A treatise on diseases of the bones / By Thomas M. Markoe.
- Thomas M. Markoe
- Date:
- 1872
Licence: Public Domain Mark
Credit: A treatise on diseases of the bones / By Thomas M. Markoe. Source: Wellcome Collection.
Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.
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![coming' al)>()rl»e<l under tlie influence of the pressure, or bent by the i;nuhi;il action of the force exerie<l, to a (h'<rree whicli we would iKjt expect in 8ound, healthy bone. l>ut perhaps the most important practical deduction from the history of atroj)ljy is tliat wliich inculcates extreme care in manip\dati<»ns with bones which have lon^ been disused. The fact that di>use for a few months, or even for a few weeks, will reduce the resisting power of bone, should never be f(»r<;otte!i, and was imj>ressed U})on my recollection, in the most em[)hatic but unpleasant manner, by the followinfj^ case : Patrick ]?arry, ajjed forty-two, was admitted to the New York Hospital, ()ctol)er 23,1854, with a dislocation of left femur, of seven weeks' standing;. The symptoms were unecpii vocal, and the head of the bone could be felt on the dorsum of the ilium. The man was of fjood muscular development, but the limb was flabby and wasted from inaction. Attempts were made to re- duce it by Reid's method of manipulation, and, beinji; unsuc- cessful, were abandoned for the ordinary method of Sir Astley Cooper. Extension was made by i>ulleys, and, while a strong movement of adduction was being made l)y my njvn hand, a crack was heard, and it inimediatoly became evident that the neck of the femur had bniken. On taking otf the pulleys, the* crei'itus, the form, and all the symptoms, made the diagnosis clear. In the original minute of the case, the remark is made : With regard to the fracture of the cervix, we were all sur- ])ris('d at the slight amount of force which was com])etent to ])ro(hu-e such a niortitying accident. A similar accident oc- curred to one itf my colleagues in attempting to reduce an old dislocation of the elbow-ioiiit. AN'hiie nnikine: extension, and at the same time trying to flex the forearm on the arm, the humerus gave way, and a very obli(pie fracture was found to have occurred about a hand's breailth above the joint. These unfortunate occurrences (and nuist surgeons have lunl a similar experience) should lead to the greatest care in using bones, which have long been disused, as levers in reducing displace- ments, renuMubering that great power is developed by the lever- action, and that the bone-tissue is not so strong to re-ist as it is in an unchanged bone.](https://iiif.wellcomecollection.org/image/b21014413_0032.jp2/full/800%2C/0/default.jpg)
