New mode of treatment for delayed or non-union of a fractured humerus : read before the Medical Society of the County of Erie, June, 1854 / by Frank H. Hamilton.

  • Hamilton, Frank Hastings, 1813-1886.
Date:
[1854?]
Catalogue details

Licence: Public Domain Mark

Credit: New mode of treatment for delayed or non-union of a fractured humerus : read before the Medical Society of the County of Erie, June, 1854 / by Frank H. Hamilton. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    head, body or upper extremities. It is probable, gentlemen, that you have made the same observation. From this and many similar facts I have been led to suspect, for a long- time, that motion has had less to do with non-union than was generally believed. I find, however, no difficulty in reconciling this suspicion with my doc- trine in reference to the case in question; and it is precisely because, as I have already explained, the motion, in case of a fractured humerus, dressed in the usual manner, is peculiar. In a fracture of the clavicle through its middle third, (its usual situation,) the motion is upon the point of fracture as upon a pivot; although, therefore, the motion is almost incessant, it does not essentially, if at all, disturb the adhesive process. The same is true in nearly all other fractures. The fragments move only upon themselves, and not to and from each other. I know of no complete exception but in the case now under consideration. Aside of any speculation, the facts are easily verified by a personal exam- ination of the patients during the first or second week of treatment, or at any time before union has occurred, both in fractures of the humerus and clavicle. The latter is always sufficiently exposed to permit you to see what occurs, and as soon as the swelling has a little subsided in the former case, you will have no difficulty in feeling the motion outside of the dressings, or perhaps in introducing the finger under the dressings sufficiently far to reach the point of fracture. I believe you will not fail to recognize the difference in the motion between the two cases. Such, gentlemen, is the explanation which I wish to offer for the relative frequency of this very serious accident—nqn-union of the humerus. I know of no other circumstance or condition in which this bone is pecu- liar, and which, therefore, might be invoked as an explanation. Overlapping of the bones, the reason assigned by some writers, is not sufficient, since it is not peculiar. The same occurs much oftener, and to a much greater extent, in fractures of the femur, and equally as often in fractures of the clavicle; yet in neither case are these results so frequent. Nor can it be due to the action of the deltoid or of any other particular muscles about the arm, whether the fracture be below or above their insertions, since similar mus- cles, with similar attachments on the femur and on the clavicle, tending al- ways powerfully to the separation of the fragments, occasion only deformity, but not non-union. If I am correct in my views, we shall be able sometimes to consummate