. A practical treatise on fractures and dislocations. d the latter is adducted, the thenar eminence being consequently 780 DISLOCATIONS. increased in thickness and diminished in breadth. The head of the meta-carpal bone projects in front as a round, smooth prominence close underthe skin, over which the tendon of the long flexor may perhaps be phalanx is quite movable from side to side, and can be rotated; itcan also be turned down so as to be parallel with the metacarpal bone, butthis movement should be avoided lest it produce the condition to whichFarabeuf gave the name of complex fo
. A practical treatise on fractures and dislocations. d the latter is adducted, the thenar eminence being consequently 780 DISLOCATIONS. increased in thickness and diminished in breadth. The head of the meta-carpal bone projects in front as a round, smooth prominence close underthe skin, over which the tendon of the long flexor may perhaps be phalanx is quite movable from side to side, and can be rotated; itcan also be turned down so as to be parallel with the metacarpal bone, butthis movement should be avoided lest it produce the condition to whichFarabeuf gave the name of complex form, the essential feature of whichhe thought to be the interposition of the sesamoid bones between thephalanx and metacarpal, and which presents great difficulty of reduc-tion. The cause of this difficulty, in all the cases in which I haveexposed the joint, has been the torn edge of the anterior ligamentclosely drawn across the back of the metacarpal behind its head, anda slight nicking of that edge made reduction easy. It is believed that Fig. Fresh dorsal dislocation of the thumb. flexion of the dislocated phalanx tends to produce this engagement ofthe capsule, but I know that it can take place without that aid. Treatment. The attitude of the thumb is maintained by the tensionof the short muscles attached to it, and all that is necessary to over-come that opposition is to relax the muscles by pressing the metacar-pal bone toward the palm ; then reduction is made, while maintainingthe phalanx in rectangular dorsal flexion, by pressing its base down-ward toward the end of the metacarpal and flexing when the properlevel is reached. If the torn anterior ligament has not caught behindthe head, as just described, it will be pushed before the base of thephalanx and the latter will turn past the head of the metacarpal inflexion as soon as it descends far enough. DISLOCATIONS OF THE THUMB AND FINGERS, 781 If, on the other hand, the ligament has caught above the head itbecomes a
Size: 1343px × 1861px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1910, booksubjectfractur, bookyear1912
