Licence: Public Domain Mark
Credit: A treatise on dislocations / by Lewis A. Stimson. Source: Wellcome Collection.
Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.
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![muscles. Keduction was readily effected with the aid of ansiesthesia. The muscles of the shoulder reacted to the feradic current; those of the arm and forearm did not. The limb wasted rapidly; under electrical treatment an almost complete cure was obtained in about two years. Rothe' reported a case of suprapubic dislocation in a girl fifteen years old, in which, three weeks afterward, the extensors of the leg upon the thigh were found to be paralyzed. The case is quoted by Kronlein as an instance of pressure upon the anterior crural nerve, but Rotlie attributes the disability to extreme flexion of the knee at the time of the accident. Kronlein (loc. cit., p. 34) also quotes Hutchinson as having seen paralysis of the sciatic nerve follow an ischiatic dislocation of the femur; and Sir Astley Cooper (loc. cit., p. 67) quotes a case in which nural)ness of the limb accompanied the same injur3^ Cooper (loc. cit., p, 74) also quotes a case of suprapubic dislocation in which the pressure of the head of the femur upon the anterior crural nerve caused numbness of the thigh ; pulsation was also arrested by the pressure of the head of the bone upon the artery. The tetanus Avhich has been occasionally observed after dislocation, especially after compound dislocation of the fingers, may provisionally be classed among the results of injury of the smaller nerves. Viscera.—Excluding the common implication of the spinal cord in dislocations of the vertebrae, there are few recorded cases of injury to parts lying within the body or neck by dislocated bones. Such injuries must, to a greater or less extent, accompany dislocation of the head of the femur through the floor of the acetabulum into the pelvis, and complete dislocation backward of the sternal end of the clavicle has in some cases been accompanied by symptoms indicating pressure on the trachea or oesophagus. In one case^ this pressure upon the oesophagus was so great as to lead to an operation for its relief. The patient, a woman, had a great deformity, arising from a distorted spine, increased by an accident which displaced the sternal extremity of the left clavicle and threw it behind the sternum. The progressive distortion of the spine gradually advanced the scapula, and occasioned the sternal end of the clavicle to project inward, behind the sternum, so as to press upon the oesophagus and occasion extreme difficulty in deglutition. Her deformit}^ had become excessive, and her emaciation extreme. The sternal end of the bone was removed by operation ; the patient survived six years and recovered considerably from her former emaciation. A case that is entirely unique, and interesting not only because of the distance to which the bone was displaced, but also because of the changes sul)sequently undergone by the bone, and of the ease with which the deformity was borne, is reported by Prochaska^ and by Larrey,* who had examined the specimen. A lad, sixteen or seventeen years old, dislocated his right humerus by a fall upon the abducted elbow, and the head of the I)one was driven between the second and third ribs (Prochaska says the 1 Rothe : Deutsche Klitiik, 1868, No. 38, p. S43. 2 Sir Astley Cooper, loc. cit., p. 309. ' Prochaska: Uisquisitio AriHtomico-physiol. Org. Huinani. Wien, 1812, quoted by Malgaigne. * Larrcy : Mem. de Chir. Militaire, vol. 2, p]). 405-107.](https://iiif.wellcomecollection.org/image/b21987063_0046.jp2/full/800%2C/0/default.jpg)
