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Updated: June 20, 2025
The available operative measures are proximal ligation of the innominate, and distal ligation. In some cases it has been found necessary to combine distal ligation with amputation at the shoulder-joint, to prevent the collateral circulation maintaining the flow through the aneurysm. Matas' operation has been successfully performed by Hogarth Pringle.
Somewhat analogous to the foregoing is a case reported in 1834 by McCosh from Calcutta. The patient was a native who had been dreadfully butchered in the Chooar campaign. One of his hands was cut off above the wrist. The remaining stump was nearly amputated by a second blow. A third blow penetrated the shoulder-joint.
The sub-deltoid or sub-acromial bursa, which usually presents a single cavity and does not normally communicate with the shoulder-joint, is indispensable in abduction and rotation of the humerus. When the arm is abducted, the fixed lower part or floor of the bursa is carried under the acromion, and the upper part or roof is rolled up in the same direction, hence tenderness over the inflamed bursa may disappear when the arm is abducted (Dawbarn's sign). It is liable to traumatic affections from a fall on the shoulder, pressure, or over-use of the limb. Pain, located commonly at the insertion of the deltoid, is a constant symptom and is especially annoying at night, the patient being unable to get into a comfortable position. Tenderness may be elicited over the anatomical limits of the bursa, and is usually most marked over the great tuberosity, just external to the inter-tubercular (bicipital) groove. When adhesions are present, abduction beyond 10
Its whole form was exceedingly agreeable and beautiful to look at. Its hump shone with great beauty and seemed to occupy the whole of its shoulder-joint. And it looked like the summit of a mountain of snow or like a cliff of white clouds in the sky. Upon the back of that animal I beheld seated the illustrious Mahadeva with his spouse Uma.
The shoulder-joint is made by the rounded head of the humerus fitting into the shallow cup of the scapula, or shoulder-blade. It is shallower than the hip joint to allow it freer movement; but this makes it weaker and much more easily dislocated, or put out of joint, the most so, in fact, of any joint in the body.
And he pierced Kripa with one arrow, and Chitrasena with three. And with another arrow, well-aimed and well-sped from his bow drawn to its fullest stretch, he struck Vikarna at the shoulder-joint. Thereupon the latter, covered with gore, sat down on the terrace of his car. Then that Rakshasa of immeasurable soul, excited with rage, O bull of Bharata's race, sped at Bhurisravas five and ten shafts.
Several sick persons were healed by merely inhaling it. One man, whose arm had been shot off at the shoulder-joint many years before, found his limb come again in an instant, by merely touching the blessed relic." The cavaliere paused to take breath. No one had spoken.
Senapati deeply struck Susarman in his vitals. Susarman also struck his antagonist with a lance on the shoulder-joint. Virata, aided by his Matsya warriors of great energy, resisted Vikartana's son in that battle. Even this was regarded as an act of great valour on the part of the Suta's son, in that, he singly resisted that whole force by means of his straight shafts.
As every one not in full training has inflexibility of the parts about the shoulder-joint, this should be the first object of attack. These twistings are well calculated to effect the desired result. While practising them, the position should be a good one, head, shoulders, and hips drawn far back.
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