| OCR Text |
Show 166 D'IsLocnION or run CLAVICLL. tremity. In truth it is the weakness of the bone more than the strength of the joint that prevents the dislocation of the clavicle at the nearer extremity. When the clavicle is dis. located from the sternum the nature of the accident cannot be mistaken. The intention in the treatment is also sufficient-r ly evident. DISLOCATION OF THE HEAD OF THE HUMERUS. arm slung, whilst a compress is to be put on the clavicle, and the roller brought round from under the arm pit of that side obliquely across the shoulder and side of the neck, in order to press down the end of the clavicle into its place. The clavicle is sometimes dislocated from its connexion with the acromion scapulae. This dislocation may at first IT is not in general a shock communicated to the joint which dislocates the humerus from the scapula, but a twist of the arm. If, for example, a boy stand holding a horse by the bridle, and the horse tosses his head, then the boy's arm is raised, and the head of the humerus is displaced from the glenoid cavity of the scapula. 01' again, if a man slip his foot and fall, and if to save himself he stretches Out the arm, then the full weight of the body being sustained by the hand, and operating with the advantage of the long lever of the arm, it turns the head of the humerus 011‘ the articulating sight be mistaken for a dislocated humerus, until the nature surface of the scapula. ‘ of the injury being understood, we find that the force used has not been such as is likely to turn out the humerus from. its place. And although their appears to be at first that hollow under the projection of the shoulder which implies the dislodgement of the head of the humerus from its place, yet presently we discover that this is only occasioned by the comparative projection of the scapular end of the clavicle; or rather more strictly speaking, that the shoulder has fallen It will be remembered, that the very free motion of the scapula is the safe-guard of the shoulder joint; for the seapula. following the motions of the arm prevents the arm bone from rising to an angle with the glenoid surface, which would in a manner facilitate dislocation. This gliding motion of the scapula keeps the humerus, even in its highest. elevation, still perpendicular to the glenoid cavity. The shoulder is to be bound moderately back, and the <~.,.M-V<.‘,~v-|- .i .‘,.,.g,_. DISLOCATION OF THE HUMERUS. \ I Still the position of the arm favourable to dislocation is when the arm bone is raised to its utmost limits, and until it 5*? Checked by the acromion process of the scapula. i [J'U‘ "" W:- -‘v':‘g'wv-.-w r. ..4. K i- Q"I"? nearer to the breast, while the clavicle is left with its further extremity projecting; we find that the humerus admits of easy and uninterrupted motion. I have said that the clavicle projects, yet properly this is rather the receding of the scapula and humerus, which are 110w no longer kept ofl‘ the breast by the clavicle. With more propriety therefore in this instance, we should term the accident the dislocation of the scapula than of the clavicle, as the clavicle remains in its place. The operation is to replace the scapula: this is to be done by holding the arm and scapula in due relation to the clavicle until the spica bandage be applied over the shoulder joint. When we suspend the fore arm, and put a pad in the arm pit to keep the scapula at its proper distance from the sternum. 17'0le M09917 The |
