American practice of surgery : a complete system of the science and art of surgery . Fig. 36.—Oblique Fracture of the Middle Third of theHumerus. (Massachusetts General Hospital.) 130 AMERICAN PRACTICE OF SURGERY. occur from diseased bone, as when it is the seat of a syphilitic lesion, of anosteomyelitis, of a malignant tumor, etc. The symptoms of fracture exhibited in these cases are local. The displace-ment varies according to the seat of fracture. When it is above the insertionof the deltoid, the upper fragment is drawn inward by the pectoralis major,the teres major, and the latissinms dors
American practice of surgery : a complete system of the science and art of surgery . Fig. 36.—Oblique Fracture of the Middle Third of theHumerus. (Massachusetts General Hospital.) 130 AMERICAN PRACTICE OF SURGERY. occur from diseased bone, as when it is the seat of a syphilitic lesion, of anosteomyelitis, of a malignant tumor, etc. The symptoms of fracture exhibited in these cases are local. The displace-ment varies according to the seat of fracture. When it is above the insertionof the deltoid, the upper fragment is drawn inward by the pectoralis major,the teres major, and the latissinms dorsi; and the lower fragment is drawn up-ward by the deltoid. When fracture occurs below the deltoid, the upper frag-ment is displaced upward and outward by the deltoid (Fig. 37), and the lower. Fig. 37-—Fracture of the Left Humerus. Skiagraph taken from the back. (Helferieh.) fragment upward and backward by the triceps and other arm Short-ening to the extent of an inch and more sometimes occurs. Loss of function,numbness and tingling, and loss of power of the tissues supplied by the mus-culo-spiral nerve, which is sometimes injured as it lies in the musculo-spiralgroove, are among the symptoms observed. Paralysis has been noticed, thepatient being unable to extend the fingers or supinate the forearm. Interposi-tion of this nerve between the fragments excites pain at the distribution of itsbranches. The prognosis, on the whole, is good, but the humerus, when fractured, ismore liable to non-union than is any other bone. Treves believes that this is FRACTURES. 131
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