. A practical treatise on fractures and dislocations. wn as Lacours method bymanipulation. Farabeuf^ studied Kochers method experimentally with a view todetermine the mechanism by which its result was accomplished, andreached the conclusion that the efficient agent was the untorn posteriorportion of the cnpsule, and that the upper portion, the coraco-humeralligament, had little or nothing to do with it. He showed, experi-mentally, that when this latter had been divided and the posterior por-tion left intact tlie mancxnivre would still effect reduction, but that whenthe posterior portion was di
. A practical treatise on fractures and dislocations. wn as Lacours method bymanipulation. Farabeuf^ studied Kochers method experimentally with a view todetermine the mechanism by which its result was accomplished, andreached the conclusion that the efficient agent was the untorn posteriorportion of the cnpsule, and that the upper portion, the coraco-humeralligament, had little or nothing to do with it. He showed, experi-mentally, that when this latter had been divided and the posterior por-tion left intact tlie mancxnivre would still effect reduction, but that whenthe posterior portion was divided and the upper portion lelt whoU^ it ^ Konig: S])0(mo1. Chirnrffio, .^d orl., vol. iii. p. 10.» Farabouf: Hull, do la 8oc. do Thir., 1S85. p. 395. 636 DISLOCATWNS. failed, and that then the head of the humerus instead of being movedoutward bv the external rotation simply revolved about the longitu-dinal axis of the shaft. His explanation is clear and to it the approximation of the elbow to the side tightens the Fig. Kochers method of reduction : 3d movement, inward rotation and lowering of elbow. (Ceppi.) posterior portion of the capsule where it extends between the posteriorlip of the glenoid fossa and the lower and back part of the neck ofthe humerus; this prevents the posterior surface of the humerus frommoving inward when the arm is rotated outward, and consequently itsattachment to the humerus serves as the fixed point or centre aboutwhich the bone rolls outward, winding itself, as it were, upon the cap-sule. The elevation and adduction of the elbow, turning upon thesame fixed point, then throws the head backward and further outward,and finally the internal rotation unwinds the capsule and leaves every-thing in place. The method is applicable to old as well as to recent cases, but thedanger of breaking the humerus during the second step—outward rota-tion—must be borne in mind, especially in elderly patients. Schinzinger^s method, the
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectfractur, bookyear1912
