. Atlas and epitome of traumatic . e lower end of the humerus, in which theline of separation takes the same direction (see Plate 41,Fig. 3, and Plate 36, Fig. 1 a; also text, Fig. 80). Thisarticular fracture is most frequently observed in the formof an epiphyseal separation, in children and youthful indi-viduals. For the development of the centers of ossifica-tion in the epiphysis the reader is referred to an anatomicatlas (Toldtfs Atlas, Figs. 255-257). The symptoms are those of contusion of the joint withslight deformity; some passive movement remains and ispractically painless. By pushing
. Atlas and epitome of traumatic . e lower end of the humerus, in which theline of separation takes the same direction (see Plate 41,Fig. 3, and Plate 36, Fig. 1 a; also text, Fig. 80). Thisarticular fracture is most frequently observed in the formof an epiphyseal separation, in children and youthful indi-viduals. For the development of the centers of ossifica-tion in the epiphysis the reader is referred to an anatomicatlas (Toldtfs Atlas, Figs. 255-257). The symptoms are those of contusion of the joint withslight deformity; some passive movement remains and ispractically painless. By pushing the forearm forciblyagainst the arm pain is elicited. When the intercondylarline is fixed, there is still a certain degree of mobility attha elbow-joint, both from before backward and from sideto side, accompanied by slight crepitation (cracking). Theexamination must be made under anesthesia. 180 FRACTURES AND DISLOCATIONS. Treatment.—Reduction. Splints or extension dress-ing acting in the long axis of the humerus with the fore-. Fig. 80.—Lower end of the humerus from a boy ten years of age;normal; skiagraph. A knowledge of the normal epiphyseal lines, asillustrated in this picture, is of the utmost importance to enable one tojudge skiagraphs obtained from children. A mistaken diagnosis offracture of the internal condyle and external oblique fracture is oftenmade from the skiagraph, an error that could be avoided if the skia-graph were compared with the picture of the sound elbow. (ComparePlate 41, Fig. 3.) arm either in flexion or extension,should be begun early. Passive movements FRACTURES OF THE UPPER EXTREMITY. 181 (c and d) Oblique Fractures of the Lower End ofthe Humerus.—In these oblique fractures either the outeror the inner portion of the articular extremity is split , as happens in exceptional cases, both are fractured, theinjury might be described as a double oblique fracture, or& fractura condi/Iica, as surgeons usually speak of an outerand an inner eond
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