Manual of Surgery Volume Second: Extremities—Head—Neck. Sixth Edition.Thomson, Alexis
Science
Manual of Surgery Volume Second: Extremities—Head—Neck. Sixth Edition.
Thomson, Alexis
Surgery
_Varieties._--Several varieties of dislocation are recognised,
according to the position in which the head of the humerus finally
rests (Fig. 17). The simplest of these is the _sub-glenoid_ variety,
in which the head rests on the long tendon of the triceps, where it
arises from the axillary border of the scapula just below the glenoid
cavity. In almost all dislocations of the shoulder the head of the
bone is at least momentarily in this position, but the sharp edge of
the scapula and the rounded head are ill adapted to one another, and
the position is not long maintained. The subsequent course taken by
the humerus depends upon the nature and direction of the force, the
position of the limb at the moment of injury, and the relative
strength and capacity for effective action of the different groups of
muscles acting upon the bone.
[Illustration: FIG. 17.--Diagram of most common varieties of
Dislocation of the Shoulder.]
In the great majority of cases it passes forward and medially, and
comes to lie against the anterior surface of the neck of the
scapula, under cover of the tendons of origin of the biceps and
coraco-brachialis muscles, constituting the _sub-coracoid
dislocation_. Much less frequently it passes under cover of the
pectoralis minor and against the edge of the clavicle--the
_sub-clavicular_ variety. In rare cases the head passes backward and
lies against the spine on the dorsum of the scapula, beneath the
infra-spinatus muscle--the _sub-spinous_ variety. Other varieties are
so rare that they do not call for mention.
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