manner formerly described, placing the
hands of the bandages as was directed, and making the turns upward.
And the patient should return the same answers to the same questions
as formerly, should be pained and recover in like manner, and should
have the bandaging renewed in the same way; and the application of
the splints should be the same. The thigh-bone is consolidated in
forty days.


PART 20
But this also should be known, that the thigh-bone is curved rather
to the outside than to the inside, and rather forward than backward;
when not properly treated, then, the distortions are in these directions;
and the bone is least covered with flesh at the same parts, so that
the distortion cannot be concealed. If, therefore, you suspect anything
of this kind, you should have recourse to the mechanical contrivances
recommended in distortion of the arm. And a few turns of the bandage
should be brought round by the hip and the loins, so that the groin
and the articulation near the perineum may be included in the bandage;
and moreover, it is expedient that the extremities of the splints
should not do mischief by being placed on parts not covered with the
bandages. The splints, in fact, should be carefully kept off the naked
parts at both ends; and the arrangement of them should be so managed,
as that they may not be placed on the natural protuberances of the
bone at the knee-joint, nor on the tendon which is situated there.