DISLOCATIONS 283 wound is associated with a fracture. But such a fracture is generally transverse and sometimes comminuted. When due to an accident, such as a fall, fracture, occurs at the weakest part of the bone, is usually spiral or oblique and is generally not accompanied by a bruise or wound. Distinction between Ante-znortem and Post-mortem Fractures.—Frac- tures caused during life show the signs of effusion of blood, laceration of muscles, pouring out of lymph, and formation of callus, but these signs are absent in fractures produced after death. However, it is difficult to distinguish if a fracture is caused immediately after death when the body is still warm, though the effusion of blood about the torn muscles and fractured ends will be very little. Besides, it should be remembered that with ordinary force it is not possible to fracture a bone after death, as it loses its tonicity and elasticity. DISLOCATIONS Dislocations are caused by falls, blows, or muscular action. They are not common in old people and in those persons whose bones have become brittle, as well as in children, in whom the separation of epiphysis is more common. They are not dangerous unless they are between the vertebrae, or are compound when death may result from secondary complications. Dislocations may occur spontaneously when the joints are diseased. It is easy to diagnose a dislocation before it is reduced. Owing to swelling, ecchymosis and limitation in the movement of a joint it may be easy to find it out even after it is reduced. But it is quite difficult to do so, after these effects have passed off, unless there is paralysis or muscular atrophy due to the involvement of a nerve as in the dislocation of a shoulder joint. After death they may be recognized by the effusion and coagulation of blood, and by the laceration of the soft tissues in the vicinity of the joint. Old dislocations may be ascertained by scar tissue in and about the capsule.