ain the limb
_in the abducted position_, which ensures the most accurate apposition
of the fragments (Royal Whitman). This position may be maintained by a
hinged long-splint, an adaptation of Thomas' hip splint. The fragments
may be fixed to one another by a long steel peg introduced through the
skin over the great trochanter, and passed so as to transfix them; or
they may be exposed by operation and sutured together. Albe uses a
bone peg.

#Fracture of the Neck of the Femur in Children.#--The use of the
X-rays has shown that this fracture is comparatively common in
children, as a result of a fall or a forcible twist of the leg. The
fracture is most frequently of the greenstick variety; when complete,
it is usually impacted. There is shortening to the extent of a half or
three-quarters of an inch, a slight degree of eversion, the movements
of the hip are restricted, and there is some pain. The patient is
often able to move about after the accident, but walks with a limp.
Unless the use of the X-rays reveals the fracture, the condition is
liable to be overlooked.

When the lesion is diagnosed, the deformity should be completely
corrected, any impaction that exists being undone; and the limb is put
up in a wide abduction splint (p. 221) or in a plaster-of-Paris case
in the position of extreme abduction.

If the condition is not recognised and treated, it is liable to be
followed by the development of coxa vara (Royal Whitman) (Fig. 65).

[Illustration: FIG. 65.--Coxa Vara following Fracture of Neck of Femur
in a child.]

#Fracture through the Base of the Neck.#--This fracture is usually
produced by a fall on the great trochanter, although it is
occasionally due to a fall on the feet or knees.

[Illustration: FIG. 66.--Non-impacted Fracture through Base of Neck.]

Although often spoken of as "extra-capsular," the line of fracture is
generally partly within and partly without the capsule. The fracture
usually lies close to the junction of the neck with the shaft, and in
the great majority of cases is accompanied by breaking of one or both
trochanters. This is due to the neck being driven as a wedge into the
trochanters, splitting them up. When the fragments remain interlocked,
the fracture is of the _impacted_ variety (Fig. 67).

[Illustration: FIG. 67.--Fracture through Base of Neck of Femur with
Impaction into the Trochanters.]

_Clinical Features._--Although this fracture is commonly met with in
strong adults