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
9. The third were of opinion, that, in undergoing a displacement, the
head of the humerus could be carried only downward, under the arm-pit,
which is the most common direction, or forward, a course which it takes
more rarely. Celsus is almost the only writer who has contended for
this division. “_Humerus_, says he, _modo in alam excidit, modo in
partem priorem_.”
10. Lastly, The fourth believe, with Hippocrates, in none but a
displacement downwards, the only one which that physician has met with
in his practice. “_At vero humerus, inferiorem in partem excidit; aliam
in partem excidere non audivi._”
11. The moderns, in borrowing from the ancients their divisions of
luxations, did not, like them, determine a priori and in a vague
manner, the precise spot and direction of displacement; but ascertained
these points by subsequent observation, with more precision, in
proportion as a knowledge of anatomy shed light on them. They also paid
particular attention to the essential difference between primitive and
consecutive luxations.
12. Petit admitted of four kinds of luxations, 1st, downward, on
the edge of the scapula: this is a very rare occurrence: 2dly,
outward, under the spine of that bone, a kind very difficult to be
primitively produced. 3dly, inwards, under the hollow of the armpit.
4thly, forward, between the corocoid apophysis and the clavicle. With
this illustrious practitioner, Heister acknowledged four kinds of
displacements; but, here again, was a new variety, both in expression,
and in meaning. The one says, downward, under the arm-pit, the other
forward, under the pectoralis major; the one, backward, under the
scapula, the other outward, under its spine. According to Duverney,
luxations are never primitively in any other direction than downward;
the others being only the subsequent effect of muscular action.
13. In the midst of these very complicated modes of treating a very
simple subject, it is necessary, first, in order to acquire definite
ideas, to divide luxations of the humerus into primitive, which are the
immediate effect of external violence, and consecutive, which succeed
the primitive, through the influence of causes which I am about to
consider.
Let us suppose four lines to inscribe, in form of a parallelogram, the
oval surface of the glenoid cavity, one representing the superior edge,
another the inferior, a third the internal, and the fourth the external.
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