A system of surgery . ELBOW. 983 head of the pronated radius rolls in the coronoid fossa in front of thehumerus. The lateral ligaments are much lacerated, but the orbicularligament retains the connection between the radius and ulna, andthe posterior ligament may remain unhurt. The ulnar nerve may bedamaged in the inward displacement, and these accidents may becomplicated with fracture, or separation of the epicondyle, a matterof importance to remember and ascertain. Dislocation backwardsand outwards or inwards were also formerly described. Herethe backward displacement of the olecranon is a mo
A system of surgery . ELBOW. 983 head of the pronated radius rolls in the coronoid fossa in front of thehumerus. The lateral ligaments are much lacerated, but the orbicularligament retains the connection between the radius and ulna, andthe posterior ligament may remain unhurt. The ulnar nerve may bedamaged in the inward displacement, and these accidents may becomplicated with fracture, or separation of the epicondyle, a matterof importance to remember and ascertain. Dislocation backwardsand outwards or inwards were also formerly described. Herethe backward displacement of the olecranon is a more importantsymptom than the lateral deviation. Symptoms.—In the dislocation outwards the fore-arm is flexed andpronated, and movements are restricted and painful. The limb ap-pears widened opposite the joint. On the outer side will be feltthe prominent displaced head of the to this is another projection; thisis the displaced olecranon. Proceeding stillmore internally, we plainly feel the projecting. Fig. 393.—Partial Dislocation of the Elbow outwards. (After Tillmann.) internal condyle, and a gap beneath it, owing to the ulna havingbeen thrown outwards. In the dislocation inwards the reverse occurs ; the fore-arm isstill flexed and held midway between pronation and supination,with the appearance of widening at the flexure of the joint; butthere is a marked projection internally obscuring the internalcondyle, and this, by manipulation, may be ascertained to be theupper end of the ulna. The external condyle is markedly prominent,and there is a gap below it, owing to the radius having been throwninwards. Method of exsasiifBDiEig1 for supposed disBocsctioas of ell wow.—The patient should have both upper limbs stripped, and shouldface the surgeon, placing the dorsum of his hands on the surgeonsshoulders. The surgeon, having carefully inspected the injuredjoint, places his thumb and little finger on the condyles and hismiddle finger on the olecranon of both elb
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