A clinical, pathological, and experimental study of fracture of the lower end of the radius : with displacement of the carpal fragment toward the flexor or anterior surface of the wrist / by John B. Roberts.

  • Roberts, John B. (John Bingham), 1852-1924.
Date:
1897
Catalogue details

Licence: Public Domain Mark

Credit: A clinical, pathological, and experimental study of fracture of the lower end of the radius : with displacement of the carpal fragment toward the flexor or anterior surface of the wrist / by John B. Roberts. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

    62/96 (page 50)
    No. 7) who fell backward, striking the back of the right arm on a fence picket. Extreme flexion is probably more often concerned in the usual mechanism of injury, as in Case i8. Here the account says that the man fell with his left arm under him, the elbow projecting The hand bent at the extreme flexion, was crushed beneath his body, the full force of the blow falling upon the radius, as it was fixed between the bent hand and the ground. My third case sustains this view. The affirmative evidence as to the causation of injury fur- nished by the statements contained in the cases which I have collected is, I admit, not very strong. Reporters would be very apt to say, without making a very thorough investigation, that the violence was received on the back of the hand, because the statement of many text-books is to this effect. Strong corroborative evidence is found, however, in the fre- quent occurrence of the opposite displacement by over-extension of the joint, due to violence applied to the palmar surface of the hand. This common and classical fracture of the base of the radius is nearly always due to falls on the palm, and shows displacement of the carpal fragment of the radius backward, with frequent penetration and impaction of the fragments. One would expect the reverse displacement to be due to a reverse application of force. It is intelligible that the injury under discussion might be occasioned by the hand and wrist being held in machinery or ■caughjt in a hole while the arm of the patient was forcibly thrown in a dorsal direction. Such a mechanism is evidently not the usual one. Lecomte's belief that the radius is broken in this injury by falls upon the palm, and that the anterior displacement is due to a secondary force applied on the posterior surface, will scarcely ibe accepted at the present day. It requires a more complicated mechanism than the opinion that the fracture and displacement are produced by one and the same force applied upon the dorsum. The careful studies of the fracture with backward displace-