A remarkable example of the manner in which pressure-changes in the skeleton may reveal the labour-history of the individual / by W. Arbuthnot Lane.

  • Sir William Arbuthnot-Lane, 1st Baronet
Date:
[1887]
Catalogue details

Licence: Public Domain Mark

Credit: A remarkable example of the manner in which pressure-changes in the skeleton may reveal the labour-history of the individual / by W. Arbuthnot Lane. 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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    shoulder-joint in a position of complete flexion in order to support the load. These facts show that the scapula was moved freely upon the clavicle, and that the movement of extreme flexion of the right shoulder-joint occurred very frequently. It is also extremely probable that the arm was loaded during the performance of these movements. The shoulder-joint presented some changes. The long tendon of the biceps passed freely through the bicipital groove, and ended in the glenoid ligament. On the right side the glenoid ligament was separated completely from the upper third of the margin of the glenoid cavity, being connected to it indirectly by a thin membrane. The upper part of the glenoid cavity was slightly increased in area. The cartilage covering the lower part had been converted into synovial membrane and areolar tissue, which formed an elevation whose surface projected beyond the level of the articular cartilage. These changes were present on the left side in a slighter degree. Now, the above conditions are found associated with the upward displacement of the head of the humerus which ensues in old age, but in this subject the abductor muscles, like the other muscles of the shoulder, were remarkably well developed, and there was no change in the form of the upper extremity of the humerus. I think we may conclude from this that the upward displacement of the head of the humerus was due either to the raising action of the flexor muscles and deltoid, or to force or resistance exerted upwards in the direction of the shaft of the humerus, or to both acting together. The elbow joints showed well-marked and peculiar pressure-changes. The articular cartilage covering the trochlear surface of the humerus and of the ulna was thick and normal in appearance, in no part presenting any degenerative change. The area of the opposing articular surfaces of ulna and humerus was extended by marginal bony growth, the surface of which was covered by articular cartilage, •which was continuous and identical in character with the original articular layer. Besides this increase in articular area, the olecranon and coronoid depressions were filled up to a great extent by bone, so that the left fore-arm could not be extended on the upper arm beyond an angle of 155°, nor could it be flexed beyond an angle of 75°. On the right side the movements of flexion and extension were still more limited. The margins of the coronoid and olecranon processes were rendered very thick, and these presented flat eburnated surfaces, which articulated in extreme flexion and extension with corresponding facets formed on the masses of bone which filled up the floor of their corresponding fossse. It is obvious that the increase in breadth and strength of the area of the humero-ulnar articulation took place in order that the elbow-joint might be rendered strong and firm, so that the fore-arm supporting a considerable load could be rapidly flexed on the upper arm with ease and safety to the elbow-joint through an angle of 80 . The filling up of the floors of the olecranon and coronoid depressions with bone,
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