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
1st, Most authors who have written on the luxations of the fore-arm,
have omitted considering separately those confined to the radius
alone. Some detached observations may be found here and there, on the
luxations of the upper extremity of this bone, which Duverney alone
has treated at some length. Those of its lower extremity, though more
frequent, and more easily produced, appear to have almost entirely
escaped the attention of the French practitioners, who have transmitted
nothing to us on that point, owing, no doubt, to their having had no
knowledge of it from experience. But since, at the present day, a
sufficient number of facts are collected on the subject, some account
of these displacements cannot be a matter of indifference to the art,
and it may be traced with as much precision as the accounts of other
similar accidents.
§ I.
OF THE DIFFERENCES IN POINT OF STRUCTURE BETWEEN THE TWO ARTICULATIONS
OF THE RADIUS WITH THE ULNA.
2. The radius, the moveable agent in pronation and supination, rolls
on the ulna its fixed basis or abutment, by means of two small
articulating surfaces, the one at its upper end, slightly convex,
broad within, and narrow without, corresponding to the small sigmoid
cavity, in which it is lodged; and the other at its lower end, concave,
semicircular, and fitted to the convex edge of the ulna, which it
receives. Hence two kinds of articulation different from each other,
with respect to their motions, the connexion of their surfaces, and the
ligaments which strengthen them. Let us specify these differences; they
will serve to shed light on those that exist between the displacements
of the two extremities of the radius.
3. At its upper end, the radius, in performing pronation and
supination, moves only on its own axis; at its lower end, it rolls
round the axis of the ulna: therefore, being farther removed from
their centre, its motions must have both a greater range and greater
force, in the latter case than in the former. The head of the radius,
turning on itself within the annular ligament, cannot distend it in
any direction or part. The cellular membrane attached to this ligament
is alone slightly stretched, but being loose and elastic, it yields
without resistance. At its lower end, on the contrary, the radius,
turning from without inwards during pronation, keeps the capsule
posteriorly in a state of tension, and draws it against the immoveable
head of the ulna, which tends to pass through it, if the motion be
forcible. The same phenomenon occurs in a contrary direction, during
supination; the radius is directed backward, and the ulna inward. Being
in this case distended before, and relaxed behind, the capsule is
disposed to laceration anteriorly.
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