Modern surgery, general and operative . s, and triceps; inward by the muscles of thebicipital groove, and forward by the great pectoral; thus, the upper end of thelower fragment projects into the axilla, and the elbow lies from the side andbackward. Pean holds that the violence drives the lower fragment upper fragment is abducted and rotated outward, which position is due,it is generally taught, to the action of the supraspinatus, infraspinatus, andteres minor muscles. In some cases displacement is forward, and in other casesit is not obvious. The lower fragment may impact into the
Modern surgery, general and operative . s, and triceps; inward by the muscles of thebicipital groove, and forward by the great pectoral; thus, the upper end of thelower fragment projects into the axilla, and the elbow lies from the side andbackward. Pean holds that the violence drives the lower fragment upper fragment is abducted and rotated outward, which position is due,it is generally taught, to the action of the supraspinatus, infraspinatus, andteres minor muscles. In some cases displacement is forward, and in other casesit is not obvious. The lower fragment may impact into the upper, in whichcase the symptoms are obscure and the diagnosis is made by exclusion. If theimpaction is solid and complete, there are the history of direct force, the im-paired movements, the slight deformity, and the absence of crepitus. In allfractures of the upper end of the htunerus the distinction can be made fromdislocation by feeling the head of the bone under the acromion and by notingthat it does not move on rotating the Fig. 2g9 —Internal angularsplint and shoulder-cap in fractureof the surgical neck of the humerus. Longitudinal and Oblique Fractures of the Head of the Humerus 557 The prognosis of fracture of the surgical neck of the bone is —Some surgeons treat a fracture of the surgical neck in exactlythe same manner as a fracture of the anatomical neck. I prefer the followingplan: In many cases give ether in order to examine and dress. Feel the pulseto see that the artery has not been damaged. Reduce by traction and manip-ulation ; if there is an impaction, pull it apart. Take an internal angular splint(PL 7, Fig. 6) and pad it well, putting on extra padding at the points that areto rest against the palm, the inner condyle, and the axillary folds. Lay thearm and pronated forearm upon the splint. Apply a padded the splint and cap in place with a spiral reversed bandage terminating as aspica of the shoulder, and hang the han
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Keywords: ., bookcentury1900, bookdecade1910, bookpublishe, booksubjectsurgery
