A Treatise on Fractures, Luxations, and Other Affections of the BonesDesault, P.-J. (Pierre-Joseph)
Science
A Treatise on Fractures, Luxations, and Other Affections of the Bones
Desault, P.-J. (Pierre-Joseph)
Dislocations; Fractures; Surgery
14. In lateral luxations, a protuberance at the internal or external
side of the articulation, always shows of what kind it is. If the
displacement be to the internal side, the olecranon is then situated
behind the small tuberosity: the middle protuberance of the os humeri
bears on the radius, which is sometimes placed even behind the internal
articular eminence of that bone, which then rests on the external
depression of the great sigmoid cavity. Hence, as Petit judiciously
observes, arises the direction of the fore-arm outward, the above
eminence presenting a manifest obliquity in that direction. In this
luxation, the ulna has been known to lose entirely its connexion
with the humerus, and the radius to be brought into contact with the
internal condyl of that bone. This is what some authors call a complete
luxation. Others reserve that name for cases where, the two articular
ranges have lost their correspondence or apposition entirely.
15. In a luxation outwards, the olecranon corresponds to the external
condyl; the middle projection of the humerus, to the internal
depression of the great sigmoid cavity; the small head of this bone, to
the external depression; the radius projects outwards; and the humerus
makes a protuberance inwardly.
16. After all, these changes of situation vary remarkably, and it
belongs to theory rather than practice, to trace their history, with
precision. In general, luxations outwardly happen more frequently
than those inwardly, a circumstance which is fully explained by the
structure of the joint. In both, the lateral ligaments are almost
always lacerated.
A swelling more or less considerable accompanies all the different
kinds of luxation, and is sometimes carried so far as to involve the
diagnosis in great uncertainty, particularly when the displacement is
not very great. This phenomenon (the swelling), seems, in general, to
correspond, in a direct ratio, to the force with which the articulation
resists. Indeed the violence, and consequently the irritation, are
always in proportion to the resistance of the parts.
§ IV.
OF THE REDUCTION.
17. The means of reduction vary according to the different kinds
of displacement. They are all, however, founded on nearly the same
principles, and it will be easy to form proper ideas of them, when we
shall have given an account of the means necessary to be employed in
luxations backward, of which the others are only modifications.
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