A manual of minor surgery and bandaging : for the use of house-surgeons, dressers and junior practitioners / by Christopher Heath.

Christopher Heath

Date:: 1866

Credit: A manual of minor surgery and bandaging : for the use of house-surgeons, dressers and junior practitioners / by Christopher Heath. Source: Wellcome Collection.

223/280 (page 199)

$Dislocation at tJie elbow.—NotwithstandiBg all the minute directions laid down for the diagnosis and treat- ment of injuries about the elbow-joint, the house-surgeon ■will find that he can efficiently treat the great majority of cases by flexing the forearm forcibly upon the upper arm. This can be most conveniently done by placing the knee in the bend of the elbow, the foot being on a chair, and bejiding the arm round it until the dislocation is reduced, when the forearm can be fully flexed upon the humerus. Should the use of the knee not give sufficient power for the pm'jDose, the foot of the operator may be employed, the patient being seated on the ground, and the opera- tor on a chair in front of him. It is possible that fracture of the humerus immediately above the condyles may be confounded with dislocation ; but the diagnosis will be readily made in a recent ex- ample, by noticing that, in the case of a fracture, the condyles move with the radius and ulna, their rela- tive distances being undistui'bed, and that the distortion is immediately reproduced, after apparent reduction, when the traction ceases. Should the rapid swelling which usually attends injuries about the elbow render the diagnosis of a doubtfid. character, it will be better to refer it to the higher authorities, rather than do damage ignorantly to a very important articidation. Dislocation at the wrist is of rare occurrence, and can be readily reduced by flexion and extension. It is Uable to be confounded in young persons with a more common accident, viz., separation of the epiphysis of the radius, the diagnosis depending upon the fact that in the latter case the styloid process can be felt to move with the carpus. Injury of the arm common to young children.—]\Ir Duncan M'iS'ab of Epping was good enough, in 1862, to call my attention to a peculiar injury occurring amon young children, and caused apparently by then- being dragged forcibly by the hand. The symptoms are pain$