American practice of surgery : a complete system of the science and art of surgery . f the shaft of the attaches greater importance to rotation of the lower fragment on theupper, the forearm acting as a lever. The intervention of muscle tissue between PSEUDARTHROSIS. 237 the fragments has been frequently reported. It is probable that all three con-ditions are very important factors in the production of pseudarthrosis in thisbone, and would go far to explain the great frequency here. Intervention ofthe musculo-spiral nerve between the fragments has also been reported fre-quently.
American practice of surgery : a complete system of the science and art of surgery . f the shaft of the attaches greater importance to rotation of the lower fragment on theupper, the forearm acting as a lever. The intervention of muscle tissue between PSEUDARTHROSIS. 237 the fragments has been frequently reported. It is probable that all three con-ditions are very important factors in the production of pseudarthrosis in thisbone, and would go far to explain the great frequency here. Intervention ofthe musculo-spiral nerve between the fragments has also been reported fre-quently. Pressure upon the nerve by forcing the two fragments together willcause pain to be transmitted down the forearm and hand, showing that thenerve is caught at the seat of fracture. In an operation for ununited fracture of the humerus, the incision is madeon the outer side of the arm, because the most important vessels and nervesare on the inner side, and because the bone is most superficial externally (seeFig. 120). The structure in greatest danger from the incision and the manipu-. Fig. 120.—Transverse Section in the Middle of the Arm. (Original.) a, Brachial vessels, withmedian and ulnar nerves; b, musculo-spiral nerve. lations necessary during the operation is the musculo-spiral nerve. It is alsofrequently injured in recent fractures of the middle of the shaft, either fromthe sharp fragments at the time of the fracture or from inclusion in the calluslater. Bound closely to the bone by the fibres of the triceps muscle as it liesin its groove, it is in greater danger from the fragments than are the brachial ves-sels, the median and the ulnar nerves, which are further removed and more looselyattached, so that they more readily escape injury. Emerging from its groovein the humerus on the outer side at the level of the insertion of the deltoid andposterior to it, it passes downward on the outer side from the middle of the shaftto the elbow, where it divides into the radial and po
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Keywords: ., bookauthorbuckalbe, bookcentury1900, bookdecade1900, bookyear1906
