. A treatise on dislocations and fractures of the joints. e were not sufficient surrounding soft parts for the granu-lations to arise from.* SECTION III. DISLOCATIONS AND FRACTURES OF THE FINGERS AND TOES. The phalanges of the fingers and of the toes are united by capsularligaments to the metacarpal and metatarsal bones, and to each other ;and their union is further strengthened by lateral ligaments, proceed-ing from the side of one phalanx to that of the next. Posteriorly,they are defended by the tendon of the extensor muscle of the fingers ;and anteriorly, by the thecae and flexor tendons. D
. A treatise on dislocations and fractures of the joints. e were not sufficient surrounding soft parts for the granu-lations to arise from.* SECTION III. DISLOCATIONS AND FRACTURES OF THE FINGERS AND TOES. The phalanges of the fingers and of the toes are united by capsularligaments to the metacarpal and metatarsal bones, and to each other ;and their union is further strengthened by lateral ligaments, proceed-ing from the side of one phalanx to that of the next. Posteriorly,they are defended by the tendon of the extensor muscle of the fingers ;and anteriorly, by the thecae and flexor tendons. Dislocation of thephalanges, therefore, is but rare ; but when this accident does occur,it more frequently happens between the first and second phalanges,than between the second and third. This dislocation may be seen in the adjoining figure; the secondphalanx being thrown forwards towards the thecae ; and the first,backwards. I could not learn if the ligaments had been torn, as thedislocation had existed for a length of time, and the ligament, if it had. ever been lacerated, was then united; the extensor tendon was verymuch stretched over the end of the first phalanx; and a new capsularligament covered the head of the dislocated bone. This accident may be readily distinguished by the projection of thefirst phalanx backwards, while the head of the second maybe, althoughless distinctly, felt under the thecal. The reduction may be effected by making extension, with a slightinclination forwards, so as to relax the flexor muscles. If the bonehas not been dislocated many hours, it is easily reduced; but if neg- * Surgical Essays, p. 120. OF THE FINGERS AND TOES. 441 lected at first, this can only be accomplished by a long continued ex-tension very steadily applied. I have seen too much mischief arisefrom injury to the tendons and ligaments of these joints, ever torecommend the division of them (which some have advised) to facili-tate reduction, when extension will not succeed. The ob
Size: 2950px × 847px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1800, bookdecade1840, booksubjectfractur, bookyear1844
