. Annals of surgery . HENRY H. M. LYLE of the arches of the hand. Any weakness or damage to tliese arches meansan impairment in strength, mobihty and fineness of movement. Irnm a surgical standpoint we can consider tlie basal element of the firstdigit as a phalanx. It possesses many oi the functional and developmentalcharacteristics of the phalanges, the most noteworthy function being itsfreedom of motion. (Jf all the metacar])als it shows the most varied mobility,next comes the fifth, then the fourth, the index possesses but little mobility,while the middle is the most fixed of all. To procur
. Annals of surgery . HENRY H. M. LYLE of the arches of the hand. Any weakness or damage to tliese arches meansan impairment in strength, mobihty and fineness of movement. Irnm a surgical standpoint we can consider tlie basal element of the firstdigit as a phalanx. It possesses many oi the functional and developmentalcharacteristics of the phalanges, the most noteworthy function being itsfreedom of motion. (Jf all the metacar])als it shows the most varied mobility,next comes the fifth, then the fourth, the index possesses but little mobility,while the middle is the most fixed of all. To procure the best functional results. Fig. 2.—Goldwaits flat hanil m ? ; in at_\i)ical amputations and in certain disabilities following trauma theserelative mobilities must be borne in mind. Huguiers o[>eration and similaroperations are based on the mobility of the first metacarpus; while on the otherhand, Baldwins ojieration for ]>aralysis of the intrinsic muscle of the thumb, isbased on the abolition of this mobility by an arthrodisis of the first carpo-metacarpal joint. Xdte that the thumli lies at least in a plane almost at right angles to theother fingers. Its palmar surface faces across the hand with a slight axialrotation toward the palmar surface of the index finger. Try and hold yourf)wn thumb in the same plane as the other fingers and see how fatiguing it we often see a damaged thumb splinted in this unphysiological fractures of the phalanges the axial rutation must be remembered. Perthes,in his operations for ])lastic substitntiim nf the thumb, reproduces this axialrotation in the tr
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Keywords: ., bookcentury1800, bookdecade1880, booksubjectsurgery, bookyear1885
