Subcutaneous nailing, exploratory incision, and the extended elbow in condyloid fractures of the humerus / by John B. Roberts.

  • Roberts, John B. (John Bingham), 1852-1924.
Date:
[1898]
Catalogue details

Licence: Public Domain Mark

Credit: Subcutaneous nailing, exploratory incision, and the extended elbow in condyloid fractures of the humerus / by John B. Roberts. 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.

    8/24 (page 4)
    is not likely to occur from fracture of a single condyle, but after a break traversing the entire width of the humerus; and he considers that the deformity has been given unnecessary importance in the determina- tion of the best posture in which to treat fractures at the lower end of the arm-bone. Stimson, of New York, on the other hand, has asserted* that displacement of a condyle, not exceeding ^ inch or ^ inch in amount, may effect a change in the humero-ulnar angle. The analogous displacements produced intentionally, by Ogston's condyloid and Macewen's supracondyloid osteotomy, for the relief of knock-knee, suffice to ex- plain the mechanical factors in the production of gun- stock deformity of the arm and convince me that frac- tures of one or of both condyles may produce the unsightly deformity. This I have proved by experi- mental fractures; some detaching the internal condyle, others causing more complicated bony lesions of the lower end of the humerus. I am not so certain of the deformity being readily produced by descent of the external condyle, when it alone is separated from the shaft of the bone. It must be recognized that the humero-ulnar angle differs greatly in individuals. I have found it less conspicuous in children and women than in men; and believe it to be most marked in those of well-devel- oped muscular power. Smith has found it to vary between — 5° and + 30°, and he states that even in the same person the two uninjured arms may differ as much as from 10° to 15°. He also found that the width of the condyloid portion of normal arms differed on the two sides of the same person. The average variation in 50 cases measured was 3.1 mm. He investigated 75 cases of united fracture of the elbow, treated according to traditional methods, to find that