A practical treatise on fractures and dislocations . Blockers method; first movement, outward rotation. [Kochers method has proved very succeessful. It is based on the followingfacts: In this dislocation the posterior portion of the capsule is untorn. Thesame is true of the tendons of the scapular muscles which cover it posteriorly ;the lower portion of the capsule, forming the rent, is tense, but the tensionis greatest at the upper part of the capsule, between the long tendon of thebiceps and the upper margin of the subscapular muscle, where it is strength- Fig. 370. Kochers method ; second m
A practical treatise on fractures and dislocations . Blockers method; first movement, outward rotation. [Kochers method has proved very succeessful. It is based on the followingfacts: In this dislocation the posterior portion of the capsule is untorn. Thesame is true of the tendons of the scapular muscles which cover it posteriorly ;the lower portion of the capsule, forming the rent, is tense, but the tensionis greatest at the upper part of the capsule, between the long tendon of thebiceps and the upper margin of the subscapular muscle, where it is strength- Fig. 370. Kochers method ; second movement, elevationof elbow. Kochers method; third movement, in-ward rotation and lowering of elbow. ened by the coraco-humeral ligament. This part of the capsule is twisted likea firm cord, and stretched. If the humerus is rotated outward, so that theforearm is turned out, this cord will also be rotated outward, the posteriorpart of the capsule will be removed from the fossa, and the torn capsule will 582 DISLOCATIONS OF THE SHOULDER. gape. The head of the bone remains fixed against the edge of the glenoidfossa, as the upper and lower parts of the capsule are still tense. But when theelbow is carried forward and raised, while the arm is held rotated outward, theupper part of the capsule relaxes and the head eaters its socket, for the tensionof the lower part of the capsule keeps it from moving forward; rotation inwardcompletes the reduction. In rotating the head outward by abducting the handthere should be greater fulness apparent in the outer deltoid region ;
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Keywords: ., bookcentury1800, bookdecade1890, booksubjec, booksubjectfractures
