A treatise on orthopedic surgery . scribed byMadelung^ as spontaneous subluxation, is sometimes seen inyoung subjects. In these cases the lower extremity of the ulnais displaced toward the dorsum of the hand; there is abnormalseparation of the two bones of the forearm from one another atthe wrist, and in many instances the lower extremity of theradius is bent forward. As a consequence the wrist is enlarged,the ligaments are relaxed, and dorsal flexion of the hand isrestricted and if the deformity is extreme, pronation and supi- ^ Archiv f. klin. Chir., Bd. xxiii. 510 OETHOPEDIC SUBGEEY. nation
A treatise on orthopedic surgery . scribed byMadelung^ as spontaneous subluxation, is sometimes seen inyoung subjects. In these cases the lower extremity of the ulnais displaced toward the dorsum of the hand; there is abnormalseparation of the two bones of the forearm from one another atthe wrist, and in many instances the lower extremity of theradius is bent forward. As a consequence the wrist is enlarged,the ligaments are relaxed, and dorsal flexion of the hand isrestricted and if the deformity is extreme, pronation and supi- ^ Archiv f. klin. Chir., Bd. xxiii. 510 OETHOPEDIC SUBGEEY. nation also. Destot suggests the term curved radius as moreproperly descriptive of the affection as there is no subluxationexcejDt in extreme cases. Lenormant^ has collected 47 cases fromliterature. Twenty-three were bilateral, 24 were unilateral (12of the left, 9 of the right, 3 unspecified). The symptoms, asidefrom the deformity and limitation of motion, are weakness andsensations of discomfort about the dorsum of the wrist. Fig. Spontaneous subluxation of the wrist. —The deformity most often develops in later child-hood and adolescence. The predisposing causes of the affectionare, apparently, relaxation of the ligaments, and, probably,slight pre-existing rhachitic deformity of the same exciting causes are occupation and injury. Treatment.—The treatment is rest, massage, forcible manipu-lation in the direction of extension, and a suj)port of leather orother material to hold the hand in the extended position. Inwell marked cases the deformity of the radius should be cor-rected by osteotomy. Deformities of the hand due to over-growth of one or other of the bones of the forearm or to lossof growth caused by disease or operative treatment are occasion-ally seen. Radical operations in early life which involve re-moval of growing bone should always be avoided. CONGENITAL DEFORMITIES AT THE WRIST. Simple congenital dislocation at the wrist is extremely ra
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Keywords: ., bookauthorwhitmanr, bookcentury1900, bookdecade1910, bookyear1910
