Notes on a case of dislocation of shoulder without rupture of capsule ; Cases of talipes ; A complete case of ossifying sarcoma / by D'Arcy Power.

  • Power, D'Arcy, 1855-1941.
Date:
1889
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Licence: Public Domain Mark

Credit: Notes on a case of dislocation of shoulder without rupture of capsule ; Cases of talipes ; A complete case of ossifying sarcoma / by D'Arcy Power. 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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    A- Reprinted from the ' Transactions of the Pathological Sooiety of London,' 1889. Notes on a case of dislocation of shoulder without rupture of capsule. By D'Aect Power, M.B. JB—, aged 69, salesman at Smithfield Meat Market, admitted • into St. Bartholomew's Hospital on December 21st, 1887, under Mr. T. Smith, having fallen a distance of eighteen feet on to the pavement, pitching on his right elbow and side. On examination he was found to have a compound T-shaped fracture of the lower end of the right humerus, with dislocation of the right shoulder. The dislocation did not answer exactly to the description of either the subcoracoid or subclavicular varieties, the head of the bone being more promiuent than is usually the case with the one and less so than is usually the case with the other. The coracoid pro- cess could not be felt and no crepitus was noticed. The reduction of the dislocation was easily effected under an anaesthetic. The patient, a stout, plethoric man, and unaccustomed to confinement to bed, died twelve days after his admission of acute broncho-pneumonia. At the autopsy the head of the humerus was in its proper posi- tion and the capsule of the joint was quite intact. It was rather lax, and its attachment to the anterior border of the glenoid cavity was slightly raised, but still quite continuous with the periosteum. The coracoid process was torn off the scapula, but still remained attached to the short tendon of the biceps ; and the muscles sur- rounding the joint were intact, with the exception of the sub- scapularis, which was lacerated, and into which there had been some extravasation of blood. On opening the capsule the joint was seen to be blood-stained, and on protruding the head of the bone there was visible on the posterior part of the articular surface a groove, which on redislocation fitted the lower part of the anterior margin of the glenoid cavity. The groove was. about three quarters of an inch long, and implicated the cartilage on the margin of the anatomical neck. The capsular ligament showed signs of injury where the head of the bone had impinged against it at the moment of dislocation, and there was a small piece of the articular cartilage lying loose in the joint. The lower end of the humerus showed a