Clinical notes upon two years' surgical work in the Liverpool Royal Infirmary / by W. Mitchell Banks.
- William Mitchell Banks
- Date:
- 1884
Licence: Public Domain Mark
Credit: Clinical notes upon two years' surgical work in the Liverpool Royal Infirmary / by W. Mitchell Banks. Source: Wellcome Collection.
Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.
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![to permit of any attcin])t at union being made—it was (£uite im- possible to trace tlie dcHcieut piece. Tliat tlie nerve liad been swal- lowed up in the inilaniniatory products out of which arcjse the great mass of callus seemed hardly doubtful. Had it been divided at the second operation its cut ends would have been tolerably well defined and would have been found near each otlier, .seeiii'' that .us the upper arm was shortened and not lengthened by the operation, there could have been no strain upon the nerve. The wound and dissection necessary to clear up the mystery about the ner\ e were very extensive, but immediate healing ensued and the patient was rapidly in static quo:—i. c, with a useful u^per arm and loss of extension in the fore-arm. A disappointing conclusion to what promised so well. Colkss Fracture.—Colles's fracture seldom jiresents anything out of the common, l)ut the case of M. E. had some features of interest. He was a poor, broken down, rheumatic creature, sixty- five years of age. Three months before admission he sustained a Colles's fracture of his right radius and was for some weeks an inmate of a workhouse hospital, where the fracture was treated, and from which he was discharged when it seemed to be duly uniteil. Nevertheless he found himself unable to use the hand from stifl- ness of the wrist and fingers, and so came to the Infirmary. The chief point was that the hand, as presented to us, displayed in the most characteristic way the deformity of a Colles's fracture which had been only recently sustained and which had never been re- duced. The dresser's notes say The deformity is well marked,. the hand and wrist beuig carried backwards and producing an elevation posteriorly, while the fiexor tendons are thrust forward in front. A careful examination shewed, however, that the frag- ments were really in position and apparently united, and that the deformity was in the soft parts. The arm was placed in splints- and kept at absolute rest for a month, at the end of which tune the deformity had quite disappeared. The case was a most useful one clinically for students, and the condition corresponded exactly with Hamilton's description of it as a broad, firm, uniform swelhng on the palmar surface of the fore-arm, commencing near the upper margin of the annular hgament and extending upwards two inches or more. This swelling continues nmch longer in old and feeble persons, than in the young and vigorous. Tt is pretty](https://iiif.wellcomecollection.org/image/b22294806_0036.jp2/full/800%2C/0/default.jpg)
