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In an athetoid hand, says Starr, the interossei and lumbricales, which flex the metacarpo-phalangeal and extend the phalangeal joints, are affected; rarely are the long extensors and the long flexors affected. Therefore the hand is usually in the so-called interosseal position, with flexion of the proximal and extension of the middle and distal phalanges.
Where the subject, suffering phalangeal fracture, manifests evidence of pain due to tensing the structures about a fractured part, one may anesthetize the parts by using about two cubic centimeters of a two per cent. solution of cocain upon the plantar nerves, proximal to the fracture.
A more or less developed organ, free at its extremity, and articulating with the head or sides of a metacarpal, metatarsal, or phalangeal bone. A fully developed separate digit. A digit intimately united along its whole length with another digit, and having either an additional metacarpal or metatarsal bone of its own, or articulating with the head of one which is common to it and another digit.
Rest is the first requisite, and in addition every mechanical means possible to change the center of gravity in the phalangeal region, is to be employed. This is best accomplished by shortening the toe and paring the sole at the toe as much as conditions will permit. The heel is raised by means of a shoe with moderately high heel calks.
In cases of sprained ligaments in the phalangeal region, because of the dense character of the structures involved, little if any evidence of the cause of lameness, other than local heat, may be found twenty-four hours after the injury has been inflicted.
On city streets, horses shod with shoes having long calks get caught in frogs of street railways or by slipping on rails, and phalangeal bones are often broken. Symptomatology. Fracture of the phalanges is nearly always signalized by lameness, and this is marked during the period of weight bearing.
The bite opened the phalangeal joint of the left thumb, causing violent inflammation, and resulted in the destruction of the joint. Three years afterward the joint swelled and became extremely painful, and it was necessary to amputate the thumb. Campbell reports the case of a private of the Thirteenth Infantry who was bitten in the throat by a large rattlesnake.
This does not apply in our country as phalangeal and metacarpal and even metatarsal fractures are observed in more instances than are such injuries to the tibia. The tibia is occasionally broken at its middle and lower thirds, but malleolar fractures are not common. Symptomatology.
The fossils were lighter than fresh bones, except such as had their pores filled with carbonate of lime, in which case they were often much heavier. The human remains of most frequent occurrence were teeth detached from the jaw, and the carpal, metacarpal, tarsal, metatarsal, and phalangeal bones separated from the rest of the skeleton.
Hersman reports an interesting case of progressive enlargement of the hands in a clergyman of fifty. Since youth he had suffered with pains in the joints. About three years before the time of report he noticed enlargement of the phalangeal joint of the third finger of the right hand. A short time later the whole hand became gradually involved and the skin assumed a darker hue.
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