On subluxation of the humerus, forwards and inwards / by Charles H. Hallett.

  • Hallett, Charles Henry.
Date:
1847
Catalogue details

Licence: Public Domain Mark

Credit: On subluxation of the humerus, forwards and inwards / by Charles H. Hallett. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    -4 of the shaft ; and this had been so regularly and evenly per- formed, that it appeared rather to have been effected by mecha- nical iheans, as by a saw applied at first longitudinally, and then transversely through the whole depth of the head of the bone, so as to remove a prismatic portion of it, than by the increased action of the absorbents induced by constant attrition of the anterior lip of the glenoid cavity against the anatomical neck and head of the humerus. The whole of the depressed surface Avas covered with cartilage, and presented here and there a number of grooves of a brownish colour, Avhere the cartilage was apparently deficient. These grooves indicated so many places in which the absorbing action was exerting its influence in removing the bone immediately before the individual expired. The loss of this portion of bone had caused a material altera- tion in the configuration of the head. It no longer possessed its rounded hemispherical form, but had become irregularly ovoidal. The head of the bone appeared at first sight to have been consi- derably elongated, and this elongation seemed to have caused the alteration in its shape ; but, on closer examination, the appearances ■were found to be deceptive. A large depression, therefore, existed on the inner and posterior part of tlie humerus : this depression presenting two surfaces, one longitudinal, which impinged against the anterior smooth surface of the neck of the scapula; the other transverse, which rested on the anterior half of the glenoid cavity, the corresponding lip of which was received into the angle formed by the meeting of these two surfaces. The glenoid cavity had not escaped from the effects of attrition, for that ])ortion of the anterior lip which projects somewhat into the axilla, and is the strongest part of the cavity, had been absorbed, and thus reduced to the level of the surface of the neck. I might briefly state tliat the glenoid cavity in a perfect scapula is somewhat pyriform, that its inferior two-thirds represent a segment of a circle, whilst the superior third is a segment of an ellipse. Now, in both the cases I have examined, the projecting border of the circular portion had been removed and brought on a level with the ellipsoid portion, so that the glenoid cavity and the neck of the scapula had an ellipti- cal form, which appeared like the change in the form of the head of the humerus, to have arisen from an increase of their longitu- dinal diameter; but I found from admeasurements, that this dia- meter was not increased—that it bore its usual relation to the size of the scapula. Besides these, some other changes require to be mentioned. The greater tuberosity of the humerus was situ- ated in the posterior half of the glenoid cavity. It had its form altered in such a manner as to permit it to perform the movements which the joint, in its existing state, would adniit of. The three surfaces into which the supraspinatus, infraspinatus, and teres minor muscles are inserted, were all merged into one smooth sur- face covered by the tendons of these muscles. The lower part ot