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The two most prolific causes of fracture are falls and blows. The few recorded instances of fracture of long bones by unaided muscular action can be ascribed solely to violent and sudden flexion. It is a generally received opinion, however, that no long bone can be broken in its shaft by the mere contraction of its muscles. But it is a conceded fact that abnormal increase of the muscular power, as during convulsions, may be sufficient to account for it. Lente has seen both femurs broken in epileptic convulsions in a child 12 years of age. Park says the compression of uterine contraction and external violence may produce an intra-uterine fracture. Professor Gurlt, who has discussed the subject of intra-uterine fractures in an exhaustive paper fortified by cases, published in Berlin in 1857, and later in his classic "Treatise on Fractures," believes that many intra-uterine fractures result from external violence
WILKINSON AD. COMPOUND INTRA-UTERINE FRACTURE OF THE FEMUR, WITH REPORT OF A CASE. JAMA. 1898;XXXI(10):536. doi:10.1001/jama.1898.92450100034002j
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