Dislocation of cervical vertebrae : five cases, recovery without operation / by George L. Walton.

  • George Lincoln Walton
Date:
1889
Catalogue details

Licence: Public Domain Mark

Credit: Dislocation of cervical vertebrae : five cases, recovery without operation / by George L. Walton. 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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    ISlovenients of the eyes are perfect. The right is slightly larger than the left, and reacts less promptly to light. Vision is good in both eyes; the fundus is normal. There is no loss of sensation in the face or elsewhere. The watch is heard at a distance of four inches on the right, of ten inches on the left. Both drumheads are retracted, the reflex, dull on the left, ami broken on the right; bone conduction is normal. Examination of the vocal cords is impossible on account of tlie elevation and immobility of the back of the tongue. , There is no si»ecial rigidity or exaggerated reflex condition of the right arm, but the muscles are not (juite as firm as those on the left; the right forearm meas- ures, however, the .same as on the left and the upper arm a quarter of an inch more. T’he lesion in this case was ])robably a unilateral dislocation of the athis on the axis, which “consists essentially” (Liddell)® “in the disphicement of the inferior articular process on one side of the cervical vertebra from the corresponding sui)crior articular process of the vertebra which lies next below; this causes the victim’s face to be turned towards the side o[)])Osite to that on which the luxation is situated.” The diagnostic features corres}»ond closely with those described by the same author, and consist in the twisting of the neck, the fixed position of the face with the chin pointing towards the left shoulder (the luxation being on the right), the immobility, and the tenseness of the muscles on one side of the neck, combined with relaxation of those on the other side. I’aralysis of an arm, and .sometimes of the lower extremities, may also occur in greater or less severity; in our case the paralysis of the right arm alone being observed from the first, and 5 Ibid., p. 732.