A practical treatise on fractures and dislocations . twolatter sometimes torn ; the subscapu-lars is displaced upwards and back-wards, while its tendon is in some in-stances completely wrenched from thehead of the humerus. Mr. Erichsenhas seen the lesser tubercle itself com-pletely broken off in two examples ofthis accident which he has been permitted to examine after the axillary nerves are carried forwards with the headof the bone; and in this case the pain produced by their being thuspressed upon is even greater than in dislocations into the axilla. In this accident, as
A practical treatise on fractures and dislocations . twolatter sometimes torn ; the subscapu-lars is displaced upwards and back-wards, while its tendon is in some in-stances completely wrenched from thehead of the humerus. Mr. Erichsenhas seen the lesser tubercle itself com-pletely broken off in two examples ofthis accident which he has been permitted to examine after the axillary nerves are carried forwards with the headof the bone; and in this case the pain produced by their being thuspressed upon is even greater than in dislocations into the axilla. In this accident, as in dislocation downwards, the long head of thebiceps is sometimes broken ; the circumflex nerve may be contused orruptured, and the capsule is generally torn very extensively. Symptoms.—If the dislocation is subclavicular (Fig. 247), a depressionexists under the outer end of the acromion process, extending also un-derneath its posterior margin; the elbow hangs away from the body,and a little backwards; the axis of the limb is much changed, being. Subclavicular dislocation. 1 Wood, New York Jonrn. of Med., May, 1850, p. 282. 2 Parker, New York Journ. of Med., March, 1852, p. 187. 3 Erichsen, Science and Art of Surgery, 2d Amer. ed., p. 250. DISLOCATION OF THE HUMERUS FORWARDS, 569 thrown inwards in the direction of the middle of the clavicle, thewhole body inclining moderately to the same side; there is also moreor less inability to move the arm, especially in a direction forwards oroutwards; a fulness is seen underneath the clavicle, and to the sternalside of the coracoid process, occasioned by the head of the humerus;the head moving with the shaft. To these we may add the commonsign of all dislocations of the humerus, mentioned by Dugas, viz., theimpossibility of placing the hand upon the opposite shoulder while atthe same moment the elbow is made to touch the front of the chest. If the dislocation is forwards, but subcoracoid, the head of the bonewill be found below this pr
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