A practical treatise on fractures and dislocations . e mentioned one example of a frac-ture of the posterior angle as being in thecabinet of Dr. Mutter, of seems to doubt its existence,but speaks of it as a fracture which sur-geons have imagined. Occasionally the bone is broken intomore than two fragments. As a result of the fracture there is usu-ally more or less displacement; generally,if the fracture is below the spine and trans-verse, and especially if its direction is ob-lique from before backwards and down-wards, the inferior fragment is displacedforwards, or forwa
A practical treatise on fractures and dislocations . e mentioned one example of a frac-ture of the posterior angle as being in thecabinet of Dr. Mutter, of seems to doubt its existence,but speaks of it as a fracture which sur-geons have imagined. Occasionally the bone is broken intomore than two fragments. As a result of the fracture there is usu-ally more or less displacement; generally,if the fracture is below the spine and trans-verse, and especially if its direction is ob-lique from before backwards and down-wards, the inferior fragment is displacedforwards, or forwards and upwards, by theaction of the serratus major anticus, or ofthe teres major, while the superior frag-ment is inclined to fall backwards, and sometimes it is carried upwardsand backwards, following the action of the rhomboideus major. In cases of comminuted fractures, and occasionally in simple frac-tures, the direction of the displacement is reversed, or altogetherchanged, so that the lower fragment, instead of being in front, is be- Fig. Fractures of the body and acromionprocess of the scapula. 212 FRACTURES OF THE SCAPULA. hind the upper fragment; and instead of overlapping, the two fragmentsare more or less drawn asunder. These are deviations which are noteasily explained, but which depend, perhaps, rather upon the directionof the blow than upon the action of the muscles. In a few cases there is no displacement in any direction, althoughthe crepitus with mobility sufficiently demonstrate the existence of afracture. Prognosis.—If displacement actually has taken place, it will be foundvery difficult, as we shall see when we come to consider the treatment,to hold the fragments in apposition until a cure is completed ; so thatthey are pretty certain to unite with a degree of overlapping, or otherirregularity. Lonsdale, Lizars, Chelius, Nelaton, Gibson, Malgaigne, and othershave spoken of the difficulty or impossibility generally of keepingthese fragments in place. N
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Keywords: ., bookcentury1800, bookdecade1870, booksubjectfractur, bookyear1875
