. A practical treatise on fractures and dislocations. tion delivery was instrumental in one,easy in one, difficult in two. Kiister, operating upon one, found the glenoid fossa normally placedbut small, and the humerus rested on its posterior border. In a caseI operated upon and in Cumstons the conditions were the same. Dr. iMalgaigne: Loc. cit., p. ^Kuster: Ein Chirurg. Triennium, 1SS2, p. 256.»Scudder: Archives of Pediatrics, April, 1890.* Phelps: Transactions American Paniiatric Association, 1S95.^o •>Cumston: American Journal Wetlical [Science, June, liXiS. 674 DISLOCATIONS. Phelps
. A practical treatise on fractures and dislocations. tion delivery was instrumental in one,easy in one, difficult in two. Kiister, operating upon one, found the glenoid fossa normally placedbut small, and the humerus rested on its posterior border. In a caseI operated upon and in Cumstons the conditions were the same. Dr. iMalgaigne: Loc. cit., p. ^Kuster: Ein Chirurg. Triennium, 1SS2, p. 256.»Scudder: Archives of Pediatrics, April, 1890.* Phelps: Transactions American Paniiatric Association, 1S95.^o •>Cumston: American Journal Wetlical [Science, June, liXiS. 674 DISLOCATIONS. Phelps told me he had found the fossa defective at its posterior mar-gin, as if a piece had been broken off. Radiographs of three of mycases show an apparently normal glenoid fossa and humerus, but allthe bones of the limb, in all four cases, were smaller than those of theother. My patients when examined were six, nine, nine, and elevenyears old; Scudders were seven and nine, Gaillards sixteen, Cum-ston\s five; five of the eight were girls. Fig. Congenital subspinous dislocation of the shoulder. The head of the humerus can be seen and felt beneath and behindthe acromion (Fig, 394), sometimes quite close to its normal position,sometimes much further back; in Gaillards at about an equal distancefrom the two ends of the spine of the scapula. The elbow is directedforward and a little outward and is markedly rotated inw^ard. Thisposition is noted in all and is evidently characteristic. Motion, activeand passive, is limited in all directions, especially outward rotation andadduction. Scudders and Cumstons electrical examination of the mus-cles showed little difference between the two sides; in one of mine themuscles supplied by the musculo-spiral and musculo-cutaneous nerveswere markedly paretic, in two all were norraalj and in one rotationof the forearm was Aveak, but its range was complete. In all mycases the condition was noticed at birth; in one the child cried when-ever the l
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