An essay upon the original or congenital luxations of the upper extremity of the humerus / by Robert William Smith.

  • Smith, Robert William, 1807-1873.
Date:
1839
Catalogue details

Licence: Public Domain Mark

Credit: An essay upon the original or congenital luxations of the upper extremity of the humerus / by Robert William Smith. 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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    glenoid cavity could not be felt beneath it; the head of the humerus formed a distinct tumour towards the dorsal surface of the scapula, beneath and behind the summit of the acromion, and closely applied to its inferior surface : the arm was not removed from the side, and the forearm was rotated inwards. Upon examining the interior of the joint, 1 found that there was no trace of a glenoid cavity in the usual situation, but there was a well-formed socket surrounded by a glenoid ligament, upon the outer surface of the neck of the scapula broader above than below, and reaching upwards close to the under surface of the acromion ; the tendon of the biceps, perfect throughout, adhered to the upper and inner part of its circumference : the aspect of this abnormal cavity was directed forwards and outwards. The head of the humerusf presented the same oval form, already described as occurring in case. No. III., with this difference, however, that in the latter case, as already described, tlie oval form was due to the deficiency of the posterior part of the head, while in the case of Doyle, it was the anterior portion which was wanting; the lesser tubercle formed a very remark- able projection, it was elongated and curved, so as to bear con- siderable resemblance to the coracoid process of the scapula. A reference to the accompanying plate will, however, give a much better idea of the appearances than any description of mine. I should think it scarcely necessary to occupy the time of the reader In attempting to prove that these joints presented examples of congenital luxations of the head of the humerus upon the dorsum of the scapula: the total want of a glenoid cavity in the natural situation, the perfect resemblance between the two abnormal sockets, in form, size, and position, the in- tegrity of the tendons and ligaments, the singular form of the head of the humerus, all confirm this idea. I might also add the very rare occurrence of such an accident as dislocation upon the dorsum of the scapula; few, comparatively speaking, have seen it. * Plate II. Figs. 4 and 5. t Plate II. Figs. 2 and 3.