. Modern surgery, general and operative. nating as a Longitudinal and Oblique Fractures of the Head of the Humerus 639 spica of the shoulder, and hang the hand or forearm in a sling (Fig. 343).The dressing is to be worn for four weeks, and the rules to be followed in chang-ing it are the same as in fracture of the anatomical neck. Massage is usedafter one week, and passive motion to amend stilTness after four weeks. Forciblebreaking up of adhesions is not admissible for at least three months. Inrare cases—those with strong anterior projection of the lower end of the upperfragment—apply an ante
. Modern surgery, general and operative. nating as a Longitudinal and Oblique Fractures of the Head of the Humerus 639 spica of the shoulder, and hang the hand or forearm in a sling (Fig. 343).The dressing is to be worn for four weeks, and the rules to be followed in chang-ing it are the same as in fracture of the anatomical neck. Massage is usedafter one week, and passive motion to amend stilTness after four weeks. Forciblebreaking up of adhesions is not admissible for at least three months. Inrare cases—those with strong anterior projection of the lower end of the upperfragment—apply an anterior angular splint. If the deformity strongly tends torecur, support by a plaster-of-Paris trough on the back and sides of the arm andshoulder, or sling the extremity and obtain extension by weights and pulleysused with a frame, the patient being kept in bed (Jones extension splint is avery valuable appliance). In a case with great deformity abduction withextension is a very useful method. I have reached the conclusion that quite a. Fig. 351.—A, Jones extension humerus splint. B, Applied for fracture of left padded portion should be higher up in the axilla. number of cases of fracture of the surgical neck are best treated by incisionand fixation. Operation is often necessary if the upper end of the lower frag-ment is displaced to the outer side. If the fracture is complicated by a com-plete dislocation operation is needed to replace the head and fix the partial dislocation may disappear under extension (Ross, Ibid.). Longitudinal and Oblique Fractures of the Head of the Humerus.—Bythis term may be designated separation of the great tuberosity or separationof a portion of the articular surface, together with the great tuberosity, fromthe shaft and lesser tuberosity (Pickering Pick, Guthrie, and Ogston). Thecause is usually direct violence to the front of the shoulder, but the greatertuberosity may be torn off by muscular action. The symptoms in l
Size: 1345px × 1858px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1910, bookidmodernsurger, bookyear1919
