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
24. The consolidation being completed generally in twenty-four or
twenty-five days, leaves, at this time, a little stiffness in the
joints, in consequence of their having remained so long without
motion: the movements of pronation and supination are performed but
imperfectly. Their return is facilitated and hastened by frequent
exercise of the limb, as well at its junction with the os humeri, as in
its own proper joints; and, in general, by the fifteenth or twentieth
day from the removal of the apparatus, things are in the same state in
which they stood before the fracture.
FRACTURE OF THE RADIUS.
§ VII.
OF THE CAUSES AND THE DISPLACEMENT.
25. The radius, which is the moveable and almost the only support or
abutment of the hand, receives, in falls on that part, a much greater
share of the shock than the ulna, which is joined to the hand by only
a small surface. Hence, without doubt, arises the greater frequency of
the fractures of the radius; fractures which, when produced by falls on
the hand, are evidently the result of a counter-stroke. Oftentimes also
this bone is broken by the immediate action of external bodies, because
it is defended below with but a thin covering of muscles.
In whatever way the fracture may be produced, it occurs in the middle
or at the extremities of the bone; very rare near its articulation
with the os humeri, it is more common in its middle; but more frequent
still at its lower end. The difference arises probably from this
circumstance, that, in falls on the wrist or hand, the shock is
weakened and lost in proportion as it is propagated upwards.
26. In such fractures, displacement is almost constantly observable
in the thickness or cross direction of the bone and fore-arm, and is
produced by the action of the pronator muscles, which, by forcing
the fragments of the radius towards the ulna, tend to diminish the
interval between the bones. The ulna remaining unbroken, always
prevents any displacement in a longitudinal direction. The first
kind of displacement is the more perceptible, in proportion as the
fracture is nearer to the middle part of the radius, where the bones
are at the greatest distance from each other. This displacement is
seldom outwards, because the interosseous ligament prevents that: yet
experience furnishes some exceptions to this rule.
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