Lectures on the American eclectic system of surgery . the large protuberance can be distinctlyfelt and seen. The fourth or the partial dislocation upward,is always attended with a rupture of the capsular ligaments, thehead of the bone resting against the outer side of the coracoidprocess of the scapula. I can not conceive how this should everhappen without a fracture of the acromion process. Downward Luxationâinto the Axilla. Among the symptoms, in this caseâbesides the obvious oneof the large hard tumor-like protuberance, which can be dis-tinctly felt in the arm-pit when the arm is raisedâthe
Lectures on the American eclectic system of surgery . the large protuberance can be distinctlyfelt and seen. The fourth or the partial dislocation upward,is always attended with a rupture of the capsular ligaments, thehead of the bone resting against the outer side of the coracoidprocess of the scapula. I can not conceive how this should everhappen without a fracture of the acromion process. Downward Luxationâinto the Axilla. Among the symptoms, in this caseâbesides the obvious oneof the large hard tumor-like protuberance, which can be dis-tinctly felt in the arm-pit when the arm is raisedâthere is acorresponding hollow below the acromion process, in conse-quence of the passing of the head of the humerus out of theglenoid cavityâ(see Fig. 32). The natural form of the shoulderis changed, the muscles being flattened, and the arm seeminglyelongated. The elbow can not without great pain be brought tothe patients side, in consequence of pressure of the head of thebone upon the axillary nerves; the patient is inclined to sepa- Fis. rate his arm from the body and support it with the other hand. When some time has elapsed, and there is inflammation with much swelling, the bone can not be readily felt; and to bring its head low enough down for this purpose, the arm should be 606 PARTICULAR DISLOCATIONS CONTINUED. raised as high as possible. The patient himself can move hisarm but little ; and even when others raise it for him, the move-ment is accomplished with difficulty and gives much pain. Thepatient can not rotate his arm, nor can he raise it to his head,though he can move it directly backward and forward with con-siderable ease. Some patients, however, will have much moremotion than others, the spasmodic force of the muscles differ-ing much in different individuals. If the dislocation is of longstanding, a crepitus can be heard on moving the arm. Thisresults from the effusion of lymph into the joint, and synovialfluid into the cellular tissue; and can be readil
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Keywords: ., bookcentury1800, bookdecade1860, booksubjectgeneralsurgery, booky
