A practical treatise on fractures and dislocations (1907) (14765084904)

Identifier: practicaltreatis1907stim (find matches)
Title: A practical treatise on fractures and dislocations
Year: 1907 (1900s)
Authors: Stimson, Lewis Atterbury, 1844-1917
Subjects: Fractures Dislocations
Publisher: New York Philadelphia : Lea brothers :
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons



Text Appearing Before Image:
k of the humerus.(R. W. Smith.) In the higher and some of the lower fractures the line is essentiallytransverse, usually with splintering or even comminution, sometimes withfissures extending through the head and sometimes with notable impac-tion. Many of the lower fractures are oblique, often markedly so. The upper fragment, since opposition to the action of the musclesattached to it is diminished or annulled by the fracture, often takes theattitude of flexion, abduction, and outward rotation, being sometimesaided therein by the impaction into it of the lower fragment (Plate V.);the latter is usually displaced inward, partly by the momentary con-tinuation of the fracturing force in some cases and partly by the actionof the pectoralis and teres major. Exceptionally the displacement isequal to the thickness of the shaft, and may be outward ot posterior, asshown in some of the figures; but in the great majority of cases thedisplacement is too slight to be clinically recognizable. \ <
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FRACTURES OF TIII<: HUMERUS. 231 An important Conn of impaction is that in which the 3hafl passes tothe front and outer side of the head and the latter is thereby broughtto a lower point on its inner side (Fig. L06). 11 is claimed by Hutch-inson that the rising of the shaft under the pull of the deltoid maypress Hie head so fur inward and downward that the final position mayresemble that of a dislocation below the coracoid. Fig. 107. Fig. 108.