American practice of surgery : a complete system of the science and art of surgery . tus and pronator radii the fracture occurs below the insertion of the last-named muscle, the upperfragment, controlled by the biceps, supinator brevis, and pronator radii teres,will likely be found midway between pronation and supination; while the 144 AMERICAN PRACTICE OF SURGERY lower fragment, which is subject to control of the supinator longus and pro-nator quadratus, may he in about the same position. Symptoms.—The long axis of the hand is deflected to the radial side of theforearm (Fig. 53); the
American practice of surgery : a complete system of the science and art of surgery . tus and pronator radii the fracture occurs below the insertion of the last-named muscle, the upperfragment, controlled by the biceps, supinator brevis, and pronator radii teres,will likely be found midway between pronation and supination; while the 144 AMERICAN PRACTICE OF SURGERY lower fragment, which is subject to control of the supinator longus and pro-nator quadratus, may he in about the same position. Symptoms.—The long axis of the hand is deflected to the radial side of theforearm (Fig. 53); there is a depression at the point of fracture, and there isalso some deformity modified by the location of the fracture; the head of theradius is not rotated by rotation of the forearm: and. finally, all the othersigns that characterize fractures in general are present. Treatment.—If the fracture is above the insertion of the pronator radiiteres, reduce it by flexing and supinating the forearm, to cause the lowerfragment to correspond with the upper, and by applying an anterior. Fig. 51.—Fracture (experimental) of the Radius alone. The drawing shows how the upperfragment is pulled upward by the biceps, while the lower fragment remains in full pronation when thehand is turned over, palm downward. Union, under these conditions, would be attended with com-plete los~ of the power of rotation, (llclferich.) angular splint, as in fracture of the lower end (if the humerus. The splintshould he worn for about four weeks, without passive motion being made. Ifthe fracture occurs below the insertion of the pronator radii teres the treatmentrequired is the same as that for fracture of both bones of the forearm. (Seethe next section. Simultaneous Fracture of the Shafts of Both Bones of the Forearm.—Fracture of the shafts of both bones of the forearm is of frequent occur-rence, but not as frequent as fracture of either bone separately. The line of fracture is often transverse, sometimes
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Keywords: ., bookauthorbuckalbe, bookcentury1900, bookdecade1900, bookyear1906
