Modern surgery, general and operative . that prona-tion as well as extension is re-quired to produce the injury;many surgeons claim that ex-tension and adduction are thecausative forces. Hutchinson asserts that supination may cause assigned falls as causes. The symptoms are very characteristic. The history points to the and perhaps a click may be felt about the elbow, and pain and aclick may also be felt in the wrist at the time of the accident. The armhangs by the side, with the elbow-joint slightly flexed and the forearm mid-way between pronation and supin
Modern surgery, general and operative . that prona-tion as well as extension is re-quired to produce the injury;many surgeons claim that ex-tension and adduction are thecausative forces. Hutchinson asserts that supination may cause assigned falls as causes. The symptoms are very characteristic. The history points to the and perhaps a click may be felt about the elbow, and pain and aclick may also be felt in the wrist at the time of the accident. The armhangs by the side, with the elbow-joint slightly flexed and the forearm mid-way between pronation and supination. Flexion to an angle of less than 60degrees and complete extension are resisted and are very painful, but movementsbetween 60 and 130 degrees are free and painless.^ The movements of the wrist-joint are free and painless. The elbow-joint presents no deformity. Pressureover the head of the radius causes pain. Strong pronation is painful; strong 1 See the instructive article by W. W. Van Arsdale, in Annals of Surgery, vol. ix, Fig. 409.—Dislocation of the radius backward. Dislocation of Individual Carpal Bones 673 supination is very painful, and there seems to be a mechanical obstacle to itsperformance. Forced supination develops a distinct cUck at the head ofthe radius, and causes pronation and supination to become natural and freefrom pain. The condition will be reproduced if the parts are not immobilizedfor a time. The nature of the lesion is not miderstood, and \-arious condi-tions have been thought to e.\ist by different obser\-ers. Among them mavbe mentioned the foUo-oing: a slight anterior displacement of a head of theradius; a slight posterior displacement; locking of the tuberosity of the radiusbehind the inner edge of the ulna; dislocation of the triangular cartUage ofthe wrist; intracapsular fracture of the radial head; painful paralysis fromnerve-injur}-; displacement by elongation, the return of the bone being pre-vented by collapse of the capsule; and
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Keywords: ., bookcentury1900, bookdecade1910, bookpublishe, booksubjectsurgery
