A case of sub-coracoid dislocation of the humerus : with the formation of an indentation on the posterior surface of the head, the joint being unopened : with remarks on the mode of production of fracture of the anatomical neck, with dislocation / by Frederic S. Eve.

  • Eve, Frederick Samuel, Sir, 1853-1916.
Date:
1880
Catalogue details

Licence: Public Domain Mark

Credit: A case of sub-coracoid dislocation of the humerus : with the formation of an indentation on the posterior surface of the head, the joint being unopened : with remarks on the mode of production of fracture of the anatomical neck, with dislocation / by Frederic S. Eve. 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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    Dissection.—The deltoid muscle was bruised, and the upper portion of its insertion separated from the bone. The muscles around the shoulder-joint were carefully dissected, but no laceration of their substance was observed; there was, however, some extravasation of blood beneath the subscapularis near the joint. On exposing the capsule it appeared quite uninjured. On opening the joint it was observed that the capsule had been stripped off from the anterior border of the gle- noid cavity, but had remained continuous with the perios- teum, which was also detached to a small extent from the adjacent anterior surface of the scapula ; the joint had not, therefore, been opened by the injury. On the posterior surface of the head of the humerus, at the margin of the articular cartilage, there was a deep vertical indentation or groove, into which the anterior margin of the glenoid cavity accurately fitted. Remarks.—The dislocation appears to have been of the true sub-coracoid variety, as described by Professor Flower.1 The bruising of the deltoid, and the mode of occurrence of the injury, indicate that the dislocation was produced by direct violence, that is, by a blow on the upper and outer part of the upper arm. The condition of the capsule in this case appears to be entirely without precedent. I have been unable to find on record a single case of traumatic dislocation of the humerus, in which the joint was not opened. It cannot be ascribed to any abnormal change in the capsule, such as enlargement from distension or unusual elasticity, since room was made for the displaced head of the humerus by the detachment of the capsule and perios- teum from the scapula, as described. The capsule and other tissues of the joint also appeared perfectly healthy. The indentation or groove on the posterior surface of the head of the humerus is another unusual feature in the case. From its position, shape, and the mode of occurrence of 1 ' Holmes' System,' 2nd ed., vol. ii, p. 814.