Some of the symptoms of fracture are certainly ambiguous. The pain and inability to move the limb commonly enumerated may arise from a mere bruise, a dislocation, or other cause; but the crepitus, the separation, and inequalities of the ends of the fracture, when the bone is superficial, the change in the form of the limb, and the shortening of it are circumstances communicating the most certain and definite information, and the crepitus in particular is the principal symptom to be depended upon, although this occasionally is attendant on dislocations, and arises from a change in the quality of the synovia or joint-oil.

The signs of fractures, however, are so expeedingly various, according to the bones which are the subject of injury, that it cannot be said that there is any one which is invariably present, and characteristically confined to them. The writers of systems usually notice loss of motion in the injured limb, deformity, swelling, tension, pain, etc., as forming the general diagnosis of fractures. However, it is easily comprehensible by any one acquainted with anatomy that numerous fractures cannot prevent the motion of the part, nor occasion outward deformity, and every one must know that though at first there may be pain in the situation of a fracture, no inflammation, swelling, and tension can take place till after a certain period. There may be, however, a swelling produced in the first instance by extravasation of blood, or by displacement of the ends of the bone.

When, therefore, a limb is broken, and the event is not manifest from the distortion of the part, it is proper to trace with the fingers the outlines of the suspected bone, and examine whether any inequality can be discovered along the anterior surface or along the edges. If it be the shoulder, trace the superficial course of the bone in the same attentive manner. Wherever any unusual pain occurs, or any unnatural irregularity appears, try if a grating or crepitus cannot be felt, on endeavouring to make one end of the suspected fracture rub against the other. In this manner you will, as a rule, arrive at a pretty accurate conclusion as to the exact seat of the injury.