. A practical treatise on fractures and dislocations. elling is nottoo great, the finger passing forward anddownward from the tip of the olecranonsuccessively recognizes the curved innermargin of the great sigmoid cavity, possi-bly also the coronoid process and the backof the trochlea, and then moving around the inner side below theepitrochlea to the front may trace the sharp circular margin of thetrochlea and recognize its rounded surface and groove in front. Diagnosis. The diagnosis should be made upon actual recognitionby palpation of the position of the two epieondyles, the olecranon, andt
. A practical treatise on fractures and dislocations. elling is nottoo great, the finger passing forward anddownward from the tip of the olecranonsuccessively recognizes the curved innermargin of the great sigmoid cavity, possi-bly also the coronoid process and the backof the trochlea, and then moving around the inner side below theepitrochlea to the front may trace the sharp circular margin of thetrochlea and recognize its rounded surface and groove in front. Diagnosis. The diagnosis should be made upon actual recognitionby palpation of the position of the two epieondyles, the olecranon, andthe head of the radius. The surgeon should never be satisfied withless than that, and if it cannot be obtained he should refuse to makea positive diagnosis. No attitude of the limb, no measurements, noapparent changes in its diameter, no considerations of abnormalmobility or fixation are sufficient, and the surgeon who trusts to themWill be only too likely to add to the already too long series of limbscrippled in consequence of errors in Dislocation of the elbow backward. 626 DISLOCATIONS. Of the different fractures that have been mentioned as complica-tions, those of the olecranon and epitrochlea are easily recognized bymanipulation; that of the coronoid process is indicated by easy recur-rence of the dislocation after its reduction, but if the patient is ether-ized at the time this symptom is by no means characteristic, and, fur-thermore, it is also present in those fractures of the internal condylewhich are complicated by displacement of the fragment and disloca-tion of the radius backward. Fracture of the head of the radius canhardly be recognized unless the fragment should be so displaced thatit can be felt on the outer side of the condyle. The records of discussions over cases presented to the various learnedsocieties show very clearly the difficulty of making a diagnosis in casesthat have remained unreduced for any length of time, especially inchildren in wh
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