Treatise on Dislocations (Paperback)

This historic book may have numerous typos and missing text. Purchasers can usually download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1888 edition. Excerpt: ...epitrochlea about two inches The triceps appears as a prominent cord directed downward and outward to the olecranon. The external epicondyle may be felt by pressing the finger firmly in above the head of the radius and behind the prom nence formed by the extensor muscles of the hand. 1 Nicoladoni: Loc. cit., p. 571. Hueter: Arch. fiir klin. Chin, vol. 9, p. 985. According to Pingaud, the forearm is so pronated that the posterior surface of the ulna looks outward, and the head of the radius lies in front of the capitellum instead of being displaced outwardly. Such cases belong. I think, to the class of dislocations of the ulna alone. Treatment.----The first indication of treatment is to lift the central ridge of the sigmoid cavity and the coronoid process out of the groove between the capitellum and the trochlea, or, in other words, to separate this portion of the ulna sufficiently from the under surface of the humerus to allow it to be pushed inward past the projecting outer border of the trochlea. This may be effected by hyperextension, or by outward lateral flexion if the head of the radius still rests against the under surface of the humerus so as to form a fulcrum or centre for the movement. If hyperextension is made, the movement takes place about the tip of the olecranon as a centre, where it rests against the back of the humerus, and the coronoid process is carried downward away from the humerus as well as backward, and when the separation is suflicient direct pressure with the thumbs upon the head of the radius will force the bones into place, or rotation of the ulna inward will carry the tip of the coronoid process past the margin of the trochlea into the groove. Nicoladoni suggests that in the latter manoeuvre an...