Remarks upon fractures of the scapula, with cases presenting striking peculiarities : read before the Medical Society of the State of Georgia, at their annual meeting in Augusta, April 8, 1857 / by L.A. Dugas.

  • Dugas, L. A. (Louis Alexander), 1806-1884.
Date:
1857
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Credit: Remarks upon fractures of the scapula, with cases presenting striking peculiarities : read before the Medical Society of the State of Georgia, at their annual meeting in Augusta, April 8, 1857 / by L.A. Dugas. 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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    Cooper not only admits its existence, but even adduces the history of three cases of the kind. We have likewise quoted Dr. Brinton on the subject. Prof. Pirrie, after defining the surgical neck, and referring to the doubts of some as to the possibility of its fracture, adds: Its occurrence has now been proved by dissection. I have seen three examples of this fracture. One was in a woman upwards of forty-five years of age; another, in a man upwards of fifty ; and a third, in a lad of sixteen. (Princ. and Pract. of Sur- gery, Am. Ed. p. 149.) Samuel Cooper admits its occurrence, in his Dictionary of Practical Surgery. It is somewhat remarkable that Malgaigne, in his elaborate work upon Fractures, makes no allusion whatever, to fractures of the neck of the scapula, either anatomical or surgical. Fractures of the surgical neck are distinct- ly described by Druitt, Fergusson, Prof. Miller of Edinburgh, and others. It is unnecessary to furnish any farther testimony to prove that this fracture may occur, and that it has been studied. But we cannot refrain from reproducing the graphic histories left us by such authority as Sir Astley Cooper. Case CCXLIII.—Mrs. R. in February, 1834, was thrown from a gig by the wheel running upon a bank. She was stunned by the fall, and remained insensible some little time; she then found that her head, shoulder, hip, and ankle, on the right side, were much bruised, so much so that she was unable to move either of them, from pain and swelling; the chief bruise on the shoulder was at the upper and back part. Thinking that the stiffness of the shoulder, as well as of the hip and ankle, arose merely from the bruise, no sur- geon saw her until ten days after the accident, when she found that notwithstanding the swelling had subsided, she was unable to move her arm. The surgeon, mistaking the case for dislocation, placed his knee in the axilla, and made violent extension ; finding, however, that upon removing the knee, the shoulder again assumed its origin- al flattened appearance, he said that there was a fracture somewhere, but could not say exactly at what part; he then placed a pad in the axilla, and put on a figure-of-8 bandage, confining the arm to the side by another bandage. Swelling and inflammation about the shoulder-joint followed the use of the extending force, to such an extent as to render the removal of the bandage immediately neces- sary. Leeches, cold lotions, and strict antiphlogistic regimen re- duced this, and in a week or ten days the bandages were again applied, and continued for six weeks, being renewed several times during that period. At the end of this time all the bandages were removed, and the patient desired gradually to use the arm as much