. Essentials of surgery; a textbook of surgery for student and graduate nurses and for those interested in the care of the sick . rus vnth displacement. Fig. 11.—Showing fracture of in-ternal condyle of humerus. outward, being held in the corrected position by adhesivestraps. Fracture of the scapula is rare except from crushinginjury or gunshot wounds. Humerus (Figs. 10, 11 and 12).—Fractures are classified as those of the (1) upper third, (2)middle third, and (3) lower third and condyles. (1) The upper third includes the head, anatomical neck,and the surgical neck, so-called because it is the
. Essentials of surgery; a textbook of surgery for student and graduate nurses and for those interested in the care of the sick . rus vnth displacement. Fig. 11.—Showing fracture of in-ternal condyle of humerus. outward, being held in the corrected position by adhesivestraps. Fracture of the scapula is rare except from crushinginjury or gunshot wounds. Humerus (Figs. 10, 11 and 12).—Fractures are classified as those of the (1) upper third, (2)middle third, and (3) lower third and condyles. (1) The upper third includes the head, anatomical neck,and the surgical neck, so-called because it is the most commonsite of fracture in this region. Fractures of the upper third BONES AND ARTICULATIONS 85 are difficult to immobilize in correct position. There is ofteninjury to the circumflex nerve and paralysis of the deltoidmuscle, with inability to raise the arm. (2) Fractures of the middle third are often oblique orspiral, with considerable displacement of fragments. Theremay be involvement of the radial or musculo-spiral nerve,with paralysis of the extensor muscles of the forearm or hand,and characteristic Fig. 12. -Showing spiral fracture ofhumenis. Fig. 13.—Showing fracture of bothbones of forearm resulting from directviolence. (3) Fractures of the lower third: (a) Above the condylesdisplacement is usually antero-posterior, and immobihzationmay be difficult. (6) Those of the condyles and elbow aredifficult to confirm without the X-ray, and immobilizationis often unsatisfactory without open treatment. Involvementof the ulnar nerve may complicate and cause paralysis. Forearm.—Fractures of the radius or ulna, or of both bonesin the upper or middle thirds (Fig. 13), occur most often from 86 ESSENTIALS OF SURGERY FOR NURSES direct violence or from bending. They require accurate appo-sition and perfect inunobilization, without crowding the bonestogether, since there is danger of fusion of the two bones andloss of function. Fracture of the lower third is most
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