Notes on dislocations of the thumb / by J.E. Kelly.

  • Kelly, James E.
Date:
1883
Catalogue details

Licence: Public Domain Mark

Credit: Notes on dislocations of the thumb / by J.E. Kelly. 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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    the short muscles is, at this stage, favourable to the traction 'forward of the base of the phalanx and to the liberation of the anterior articular wall. The phalanx is brought to a right angle, i and circumducted on the internal lateral ligament to displace, ’ if necessary, the tendon of the long flexor® and to induce the ; upper detached margin of the anterior ligament to pass from its I i position, between the bones, over the narrow inner edge of the ! I metacarpal head, and it is swept round the anterior margin as far I as the prominent external condyloid eminence to complete this ;!transposition, and extended at this point that the projection may ! i hook forward the ligament and allow the head to resume its posi- rtion within the deep articular fossa. It is well to observe that in i;the second and third stages two movements of circumduction are (.employed, which coincide at a point posterior to the i internal lateral ligament, the first passing inwards ;and upwards, with a sharp curve, and the second i inwards, downwards, forwards, and outwards. They I are represented by the accompanying diagram. Fig. 1, \ which indicates the curves for the left thumb. Should mechanical aid be necessary when a special t thumb forceps is not available, the accompanying t engraving represents a clamp. Fig. 2, which will ] prove an efficient substitute. It consists of two {pieces of wood about six inches long and half an inch 1 broad, which are connected, not too tightly, at one e end by a cord, close to which are transverse con- (cavities to receive the first phalanx. * ** It is made 1 more secure and less painful by a strip of lint being V wound round the grasping portions. It can be applied to the first i phalanx, between the prominences of the head and base, and, by per- : mitting the flexion of the terminal phalanx, it favours the relaxation ' of the tendon of the long flexor. It affords a firmer grasp than i that derived from any forceps, retractor, or other apparatus with V’ which the writer is acquainted, except that of M. Faraboeuf, which has the same advantage as to the grasp, but is inferior in only I allowing rotation on its axis and in the power being applied at a considerable distance from the position of utility, whereas this simple apparatus affords most powerful leverage with an important * Wordsworth. I Messrs. Fannin, Dublin, will supply a more elaborate apparatus constructed upon this principle.