The surgical diseases of children . y village some brotherpractitioner can and should be found to help withanaesthetic and counsel. If, when all swelling has subsided, union be takingplace with some deformity, the surgeon should thinktwice before breaking it down with the idea of re-setting the bone. Such interference might result infracture of the bone in a fresh place, or might befollowed by serious local disturbance. Fracture through the lower epiphysis isapt to be mistaken for dislocation at the elbow epiphysial cartilage passes horizontally just abovethe condyles, the trochlea,
The surgical diseases of children . y village some brotherpractitioner can and should be found to help withanaesthetic and counsel. If, when all swelling has subsided, union be takingplace with some deformity, the surgeon should thinktwice before breaking it down with the idea of re-setting the bone. Such interference might result infracture of the bone in a fresh place, or might befollowed by serious local disturbance. Fracture through the lower epiphysis isapt to be mistaken for dislocation at the elbow epiphysial cartilage passes horizontally just abovethe condyles, the trochlea, and the capitellum. These chap, xxvii.] Fracture near Elbow. 335 portions of the humerus have separate centres of ossi-fication and (with the exception of the internal con-dyle) coalesce to form an epiphysis which is unitedto the shaft in the sixteenth or seventeenth year.(The internal condyle joins with the shaft in theeighteenth year.) The plane of the fracture may wander slightlyinto the adjoining bone tissue. The injury is most. Fig. 64.—Fracture throughLower Epiphysial Cartilage. Fig. 65.—Dislocation of Radiuaand Ulna backwards. likely caused by a fall upon the elbow, a wheelpassing over it, or by a fall upon the outstretchedhand. The diagnosis is generally easy, but if the signsbe indefinite, an anaesthetic should be administeredand a deliberate examination made. It may be no-ticed that the front of the fore-arm is shortened, andthat there is a projection behind the lower end of thehumerus. On grasping the limb above and below thejoint a strange lateral movement is detected. Thejoint fragment, if previously displaced, can be easilyrestored, though it is apt to slip back again. Themovements of pronation and supination are permitted ;z—19 386 The Surgical Diseases of Children. the top of the olecranon process is still in the normalhorizontal line with the condyles of the in the dislocation, as shown in Fig. 65,the top of the olecranon process is raised hig
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Keywords: ., bookcentury1800, bookdecade1880, booksubjectsurgery, bookyear1885
