A case of supposed dislocation of the tendon of the long head of the biceps muscle / by J. William White.

  • White, J. William (James William), 1850-1916.
Date:
1884
Catalogue details

Licence: Public Domain Mark

Credit: A case of supposed dislocation of the tendon of the long head of the biceps muscle / by J. William White. 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.

    11/50 (page 5)
    Dr. James S. Green reports a case ( Virginia Medical Monthly, vol. iv. p. 106) of supposed luxation o( the tendon occurring during muscular action. It was thought that in this case the tendon was preternaturally mobile (see supra, case of Monteggia), at least after the first of a series of accidents which took place as follows : In November, the patient, a large corpulent woman, aged 52 years, fell on a slippery step, injuring her shoulder. She was taken home in a carriage, on net- ting out of which she tell again and felt something—“ the bone” return to its place, upon which she was relieved. Ten weeks later, while attempting to drive a bird into its cage, striking at it over head with a newspaper, she was seized with violent pain in the same shoulder, and the arm fell to her side. The next day she had the following symptoms: Exquisite tenderness on the anterior and inner surface of the shoulder, over a space about a finger’s width and finder’s ength in extent; abduction of the arm gave great pain; movement of thc^arm backward, either passively or by means of the latissimus dorsi, gave rise to the same pain which extended along the tract of the musculo-cutaneous nerve This pain was constantly present as far as the external condyle of the humerus Active flexion of the forearm upon the arm, to less than a right angle, gave most acute pain at the shoulder. e There were no symptoms of fracture or of scapulo-humeral displacement. 1 artial relief from pain was obtained by keeping the arm close to the body and elevating it by a sling and bandage. J len days later, in an eflort to save herself from another fall, she suddenly threw the injured arm upward and backward, when she “ felt somethin** return to its p ace with a snap,” accompanied by agonizing pain. After this the symp- toms all gradually disappeared. ' 1 nntTlTfV116 Stud/ of t]ie,mode whjch this spontaneous reduction took place, an 1 of the symptoms of the case, Dr. Green recommends in the treatment of such cases, flexion of forearm, rotation of the hand outward, and the use of a slin<*. r Mr. G. W. Callender, in an article on Dislocations of Muscles and their Treatment (The British Medical Journal, July 13, 1878), wrote: “Perhaps of all tendons, those which have been most under notice are the biceps of the arm, and the conjoined tendon, which, through the patella, comes occasionally to be dislocated from the front surface of the femur. There is Dr Hamilton’s case of supposed dislocation of the biceps tendon ; and in our London museums there are specimens showing displacement of the tendon of this muscle Jt is not long since a woman was under our notice in Sitwell ward, who suffered fiom a hurt of this nature I am very sorry we could do but little for her • but we did not see her until long after the first occurrence of her trouble This worna,, had great pain with her hurt. The shoulder seemed to droop forward and she shrank from using the biceps, and, indeed, from moving the joint The ko, IS ° !e,'nmT pde ° ltS gr°0VC’ T‘ by Pressinb' aguinst it so as to push t outwards, and by rotating the arm inwards, it would slip back into the groove but mdy to slip out again, when the pain, which had been for the time relieved’ waspun k‘1.t- k c'.ou!’se continued rest was tried in the hope that the tendon would be resheathed in its groove, but it was not so ; and the conclusion we came to was that the groove had become in part filled up, probably, by fibrous tissue^ the tendon had escaped and had slipped completely over the head of the bone lvinv at the inner and posterior part of the joint. ’ J ° No symptoms are mentioned except that the dislocation was “ very high un ” The diffieu'ty in reduction was attributed to the complication of the injury to the biceps Ihc inferences from the former case would lead us to expect that, had the tendon been rn snt.u ,t would have aided in the return of the bone; but its influence being removed the influence of the upper capsular muscles became doubled, and twice the amount of force was consequently required to overcome it.”