Selections from the works of Abraham Colles : consisting chiefly of his practical observations on the venereal disease, and on the use of mercury / Edited, with annotations, by Robert McDonnell.

  • McDonnell, Robert, 1828-1889.
Date:
1881
Catalogue details

Licence: Public Domain Mark

Credit: Selections from the works of Abraham Colles : consisting chiefly of his practical observations on the venereal disease, and on the use of mercury / Edited, with annotations, by Robert McDonnell. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    of the shaft of the radius appears, in old cases where union has long since taken place, to have penetrated the lower fragment in consequence of its having become encased in osseous matter deposited for the union of the fracture. The impaction theory is liable to the following objections:—1. The distance between the line of compact tissue and the posterior wall of the lower fragment is but the measure of the amount of displacement back- wards of that fragment. 2. This interspace is considerable even in those cases in which the fragments are found to be on the same plane in front. 3. Were the theory correct the amount of shortening of the posterior surface of the bone should be much greater than it ever is. 4. There is no correspondence between the length of the line of compact tissuo and the amount of shortening of the back of the radius. 5. The possibility of either fragment being driven into the other is difficult to bo conceived as long as the ulna remains entire and the ligaments uninjured. 6. Were it possible to separate the united fragments, and draw down the inferior so as to extricate it from the apparent impaction, we would not thereby succeed in restoring the normal form of the lower end of the radius. In addition to those arguments Professor Smith adds that the appear- ances disclosed by the examination of recent specimens are opposed to the impaction theory. This, however, we now know is not altogether true. Tho examples of recent fracture dissected by the late Mr. Callender and others prove beyond doubt that penetration may take place, and that, too, without any fracture of the ulna. Professor Bennett, by a careful examination of a large number of specimens, seems to have placed himself in a good position to decide between the relative merits of those who have advocated the impaction or the non-impaction theory, and of whom Voillemier and E. W. Smith are the respective champions. His memoh* appears to me so valuable a contribution to the pathology of this subject that I do not hesitate to quote from it at some length the part referring to this topic:— Since their views have been published, we find authorities ranging themselves on opposite sides, according as they adopt the non-imraction theory of Smith or the opposing doctrine of Voillemier, that all these injuries are fractures by penetration. Of late the number of recent dissections have forced most writers to admit the occurrence of each form. We have ample proof that the simple transverse fracture without im- paction, the impacted, and the fracture par ccrasement with a shattered lower fragment, are all possibilities. Intimately connected with the theory of impaction is the explanation of the variability of the symptom * Remarks on Colles's fracture, &c. By Ed. H. Bennett, M.D., M.Ch., Professor of Surgery in the Uuiversity of Dublin, &c. Read in the Section of Surgery at the Annual Meeting of the British Medical Associa- tion in Cork, August, 1879.