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Updated: May 13, 2025
The displacement of the scapula is not so marked as in the preceding type, and the patient is able to perform pushing movements below the level of the shoulder. If the reaction of degeneration develops, an operation may be performed, the ends of the nerve being sutured, or the distal end grafted into the posterior cord of the brachial plexus.
The patient landed on his feet, the blood spurting from each brachial artery in a large stream. His fellow-workmen, without delay, wound a piece of rope around each bleeding member, and the man recovered after primary amputation of each stump. Will gives an excellent instance of avulsion of the right arm and scapula in a girl of eighteen, who was caught in flax-spinning machinery.
"He was struck by a conoidal ball, which entered just above the interclavicular notch of the sternum and lodged near the superior angle of the scapula. Assistant Surgeon Jenning, U. S. V., removed the bullet and applied simple dressings. There was a longitudinal groove on the bullet which may have been caused by contact with the bone, but there are no symptoms of injury to the osseous tissue.
Walters reports complete recovery in humeral fracture in a foal three days old. The only treatment given was the application of a pitch plaster from the top of the scapula to the radius. The colt was kept in a comfortable box stall and in about four weeks regained use of the leg. Complete recovery eventually resulted. In the experience of the author, recovery has not occurred in humeral fractures.
"Is he your follower?" inquired the man. "That very much depends upon who walks first," replied Timothy, "but whether or no we hunt in couples." "I understand you are companions. 'Concordat cum nominativo numero et persona. Tell me, can you roll pills, can you use the pestle and the mortar, handle the scapula, and mix ingredients?" I replied that of course I knew my profession.
Relative to anomalous dislocations the field is too large to be discussed here, but there are two recent ones worthy of mention. Bradley relates an instance of death following a subluxation of the right humerus backward on the scapula It could not be reduced because the tendon of the biceps lay between the head of the humerus and a piece of the bone which was chipped off.
He could displace his muscles so that the lower angles of the scapulae projected and presented the appearance historically attributed to luxation of the scapula. Warren was well informed on surgical landmarks and had evidently been a close student of Sir Astley Cooper's classical illustrations of dislocations.
There is complaint of pain above the clavicle, and winging of the scapula; the patient is unable to raise the arm in front of the body above the level of the shoulder or to perform any forward pushing movements; on attempting either of these the winging of the scapula is at once increased.
Gilbert's surgical chapters discuss the general treatment of wounds and their complications, and more specifically that of wounds of the head, neck, throat, wounds of nerves, of the oesophagus, scapula, clavicle, of the arm, the stomach, intestines and the spleen; fractures of the clavicle, arm, forearm and ribs; compound fractures; dislocations of the atlas, jaw, shoulder and elbows; fistulae in various localities, and the operations on the tonsils and uvula, on goitre, hernia and stone in the bladder, etc. certainly a surgical compendium of no despicable comprehensiveness for a physician of his age and country.
The whole of the child's right thigh was encircled by a shining black mole, studded with white hairs; there was another mole on the spine of the left scapula. A lady in comfortable circumstances, aged 24, not markedly emotional, with one child, in all respects healthy, early in her pregnancy saw a man begging whose arms and legs were "all doubled up."
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