A Treatise on Dislocations Volume 2 (Paperback)

This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1888 Excerpt: ... character of the displacement, but in some the account is not sufficiently complete to determine to which class the case should belong. In one, apparently the least frequent, the displacement is directly outward and a little upward, so that the inner edge of the sigmoid cavity rests against the outer surface of the external condyle, the elbow being partly flexed, with the olecranon behind and the coronoid process in front of the epicondyle. The radius preserves its relations with the ulna and is situated still further to the outer side, or is carried to a somewhat higher level by pronation of the forearm. This involves complete rupture of the lateral and anterior ligaments. In Neilson's case it was thought the external condyle was broken; the olecranon was three inches above its usual position. In the second class the forearm is pronated as well as flexed, and this pronation is effected by rotation about the long axis of the ulna, so that the head of the radius lies above, or is even carried to the inner side of the ulna. The great sigmoid cavity embraces the outer surface of the external condyle, the tip of the olecranon lying behind the condyle and that of the coronoid process in front of it. The anterior surface of the ulna looks inward. The head of the radius lies above its normal position, in front of the humerus, and possibly still in contact with the upper part of the articular surface of the capitellum. Study of the skeleton indicates that this form can be easily produced from an incomplete outward dislocation by pronation of the limb; it is, I think, the most common of the three classes, and it seems possible that the external lateral ligament may be preserved untorn. Denuce has given it the name of xub-epicondylar, in distinction from the followi...