A treatise on orthopedic surgery . nd acertain weakness of the armpersists, even though no ac-tual paralysis remains. In many instances recov-ery is but partial, the arm isweak, certain muscles areparalyzed, and there is muchrestriction of movement atthe shoulder. The growth ofthe member is retarded, andas has been mentioned, theattitude is that characteristicof posterior dislocation. Xot infrequently, although the actualparalysis is slight, the disability is extreme because of the dis-placement which restricts movement and causes first essential in treatment, therefore, is to re
A treatise on orthopedic surgery . nd acertain weakness of the armpersists, even though no ac-tual paralysis remains. In many instances recov-ery is but partial, the arm isweak, certain muscles areparalyzed, and there is muchrestriction of movement atthe shoulder. The growth ofthe member is retarded, andas has been mentioned, theattitude is that characteristicof posterior dislocation. Xot infrequently, although the actualparalysis is slight, the disability is extreme because of the dis-placement which restricts movement and causes first essential in treatment, therefore, is to replace thehead of the humerus in the proper position. This ajDplies to thecongenital as well as to the acquired disability. Reduction of —The principles of the treatment ofthe displaced humerus are to reduce the deformity, to fix thepart for a time sufficient to prevent relapse, to restore functionas far as may be by .systematic passive motion, and by method employed l)y the author with success is somewhat. The characteristic attitude of obstetricalparalysis in infancy. DEFORMITIES OF THE UPPER EXTREMITY. 501 Fig. 331. similar to the Lorenz treatment of congenital dislocation at thehip.^ The child having been anaesthetized, is brought to the edgeof the table. The shoulder is grasped firmly with one hand inorder to restrain the movements of the scapula, and with theother the arm is drawn upward and backward over the fulcrumof the thumb, which lies behindthe joint. This, the so-calledpump-handle movement, alter-nately relaxing and stretchingthe contracted parts, is carried outover and over again with slowlyincreasing force, the aim beingto force the head of the bone for-ward, and thus to thoroughlystretch the anterior part of thecapsule. When this has beenaccomplished, there is a distinctdepression behind, and the headof the humerus j)rojects in front,at a point below its proper posi-tion. One then attempts to over-come the abduction and to forcethe head
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